Surgical Tools and Equipment

Topics

• Open heart surgery (Julianne)• Heart lung machine (Philicia)• Patent Foramen Ovale (Kelsey)• Catheter-based procedures (Suzy)• MEMS (Ashley)

Open Heart Surgery

SternotomyCardioplegia Heart-lung machine (Philicia will discuss)

Most common in most adult patients:Bypass surgery Valve surgery

http://www.youtube.com/watch?v=qsNHVy2CYZk – Open Heart Surgeryhttp://www.youtube.com/watch?v=P6hbOV-Io40&feature=related – Aortic Valve ReplacementWant to read about the first open heart surgery/ a movie made about it? http://en.wikipedia.org/wiki/Something_The_Lord_Made

References• http://www.google.com/imgres?num=10&hl=en&biw=1113&bih=763&tbm=isch&

tbnid=SFsd8uyhTCj0IM:&imgrefurl=http://www.metrohealth.org/body.cfm%3Fid%3D1320&docid=LUVsql3GICo9AM&imgurl=http://www.metrohealth.org/images/Patient%252520Services/Heart%252520and%252520Vascular/cv/cabg.JPG&w=1112&h=1037&ei=J7FjUPrUKO3KiAKn4YHoBw&zoom=1&iact=hc&vpx=583&vpy=264&dur=6299&hovh=217&hovw=232&tx=120&ty=94&sig=101442801249663108310&page=3&tbnh=133&tbnw=138&start=43&ndsp=28&ved=1t:429,r:3,s:43,i:252

• http://www.google.com/imgres?num=10&hl=en&biw=1113&bih=763&tbm=isch&tbnid=lYhcO2OZ5v5N1M:&imgrefurl=http://ccvsa.com/medical-surgical-procedures/cardiac-surgery&docid=coPeisU26DyAAM&imgurl=http://ccvsa.com/wp/wp-content/uploads/2010/11/cardiac-surgery-2-artery_bypass.jpg&w=403&h=258&ei=J7FjUPrUKO3KiAKn4YHoBw&zoom=1&iact=hc&vpx=303&vpy=279&dur=8554&hovh=180&hovw=281&tx=199&ty=108&sig=101442801249663108310&page=4&tbnh=121&tbnw=189&start=71&ndsp=27&ved=1t:429,r:1,s:71,i:336

Cardiopulmonary Bypass• aka heart-lung machine, the “pump”

http://www.cts.usc.edu/zglossary-heartlungmachine.htmlhttp://www.heartonline.org/heartlung.htmhttp://en.wikipedia.org/wiki/Cardiopulmonary_bypass

• video: http://video.about.com/heartdisease/Heart-Lung-Machine.htm

• Heart-lung machine in action: http://www.hsforum.com/stories/storyReader$1486 http://www.youtube.com/watch?v=qo3oL8B4ji4

Patent Foramen Ovale

• A hole between the left and right atria of the heart fails to close naturally soon after a baby is born (first 2 years)

• Relatively common - 10-20% of adults

• Can be diagnosed by an echocardiogram or “bubble test”

• The lowest mortality rates are achieved in individuals with a pulmonary artery systolic pressure of less than 40

• Not usually treated unless there are other heart problems, or the person had a stroke

• Closure of an ASD in individuals between the ages of 25 and 40 who are asymptomatic but have a clinically significant shunt is controversial.

• Repaired by surgery, cardiac catheterization procedure, or percutaneous closure– A cardiac catheterization involves slowly moving a catheter (a

long, thin, flexible, hollow tube) into the heart. The catheter is initially inserted into a large vein through a small incision made usually in the inner thigh (groin area) and then is advanced to and into the heart.

ASO - Amplatzer Septal Occluder

The Amplatzer Septal Occluder (ASO) consists of two self-expandable round discs connected to each other - Nitinol wire mesh filled with Dacron fabric)

Cardiac Catheters• Catheter= long, thin, and flexible tube

– Diagnostic and treatment• Can do minor surgeries during the catheterization such as removing the bloackage

• Minimally invasive – inserted into a blood vessel• Small incision is made after local anesthesia• Dye is introduced into the catheter • X-ray pictures are taken• Once removed, incision is stitched up• Risks? It is a surgery after all.

• http://www.youtube.com/watch?v=JeH4zPzQgRc

http://www.daviddarling.info/encyclopedia/C/cardiac_catheterization.html

MEMS and Their Fabrication

What are MEMS?

• “Technology of very small devices” [1]

• Multi-component

[3][4]

MEMS and Materials

• Silicon• Polymers• Metals• Ceramics

[5] [6] [7] [8]

Fabrication

• Three Basic Steps [2]

Fabrication [2]

References

• 1:http://en.wikipedia.org/wiki/Microelectromechanical_systems#MEMS_basic_processes

• 2:http://www-bsac.eecs.berkeley.edu/projects/ee245/Lectures/lecturepdfs/Lecture2.BulkMicromachining.pdf

• 3:http://www.memx.com/products.htm• 4:http://www.memsnet.org/mems/what_is.html• 5:http://en.wikipedia.org/wiki/Silicon• 6:http://www.innovscience.com/polymer.php• 7:http://en.wikipedia.org/wiki/Gold• 8:http://en.wikipedia.org/wiki/Silicon_carbide