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Heart valve surgery – operation for replacement heart valves

Heart valve surgery – operation for replacement heart valves

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heart valves maintain the unidirectional flow of blood in the heart by opening and closing depending on the difference in pressure on each side. They are mechanically similar to reed valves.

Atrioventricular valves

These are small valves that prevent backflow from the ventricles into the atria during systole. They are anchored to the wall of the ventricle by chordae tendineae, which prevent the valve from inverting.

The chordae tendineae are attached to papillary muscles that cause tension to better hold the valve. Together, the papillary muscles and the chordae tendineae are known as the subvalvular apparatus. The function of the subvalvular apparatus is to keep the valves from prolapsing into the atria when they close. The subvalvular apparatus have no effect on the opening and closure of the valves, however. This is caused entirely by the pressure gradient across the valve.

The closure of the AV valves is heard as the first heart sound

Echocardiography — The echocardiogram is an ultrasound of the heart. Using standard ultrasound techniques, two-dimensional slices of the heart can be imaged. 

Heart — The heart is a hollow, muscular organ in vertebrates that pumps blood through the blood vessels by repeated, rhythmic contractions, or a similareart. Veins form part of the circulatory system. The vessels that carry blood …

Vein — In biology, a vein is a blood vessel which carries blood toward the heart. Veins form part of the circulatory system

The tricuspid valve is the three flapped valve on the right side of the heart, between the right atrium and the right ventricle which stops the backflow of blood between the two. It has three cusps.

Semilunar valves

These are located at the base of both the pulmonary trunk (pulmonary artery) and the aorta, the two arteries taking blood out of the ventricles. These valves permit blood to be forced into the arteries, but prevent backflow of blood from the arteries into the ventricles. [1] These valves do not have chordae tendineae, and are more similar to valves in veins than atrioventricular valves.

Aortic valve

Main article: aortic valve

The aortic valve lies between the left ventricle and the aorta. The aortic valve has three cusps. During ventricular systole, pressure rises in the left ventricle. When the pressure in the left ventricle rises above the pressure in the aorta, the aortic valve opens, allowing blood to exit the left ventricle into the aorta. When ventricular systole ends, pressure in the left ventricle rapidly drops. When the pressure in the left ventricle decreases, the aortic pressure forces the aortic valve to close. The closure of the aortic valve contributes the A2 component of the second heart sound (S2).

The most common congenital abnormality of the heart is the bicuspid aortic valve. In this condition, instead of three cusps, the aortic valve has two cusps. This condition is often undiagnosed until the person develops calcific aortic stenosis. Aortic stenosis occurs in this condition usually in patients in their 40s or 50s, an average of over 10 years earlier than in people with normal aortic valves.

Pulmonary valve

Main article: pulmonary valve

The pulmonary valve (sometimes referred to as the pulmonic valve) is the semilunar valve of the heart that lies between the right ventricle and the pulmonary artery and has three cusps. Similar to the aortic valve, the pulmonary valve opens in ventricular systole, when the pressure in the right ventricle rises above the pressure in the pulmonary artery. At the end of ventricular systole, when the pressure in the right ventricle falls rapidly, the pressure in the pulmonary artery will close the pulmonary valve.

The closure of the pulmonary valve contributes the P2 component of the second heart sound (S2). The right heart is a low-pressure system, so the P2 component of the second heart sound is usually softer than the A2 component of the second heart sound. However, it is physiologically normal in some young people to hear both components separated during inhalation.

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A new generation

Campaigners want the legal limbo of young immigrants resolved 

They were brought to the US at a young age by the parents, first generation immigrants who often still have close ties to their home countries.

Younger brothers and sisters were born in America, second generation immigrants who enjoy the status of US citizens.

Not Generation 1.5. Despite having lived most of their lives in the US and speaking fluent English, many cannot legally work, vote or drive in most US states.

They are subject to arrest and deportation just like any other undocumented migrant.

“They fear being deported but many of them don’t know (anything) other than English, so they have no idea what awaits (them) in their countries of origin, said Ruben Rumbaut of the University of California in Irvine, who coined the Generation 1.5 term.

There are no official figures of how many undocumented children live in the US, but the Pew Hispanic Center estimates that 7% of all Hispanic children are unauthorised immigrants.

This suggest there are 1.1 million Latino children who are not US citizens.

Living robots powered by muscle

The robot is a dramatic example of the marriage of biotechnology with nanotechnology

Tiny robots powered by living muscle have been created by scientists at the University of California, Los Angeles.

The devices were formed by “growing” rat cells on microscopic silicon chips, the researchers report in the journal Nature Materials.

Less than a millimetre long, the miniscule robots can move themselves without any external source of power.

The work is a dramatic example of the marriage of biotechnology with the tiny world of nanotechnology.

In nanotechnology, researchers often turn to the natural world for inspiration.

But Professor Carlo Montemagno, of the University of California, Los Angeles, turns to nature not for ideas, but for actual starting materials.

In the past he has made rotary nano-motors out of genetically engineered proteins. Now he has grown muscle tissue onto tiny robotic skeletons.

Living device

Montemano’s team used rat heart cells to create a tiny device that moves on its own when the cells contract. A second device looks like a minute pair of frog legs.

“The bones that we’re using are either a plastic or they’re silicon based,” he said. “So we make these really fine structures that mechanically have hinges that allow them to move and bend.

“And then by nano-scale manipulation of the surface chemistry, the muscle cells get the cues to say, ‘Oh! I want to attach at this point and not to attach at another point’. And so the cells assemble, then they undergo a change, so that they actually form a muscle.

“Now you have a device that has a skeleton and muscles on it to allow it to move.”

Under a microscope, you can see the tiny, two-footed “bio-bots” crawl around.

Professor Montemagno says muscles like these could be used in a host of microscopic devices – even to drive miniature electrical generators to power computer chips.

But when biological cells become attached to silicon – are they alive?

“They’re absolutely alive,” Professor Montemagno told BBC News. “I mean the cells actually grow, multiply and assemble – they form the structure themselves. So the device is alive.”

The notion is likely to disturb many who already have concerns about nanotechnology.

But for Carlo Montemagno, a professor of engineering, it makes sense to match the solutions that nature has already found through billions of years of evolution to the newest challenges in technology.