Artificial Heart 3: Proceedings of the 3rd International Symposium on Artificial Heart and Assist Devices, February 16–17, 1990, Tokyo, Japan

339 Pages·1991·12.62 MB·English

by  Peter L. Frommer (auth.)

ARTIFICIAL
H E A R T
3
Proceedings of the 3rd International Symposium on
Artificial Heart and Assist Devices, February 16-17, 1990,
Tokyo, Japan
Editors:
Tetsuzo Akutsu and Hitoshi Koyanagi
Associate Editors:
James M. Anderson, Lawrence H. Cohn, Peter L. Frommer,
Mitsuhiro Hachida, Kazunori Kataoka, Shin-ichi Nitta,
Chisato Nojiri, Donald B. Olsen, D. Glenn Pennington,
Setsuo Takatani, Ryohei Yozu
With 357 Illustrations
Springer-Verlag
Tokyo Berlin Heidelberg
New York London Paris
Hong Kong Barcelona
TETsuzo AKUTSU, M.D., PH.D.
Director, Terumo Research and Development Center, 1500 Inokuchi, Nakai, Ashigarakami, Kanagawa,
259-01 Japan
HrroSHI KOYANAGI, M.D.
Professor and Chairman, Department of Cardiovascular Surgery, The Heart Institute of Japan,
Tokyo Women's Medical College, 8-1 Kawadacho, Shinjuku-ku, Tokyo, 162 Japan
ISBN-13: 978-4-431-68128-1 e-ISBN-13: 978-4-431-68126-7
DOl: 10.1007/978-4-431-68126-7
Library of Congress Cataloging-in-Publication Data
International Symposium on Artificial Heart and Assist Device (3rd : 1990 : Tokyo, Japan), Artificial heart 3 :
proceedings of the 3rd International Symposium on Artificial Heart and Assist Device, February 16-17, 1990, Tokyo,
Japan I editors, Tetsuzo Akutsu and Hitoshi Koyanagi; associate editors, James M. Anderson ... ret al.]. p. cm. Includes
index. ISBN-13:978-4-431-68128-1 1. Heart, Artificial - Congresses. I.
Akutsu, Tetsuzo, 1922- . II. Koyanagi, Hitoshi, 1936- . III. Anderson, James M. IV. Title. V. Title: Artificial heart
three. [DNLM: 1. Assisted Circulation - congresses. 2. Heart, Artificial - congresses. WG 169.5 I607a 1990]
RD598.35.A78I57. 1990. 617.4'120592-dc 20. DNLM/DLC. for Library of Congress 91-5010
© Springer-Verlag Tokyo 1991
Softcover reprint of the hardcover 1st edition 1991
This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concerned,
specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms
or in other ways, and storage in data banks.
The use of registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific
statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general
use.
Product liability: The publisher can give no guarantee for information about drug dosage and application thereof
contained in this book. In every individual case the respective user must check its accuracy by consulting other
pharmaceutical literature.
Dedication
This book is dedicated to Dr. Hiroto Yoshioka, who was the president of the International
Symposium on Artificial Heart and Assist Devices which has been held three times since
1985. We learned with great regret of the death of Dr. Yoshioka on August 6, 1991. In
honoring his contribution to the symposium, we will initiate the Yoshioka Memorial Prize
to be awarded to the best paper contributed to the next symposium, which will be held
from August 7-8, 1992. Dr. Yoshioka led a rich, full life until the age of eighty-eight
years, and we sincerely pray that his soul now rests in peace.
Hitoshi Koyanagi
v
Preface
The International Symposium on Artificial Heart and Assist Devices has been held three times,
first in 1985, then in 1987 and 1990. It is my great pleasure to present Artificial Heart 3
(Proceedings of the 3rd International Symposium on Artificial Heart and Assist Devices). The
third symposium was held in Tokyo on February 16 and 17, 1990.
Our original intention was to invite all the principal investigators from the major artificial heart
research laboratories in the world, in the first three symposia. The numbers of investigators in the
fields of the artificial heart, ventricular assist systems, and biomaterials, invited for the symposia,
totalled 7 in 1985, 8 in 1987, and 13 in 1990. The program of the third symposium consisted of 41
papers; 13 invited lectures, 8 papers contributed upon request, with 2 from the United States, and
20 regular selected papers including 2 from the United States, ana 1 each from Australia,
Germany, and South Korea.
During the last three years, the state of clinical application of artificial hearts and assist devices
has changed. In the case of pneumatically driven blood pumps, we have now stepped into the age
of practical use in patients. Accordingly, in this symposium we gave a special emphasis to topics
of clinical application, particularly the use of an artificial heart as a bridge to heart
transplantation. Sessions on implantable artificial hearts, biomaterials for the artificial heart, and
heart transplantation were also included.
We had a scientific exhibition, as in the second symposium, though on a larger scale and better
arranged, and 19 artificial heart and ventricular assist systems, including also those from abroad,
were displayed. We will be glad if you find the proceedings useful and enjoy the informative
papers, together with the pictures of the scientific exhibits.
We will expect to see you again here in Japan at the fourth symposium, which will be held in
August, 1992.
Tetsuzo Akutsu
Vice-President
VII
Introductory Address
It is a great pleasure for me to introduce the latest issue of our series of Artificial Heart. I would
also like to express my appreciation to my friends and colleagues from all over the world, who
contributed papers to the third International Symposium on Artificial Heart and Assist Devices,
in February 1990.
Years ago, I had a dream that basic scientists and clinical surgeons would get together, even if
only in a small conference room, and discuss and rebuild a new concept of the artificial heart. My
dream came true in 1985 at the first International Symposium on Artificial Heart and Assist
Devices, with vice president Professor Tetsuzo Akutsu. Since 1985, the symposium has been held
every two years, and Artificial Heart 1 and Artificial Heart 2 were published by Springer-Verlag,
Tokyo. I believe that the value and success of this series truly depends upon the great
contributions of those who attend and contribute to the symposia.
During the last five years, the left ventricular assist device has been widely used in clinical
applications as a bridge bypass, and has shown promising results. Furthermore, the relationship
between the artificial heart and the donor heart has become more enthusiastically accepted by
most of us, including those in this field. Therefore, these dramatic advances directly influenced
the symposium program, and thus the content of Artificial Heart 3, which includes "Cardiac and
Cardiopulmonary Transplantation" and "Clinical Bridge Bypass." Accordingly, the subtitle of
the third symposium was "Heart Replacement."
We hope that this book will serve as both a comprehensive and a practical resource for basic
scientists, cardiac surgeons, residents, nurses, and other staff interested in the Artificial Heart.
I look forward to meeting you at the fourth symposium in 1992.
Acknowledgment. We are most grateful for the support of the Ministry of Health and Welfare of
Japan, Ministry of International Trade and Industry, Science and Technology Agency, Japan
Keirin Association, Asahi Shimbun, Chunichi Shimbun, Mainichi Shimbun, Nihon Keizai
Shimbun, Inc., Sankei Shimbun, Yomiuri Shimbun, NHK (Japan Broadcasting Corp.), Japanese
Association for Thoracic Surgery, Japan Society for Transplantation, Japanese Society for
Artificial Organs, and Japanese Society for Cardiovascular Surgery. I would also like to thank all
the people who made this symposium possible, whose support was indispensable for the
organization of the third symposium.
Hitoshi Koyanagi
Secretary General
IX
Presidential Address
Two years have passed since the Second International Symposium on Artificial Heart and Assist
Devices was held in this hall. On behalf of the organizing committee and the Japan Research
Promotion Society for Cardiovascular Diseases, it is a great honor for me to hold this third
symposium. It is also a privilege and a pleasure for me to extend a cordial welcome to all the
participants in this symposium, especially those who have traveled long distances from the United
States, Australia, and Europe.
The first meeting was held in August 1985, and the second meeting in August 1987, in order to
make progress in this field. The distinguished guest speakers invited each time covered the topics
of the Ventricular Assist Device, Total Artificial Heart, Biomaterials, and Cardiovascular
Surgery, and actively contributed to the academic sessions and to the publication of the
proceedings Artificial Heart 1 and Artificial Heart 2. The two previous symposiums have
contributed to the improvement of artificial heart technology and its clinical applications in
hundreds of cases in Japan. I am pleased that the results will be presented and exhibited today.
Finally, I would like to express my gratitude to the government organizations, newspaper
companies, and various associations and societies for their kind cooperation. Also, I wish to
express my thanks to the Japan Keirin Association and the many companies which donated
generous financial support for this third symposium.
Hiroto Yoshioka
President
XI
Congratulatory Address
Dr. Akutsu, Vice-president of the Third International Symposium on Artificial Heart and Assist
Devices, distinguished guests, ladies and gentlemen:
On behalf of the Ministry of Health and Welfare, it is a great pleasure for me to have the
opportunity to speak at the opening of this symposium.
First of all, I would like to extend my cordial welcome to those of you who have come from
abroad. In Japan, heart diseases have become the second leading cause of death in recent years
and are supposed to be increasing continuously. In these circumstances we believe it is extremely
meaningful that this symposium is being held here in Tokyo. We know that clinical use of the
total artificial heart has already started in many countries, such as the United States and some
European countries. In our country we have already applied ventricular assist devices to more
than one hundred cases, and more efficient and reliable devices are now being developed. On the
other hand, heart transplantation from a donor is not performed yet in our country mainly
because of the Japanese cultural background concerning brain death. It is also noteworthy, in the
context of progress in heart transplantation, that there remain many problems, such as donor
availability and immunosuppression.
On the other hand, as you know, the artificial heart has many advantages, including ensuring
stable supply to the recipients. Therefore, development of the artificial heart is keenly anticipated
by patients, and so we sincerely hope this symposium will be fully successful and fruitful and
contribute to the health and welfare of human beings.
Eiichi Nakamura
Director-General of the
Health Policy Bureau,
The Ministry of
Health and Welfare
of Japan
XII
Congratulatory Address
Mr. President, distinguished guests, ladies and gentlemen:
It is a great honor for me to have this opportunity to speak before this symposium on "Artificial
Heart and Assist Devices."
The Agency of Industrial Science and Technology, which is an agency of the Ministry of
International Trade and Industry, is promoting industrial technology for the purpose of achieving
prosperity in the world. Japanese industrial technology, which has helped Japan grow, has a very
substantial and positive impact on economic growth, thereby bringing social and economic
benefits. We will continue to use Japanese industrial technology for the happiness and welfare of
the whole world.
Artificial hearts and assist devices promise a great future to patients who are suffering from
heart disease. This technology, when established, will be a proof that technological development,
which has sometimes caused harm to humans and to the environment, still has much more
potential to make positive contributions to mankind.
I am confident that a deeply rooted mutual trust and goodwill exist between us, who believe in
the future possibilities of technological development. I strongly believe that this goodwill shall
overcome whatever obstacles may exist.
I hope the present symposium will playa key role in this effort, help bring good news to
sufferers of heart disease, and ultimately contribute to the happiness and welfare of the whole
human race.
Masaru Sugiura
Director General of the
Agency of Industrial
Science and Technology,
Ministry of International
Trade and Industry
XIII
Congratulatory Addresses
Mr. President and Vice-President, ladies and gentlemen, guests of honor:
It is a great honor and privilege for me to make a statement in this opening ceremony for the
Third International Symposium on Artificial Heart and Assist Devices.
The artificial organ has been recognized as one of the important research areas, according to
the recommendations of the Council for Science and Technology, which is an advisory body to
the Prime Minister. The recommendation says that it is necessary to advance accurate, rapid, and
reliable diagnostic and therapeutic technologies.
The Science and Technology Agency has carried out comprehensive research on the
biocompatibility of artificial organs, and other related research and development, under an
objective-oriented research project of the Institute of Physical and Chemical Research (RIKEN),
and cooperative development with industry by contract with the Research Development
Corporation of Japan (JRDC).
For research and development of artificial organs, it is indispensable to integrate the need and
know-how from clinical doctors with the technologies from material, instrumentation, and
control engineering (Medical Electronics). The Science and Technology Agency would like to be
a bridge between medicine and engineering, through various schemes.
Nowadays, a heightened Japanese contribution to the internatio'nal community is increasingly
expected in the area of science and technology. I hear some comments and opinions from
overseas, complaining about difficulty in understanding and accessing the research and
development activities in Japan, so I would feel happy if those who are here today from abroad
would fully utilize this opportunity to see research activities and to increase their understanding
about Japan itself.
Finally, I strongly hope that this symposium will contribute to the advancement of life science
research in Japan as well as overseas; and I do wish that an intelligent artificial heart suitable for
Dr. Akutsu will be developed soon.
Motohide Konaka
Director of Life Science
Division, Science and
Technology Agency
I am very honored to nave this opportunity to be here and to speak in front of this great audience.
I remember a famous economist who had a great influence over the Japanese government.
Unfortunately, he had trouble with his heart and he underwent an operation. Though the
operation took a long time, it was successful and the doctors put a small pacemaker in his chest.
At the celebration for his recovery, he said gratefully, "I was very impressed with the fact that
medical technology is progressing three or four times faster than economics." He died two years
later, but before his death, he suggested a lot of significant policy plans to the government. If he
had lived longer, he would, no doubt, have made many more meaningful proposals.
I certainly hope and believe this symposium will achieve excellent results. Thank you.
Norihiro Mitsuhashi
Editor, Life Science
and Technology Department,
Nihon Keizai Shim bun
XIV