Arrificid Organs 18(1):1-3. Blackwell Scientific Publications. Inc., Boston C 1994 International Society for Artificial Organs

Guest Editorial

Baylor Contributions

The Department of Surgery at Baylor College of Medicine has been led by Michael E. DeBakey, M.D., Chancellor of Baylor College of Medicine for more than 45 years. Dr. DeBakey is a leading figure worldwide in the field of cardiovascular surgery. He is well known for initially applying the roller pump for cardiopulmonary bypass, which has since been used routinely around the world because of its sim- ple mechanism, easy handling, and reliability. Dur- ing these 45 years, Dr. DeBakey has been respon- sible for the development of various types of blood pumps. Thus, many regard him as one of the pio- neers of the total artificial heart (TAH) and the ven- tricular assist device (VAD).

George P. Noon, M.D., Professor of Surgery and Head of the Transplant and Clinical Circulatory As- sist Program at Methodist Hospital, has been ambi- tiously implanting various types of VADs and TAHs for bridge to transplantation and postcardiot- omy cardiogenic shock cases. He has the largest number of clinical cases utilizing nonpulsatile ven- tricular support pumps. Dr. Noon, as the head of the clinical artificial heart program, coordinates with our research team via weekly meetings, advis- ing us from the clinical point of view.

Since October 1989, when Yukihiko Nose, M.D., Ph.D., came to the Department of Surgery, Baylor College of Medicine, as Professor of Surgery, from the Cleveland Clinic Foundation, our projects have remarkably advanced. At the beginning of this “re- start,” there were only four members (two medical doctors and two engineers) in our laboratory: Setsuo Takatani, Ph.D., Associate Professor; Motomi Shiono, M.D., Ph.D., Assistant Professor; Tomoaki Jikuya, M.D., Ph.D., Research Instruc- tor; and Takeshi Aizawa, M.S.E.E., Research As- sociate. Through these members’ contributions, many new projects have been developed, led by Dr. Nose’s great enthusiasm. Later, Ichiro Sakuma,

Address correspondence to Dr. Y. Orirne, c/o Dr. Y. Nost at Department of Surgery, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030. U.S.A.

to Artificial Organs

Ph.D., Research Instructor, Tatsuya Sasaki, M.D., Ph.D., Research Instructor, and Naoki Minato, M.D., Ph.D., Research Instructor,joined this team.

The current members of our team are young med- ical doctors and engineers, the so-called second- generation of our laboratory. Of course, we are also indebted to the technical support team in the labo- ratory for their help in our projects. All of the fac- ulty members are deeply appreciative of their ex- pert technical support. Currently, the Surgical Research Laboratory includes 20 full-time members (10 faculty members and 10 technical staff), to- gether with six part-time faculty members. Usually four or five short-term visiting scientists and physi- cians from all over the world are present (Fig. 1).

In our laboratory, we have 12 active projects, which can be classified into four major categories: Baylor cardiac prostheses projects, metabolic assist projects, noninvasive sensor projects, and other Surgical projects (Table 1).

As cardiac prostheses, six types of blood pumps (three nonpulsatile and three pulsatile) have been developed. The Baylor-Nikkiso pump, a compact and atraumatic centrifugal pump, is available for clinical use as a second-generation cardiopulmo- nary bypass pump. The Baylor-Kyocera Gyro pump is a seal-less centrifugal pump for an implant- able VAD, aiming for up to 3 months’ pumping. We also have developed a long-term (over 3 months) implantable axial pump for a VAD which is a joint effort between Baylor and the NASA/Johnson Space Center of Houston. The Baylor TAH is a one-piece totally implantable electromechanical TAH system that was supported by a National In- stitutes of Health (NIH) small business grant. Using many universal components of the TAH, an im- plantable electromechanical VAD has also been de- veloped, together with a muscle-driven VAD. Both electromechanical pulsatile pumps are for perma- nent use. Owing to the many research programs at Baylor, various types of cardiac prostheses will be available to provide support from a 2-day period to that of a patient’s lifetime (Fig. 2 ) .

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2 GUEST EDITORIAL

FIG. 1. Members of the Surgical Re- search Laboratory, Department of Sur- gery, Baylor College of Medicine.

In addition, metabolic assist projects recently be- gun in our laboratory include plasma and leukocyte filters. Noninvasive sensors have also been devel- oped and tested as a new project. We also have two small projects: namely, the sterilization of mini- mally invasive surgical instruments and the devel- opment of a new device for measuring the athero- sclerosis grade of vessels in patients.

All the faculty members are assigned to their own projects and have a responsibility to plan and per- form each project as a project leader. These pro- jects are usually supported and supervised by Dr. Nose and Dr. Takatani, from both the medical and engineering points of view.

TABLE 1. Projects in the Department of Surgery, Baylor College of Medicine

In this special issue, we assembled papers only from our laboratory, representing Baylor's contri- bution to artificial organs. Most of the project lead- ers in our department submitted papers describing the status of their devices' development. Most of these papers were presented at the 9th Congress of the International Society for Artificial Organs (ISAO) in Amsterdam, The Netherlands, in July 1993. Setsuo Takatani, Ph.D., made a presentation on the hybrid microcontroller of the Baylor TAH. Yukihiko Orime, M.D., Ph.D., proposed in vitro and in vivo test protocols for the TAH and reported flow visualization of the Baylor TAH. Yasuhisa Ohara, M.D., presented the development of the Gyro pump. Kimitaka Tasai, M.D., Ph.D., reported on thermal management of the Baylor VAD. Kozo Naito, M.D., proposed a new concept of the index

Baylor cardiac prostheses projects Nonpulsatile pump projects

Baylor-Nikkiso centrifugal pump Baylor-Kyocera Gyro pump Baylor-NASA axial flow pump

Baylor total artificial heart (TAH) Baylor ventricular assist device (VAD) Muscle-driven pump

Pulsatile pump projects

Metabolic projects Low-density lipoprotein filter project Thermal filtration project

Noninvasive sensor projects Blood pressure (oscillometric and tonometry) project Reflectance oximetry project

Sterilization of Minimally Invasive Surgical Instruments Atherosclerosis study project

Other projects

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of hemolysis iIHj. Kazumi Mizuguchi, M.D.,

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FIG. 2. Support duration of Baylor cardiac prostheses.

Art$ Organs, Vol. 18, No. I , 1994

GUEST EDITORIAL 3

George Damm, M.S.E.E., presented the current status of the Baylor/NASA axial pump. In addition, Kenzo Makinouchi, M.S.E.E., reported on a new concept of in vitro evaluation for centrifugal pumps. Yukihiro Matsuda, M.D., and Ryusuke Kojima, M.D., Ph.D., also presented papers on their spe- cialties. These two papers were not presented at the 9th ISAO congress.

I sincerely hope that our projects will be a great

contribution toward the advancement of various ar- tificial organs in the near future.

Yukihiko Orime, M.D., Ph.D. Assistant Professor and Chief of Medical Staff for

the Surgical Research Laboratory Department of Surgery

Baylor College of Medicine Houston, Texas, U.S .A.

ArtifOrgans. Vol. 18, No. I , 1994