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The Artificial Heart Prototypes, Policies, and Patients (1991) / Chapter Skim
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Index
Pages 289-298

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From page 289...
... , 124, 125, 129, 178 Animal trials survival rates in, 211-212 use of, 29, 160 using total artificial hearts, 213-214 using ventricular assist devices, 217-220 Appropriate use committee conclusions and recommendations concerning, 177-178 of mechanical circulatory support systems, 7-9, 122, 123, 125-131, 133, 177-178 of medical treatment, 127 of resources, 139 of technology, 122-124, 177-178 289 Artificial heart program. See also Total artificial hearts (TAHs)
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From page 290...
... . See also Heart failure deaths from, 251-253 prevalence of, 257-258 quality of life of patients with, 95, 99 Congress, U.S., technology use and, 124, 125 Converters electric motor-driven, 230-231 thermal heat-cycle energy, 231-232 Coronary artery bypass surgery, 112, 113, 121
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From page 291...
... high technology, 57-58 health and life expectancy gains, 5152 impact on health care costs, 55-56 impact on patients' families, 56 impact on U.S. global standing, 59~0 implementation time, 58 likelihood of R&D success, 53 nonfinancial impact on health care system, 56 number of persons benefited, 52-53 private-sector R&D support, 59 and protection of individual patient, 147, 148 relevance to NHLBI mission, 54-55 Design limitations, 37 Discount rates, 108, 268, 271-273, 278281 Distributive justice issues, 136-139, 142145 Donor heart supply, 36, 75, 76, 263 Durable power of attorney, 146- 147 E Economic theory, 152-153, 155 Elderly patients, expectations of treatment by, 95
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From page 292...
... See also Heart transplantation; Medical treatment End-stage heart disease patients comorbidities in, 70-71, 80 preference for life-sustaining treatment of, 73 projected mechanical circulatory support systems, need for, 4-5, 52-53, 73-74, 81, 157, 252-260 quality of life for, 86, 88, 90-102 See also Quality of life Energy sources, 31, 229-232 Ethical issues age of recipient and, 144 for mechanical circulatory support system implantation, 10 raised by incomplete technologies, 136-139 F Family members and friends, 56, 85-86, 90 Federal Coordinating Council for Science, Engineering, and Technology (FCCSET) , 168 Federal government industrial policy and, 156-158 research and development support by, 39, 40, 152-154, 176 role in support for artificial heart program, 39~0, 152-154, 158-159 role in use of medical technology, 159-163 INDEX Food and Drug Administration (FDA)
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From page 293...
... See Pennsylvania State University/Sarns-3M TAH High technology, halfway vs., 57-58 Hospital charges, estimates for ven tricular assist device and total artificial heart implant, 2 Hospital discharge data, 256 I Implantation costs, estimates for ventricular assist device and total artificial heart, 2, 267-268, 283 In vitro device readiness testing, 29. See also Bench testing Incomplete technology, 135, 136, 141-142 293 effect of involvement on communication among researchers, 168-169 effect of regulator of new technology on, 159 federal government and role of private, 157-159 role in mechanical circulatory support systems R&D, 176 Industry research and development (R&D)
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From page 294...
... current status of, 212-227, 243-245 development and use of, 1-2, 211-212 effects of new or emerging technologies on, 236-241 engineering assessment of, 29-32 ethical issues regarding, 135-150 heart transplantation vs., 36-37, 66, 68, 236-237 interdisciplinary and collaborative development of, 163-168 long-term. See Long-term mechanical circulatory support systems (MCSSs)
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From page 295...
... , 165 New York Heart Association, functional Class IV, 36n 295 NHLBI Cardiology Advisory Committee, 46 Nimbus/Cleveland Clinic TAH, 29, 213, 222-223 Novacor Division (Baxter Healthcare Corporation) , 2, 14 Novacor VAD, 14, 29, 30, 217-218 assessment of, 22, 220, 221 design of, 18 trial use of, 14, 68, 160, 187, 189190, 192 p Pacemaker registries, 128 Patient access age and, 74, 144 clinically limited, 179-180 committee conclusions and recommendations regarding, 178-180 health care policy regarding, 9, 144145, 149, 178-180 to incomplete technologies, 135136, 141-142 to mechanical circulatory support systems, 9-10, 178-180 racial variations in, 140-141 third-party payers and, 144, 179, 180 to total artificial hearts, 144-145, 149 Patient registry, 128-129 Patients.
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From page 296...
... calculation of, 92 in cost-effectiveness analysis, 175176, 271-275, 278-282 In R&D investment decisions, 6061 use of, 6, 12, 110, 111 Quality of care assessment of, 87-88 definition of, 122 Quality of life committee conclusions and recommendations regarding, 181-182, 195 INDEX cost-effectiveness and, 6, 270-271 determinants of, 72-73 and domains for utility assessment, 90-92 for end-stage heart disease patients. 86, 88, 90-102 health-related, 89-90 and machine dependence, 93 and meaning and purpose of life vs.
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From page 297...
... program, 58, 156 Societal issues costworthiness as, 101 incomplete technologies as, 136139 total artificial hearts and, 145 Spiritual well-being, concept of, 94 Substantive justice, 140, 142, 143, 149 Surgical procedures degrees of use of, 122 postmarketing surveillance and new, 127-128 Surgical treatment, for coronary artery disease, 16-17 Survival rates. See also Mortality rates animal, 211-214 for heart transplantation patients, 17, 110, 228-229, 269-270 for patients receiving medical management, 127 Symbion ventricular assist device, 218 Symbion/Jarvik TAH, 27, 213-216.
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From page 298...
... U balance-of-trade considerations, 157-158, 189 as leader in health technology, 157 state of mechanical circulatory support systems in, 212 University of Perkinje heart, 213 University of Utah total artificial heart, 29, 222, 226 Utility assessment domains for, 90-92 explanation of, 88 use of, 110-111 V VADs. See Ventricular assist devices Valves, problems with, 31, 37 Ventricular assist devices (VADs)
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Key Terms

  • mechanical circulatory
  • circulatory support
  • ventricular assist
  • artificial hearts
  • artificial heart

  • heart disease
  • assist devices
  • heart transplantation
  • committee conclusions
  • clinical trials

  • heart failure
  • patient access
  • assist device
  • survival rates
  • transplantation patients

  • disease patients
  • committee recommendations
  • heart program
  • clinical effectiveness
  • care costs

  • temporary total
  • care policy
  • pneumatic artificial
  • funding decisions
  • regarding development

  • committee recommendation
  • medical treatment
  • health state
  • temporary ventricular
  • baxter healthcare


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