Expert review of medical devices
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Expert Rev Med Devices · Sep 2005
ReviewHeartMate II left ventricular assist device: a new device for advanced heart failure.
Since the initial use of artificial heart devices decades ago, advances in technology have yielded new artificial heart devices that can finally achieve the goal of providing life-saving treatment and good quality of life in terminally ill patients with heart failure. The HeartMate II left ventricular assist device is a new generation of device that is small, quiet and relatively easy to implant. A pilot study in the USA recently completed enrollment, and the pivotal trial is now underway to study this device in patients who are awaiting transplant and patients who are not candidates for transplant. To date, the results look promising that this device may be widely applicable to patients who have heart failure that do not respond to conventional treatments.
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Expert Rev Med Devices · Sep 2005
ReviewEdwards FloTrac sensor and Vigileo monitor: easy, accurate, reliable cardiac output assessment using the arterial pulse wave.
Edwards Lifesciences has recently introduced the FloTrac sensor and Vigileo monitor system for monitoring cardiac output continuously. It does not require thermodilution or dye dilution, but rather bases its calculations on arterial waveform characteristics in conjunction with patient demographic data. ⋯ Studies thus far indicate that it is robust and accurate over a wide range of cardiac output and clinical conditions. It will be valuable in the care of many patients, such as those with critical illness, cardiovascular dysfunction, trauma or undergoing major surgery.
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Expert Rev Med Devices · Sep 2005
Computed tomography: important considerations for pediatric patients.
Computed tomography plays a central and increasingly important role in medical imaging. From the very beginning more than 30 years ago, computed tomography technology has continued to develop and provide a wide variety of applications for evaluation of disorders of virtually any organ system in both children and adults. ⋯ However, these benefits must be carefully weighed against the potential risks, which include a relatively high radiation dose. Current research efforts are directed at both further improvements in the diagnostic potential with computed tomography, as well as managing radiation dose.
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The aim of this review is to report on studies of hydroxyapatite-coated external fixation pins as a solution to enhance pin fixation. In a highly loaded animal study, three tapered pin types were compared: Type A uncoated, Type B coated with hydroxyapatite and Type C coated with titanium. There was a 13-fold increase in the extraction torque of Type B pins compared with Type A, and a twofold increase compared with Type C pins. ⋯ Extraction torque of the hydroxyapatite-coated pins was higher than the extraction torque of the standard pins in both cancellous and cortical bone (p < 0.005). In a prospective, randomized clinical study of osteoporotic wrist fractures, extraction torque of the coated pins was higher than with standard pins (p < 0.0001). These studies demonstrate that with the use of hydroxyapatite-coated pins, no deterioration of pin fixation occurs, and that there is no significant pin loosening and infection, regardless of bone type and loading conditions.
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Expert Rev Med Devices · Jul 2005
ReviewComputer-aided surgery of the paranasal sinuses and skull base.
Endoscopic sinus surgery is one of the most common surgical procedures in otolaryngology. However, the location of the orbit and intracranial contents in close proximity to the paranasal sinuses makes endoscopic sinus surgery potentially hazardous. Otolaryngologists have employed computer-aided surgery, or image-guided surgery, over the past two decades to enhance surgeon confidence, allow more thorough surgical dissections and possibly reduce the complication rate of endoscopic sinus surgery. ⋯ A number of institutional series noting surgeon experience with computer-aided surgery in the domain of paranasal sinus surgery are reviewed. Furthermore, the authors evaluate the utility of image-guidance technology beyond the paranasal sinuses and skull base, such as its use in surgery of the pituitary gland and pterygopalatine fossa, research and resident education. Finally, potential future applications of computer-aided surgery technology are discussed.