Yasmine Saikali – Independent Project

Yasmine Saikali – Independent Project

Class of 2017

Introduction to Topic

While the use of heart stents is a great way to combat artery blockage, the procedure requires patients to use blood thinners right after, such as Plavix for about a year, but aspirin indefinitely.  Blood thinners keep platelets from dangerously clotting around the stent due to its being a foreign object to the body. However, many patients are allergic to blood thinners and/or experience severe side effects from them, making them high-risk patients who don’t always get to participate in the procedure.  How can we prevent people from using blood thinners after a procedure?

Project Description

Heart stents are used to open arteries that are closing or are already closed. After a procedure a patient is given blood thinners such as aspirin to help prevent clogging/closure of the arteries. My product idea is to cover the stents with endothelial cells before the surgery to prevent complications, the use of blood thinners, and the many side effects that come with them. Covering the stent with Endothelial cells would prevent the body from recognizing the stent as a foreign object, a rupture of the arteries, and restenosis and rejecting it. This would significantly reduce the need for blood thinners for patients of this procedure. Which would save the side affects of those blood thinners as well as time and money.

Experience Description

I had an amazing experience with My mentor Dr. Ali Tabrizchi, I learned so much from him and his whole staff. I was really able to interact with everyone and be a part of it all, I did not just stand around. How Dr. Ali Tabrizchi would visit each patient would be by taking the patient’s folder that was hanging outside of the door that the nurse put out and he would examine the medical history of the patient to see if in the past, they had any surgeries done or any other complications also the type of medication the patient is on. Normally the patient would have an older EKG attached to their folder as well as an updated one from this visit because to compare the EKGs and to see if the medication that they were prescribed originally helped in any way.  Dr. Tabrizchi allowed me and the Physician’s Assistant who was doing a rotation at his office, to go in and do a quick exam before he goes in. We would look at the folder sitting outside of the room and then go inside and ask questions that will help us diagnose the patient. And then we would report back to Dr. Tabrizchi. Patients are referred to Dr. Ali Tabrizchi cardiovascular associates of Maryland office because their general practitioner or their internist Physician as referred them to see a specialist because abnormalities of the heart has shown up in general tests such as EKG also if the patient describes symptoms of heart disease or heart complications like angina or shortness of breath while walking short distances or at rest. Or because they have a family history of heart disease, and they need annual checkups. A Lab procedure that is completed regularly for patients with symptoms at this office would be a blood test because these blood tests analyze the cholesterol transport behavior such as HDL, LDL and triglycerides also for blood sugar control. The blood test showing the amount of cholesterol buildup will show if the arteries in the heart need opening. That’s when Dr. Ali Tabrizchi would schedule a stent surgery also known as coronary artery bypass surgery. Which he does at Upper Chesapeake Medical Center, or Sinaii Hospital. I learned the Use of the Cardiac stress test machine, Which is where a patient is put on a treadmill, with an increasing speed of the treadmill to get a Maximum level of exercise in order to increase the patient’s stress until the heart rate of the patient will not increase any higher. To give an accurate estimate of the target heart rate of that patient because when there is an increase in heart rate, it means that the heart is pumping a lot of blood and this exam will show pictures of the heart and tell if there is an artery that is not pumping out as much blood as the other arteries, which will then lead to a cardiac catheterization which is when the cardiologist will take a closer look at the artery to see if it needs opening (Tabrizchi).

Innovation Description

My innovation focuses on coronary heart bypass surgeries, to innovate a new way to make it more officiant, and less complicated before, during, and after the angioplasty procedure. I want to show through a 3D model that I 3D printed a stent that represents a covering from the inside and out of Endothelial cells. This To make this model i used fusion 360, and designed a cylinder with holes to represent the cells covering it. The 3D printer, printed it out to make this model out of plastic. So the endothelial cells of a patient would be collected days before the procedure, from the cells that are in the artery that is being opened up, local cells. and then replicated using cell replication in a lab “Porcine aortic endothelial cells were isolated and maintained in Dulbecco’s modified Eagle’s medium (DME medium)/10% citrate-treated human plasma. They were stimulated by DME medium/10% human serum to grow from a density of 10,100 ± 500 per well to a final density of 83,000 ± 1,800 per well over a 9-day period”( Clemmons, 2017). This article states that the replication of endothelial cells is happening, and is happening successfully with making so many more copies, and that is enough to cover a stent that is less than 7mm long (Tabrizchi).  Dr. Tabrizchi taught me that after a surgery, there are many things a patient must follow and keep in mind. Such as always taking their blood thinners prescribed since the day of the procedure, such as plavix for about a year, but aspirin indefinitely. Also the stent should not be placed for no reason, so the patient must follow a strict diet to not have more cholesterol buildup (“What To Expect After a Stent Procedure – NHLBI, NIH”, 2017). We constantly were looking at patient’s EKG readings to determine the condition of the patient’s heart, and to see what other tests should be done if it is abnormal, so we can examine the patient more. And to see if a stent is necessary for a patient that needs opening of an artery. I learned so much from him and the process of putting a stent in and the complications such as rejection, rupture of the arteries, and restenosis could all occur, so that is when I had the creative idea to provide a stent that is covered in that person’s cells to be able to prevent that. This innovation addresses the problem of complications that come with this risky surgery.  The closest competitor would be drug-eluting stents, where the stents are covered with the drugs that are needed after surgery such as aspirin and plavix. But studies have shown that they have increased long-term thrombosis risk with these drug eluted stents (“Elsevier: Article Locator”, 2017). Which made me think what can be done to take away the need of medication after surgery, and the only solution for that would be to “trick” the body into thinking nothing changed. Legalities would be that you can’t put stents without patient approval, as well as getting their cells to be able to use for replication.  

Project Topic

Introduction to Topic

While the use of heart stents is a great way to combat artery blockage, the procedure requires patients to use blood thinners right after, such as Plavix for about a year, but aspirin indefinitely.  Blood thinners keep platelets from dangerously clotting around the stent due to its being a foreign object to the body. However, many patients are allergic to blood thinners and/or experience severe side effects from them, making them high-risk patients who don’t always get to participate in the procedure.  How can we prevent people from using blood thinners after a procedure?

Project Overview

Project Description

Heart stents are used to open arteries that are closing or are already closed. After a procedure a patient is given blood thinners such as aspirin to help prevent clogging/closure of the arteries. My product idea is to cover the stents with endothelial cells before the surgery to prevent complications, the use of blood thinners, and the many side effects that come with them. Covering the stent with Endothelial cells would prevent the body from recognizing the stent as a foreign object, a rupture of the arteries, and restenosis and rejecting it. This would significantly reduce the need for blood thinners for patients of this procedure. Which would save the side affects of those blood thinners as well as time and money.

Experience

Experience Description

I had an amazing experience with My mentor Dr. Ali Tabrizchi, I learned so much from him and his whole staff. I was really able to interact with everyone and be a part of it all, I did not just stand around. How Dr. Ali Tabrizchi would visit each patient would be by taking the patient’s folder that was hanging outside of the door that the nurse put out and he would examine the medical history of the patient to see if in the past, they had any surgeries done or any other complications also the type of medication the patient is on. Normally the patient would have an older EKG attached to their folder as well as an updated one from this visit because to compare the EKGs and to see if the medication that they were prescribed originally helped in any way.  Dr. Tabrizchi allowed me and the Physician’s Assistant who was doing a rotation at his office, to go in and do a quick exam before he goes in. We would look at the folder sitting outside of the room and then go inside and ask questions that will help us diagnose the patient. And then we would report back to Dr. Tabrizchi. Patients are referred to Dr. Ali Tabrizchi cardiovascular associates of Maryland office because their general practitioner or their internist Physician as referred them to see a specialist because abnormalities of the heart has shown up in general tests such as EKG also if the patient describes symptoms of heart disease or heart complications like angina or shortness of breath while walking short distances or at rest. Or because they have a family history of heart disease, and they need annual checkups. A Lab procedure that is completed regularly for patients with symptoms at this office would be a blood test because these blood tests analyze the cholesterol transport behavior such as HDL, LDL and triglycerides also for blood sugar control. The blood test showing the amount of cholesterol buildup will show if the arteries in the heart need opening. That’s when Dr. Ali Tabrizchi would schedule a stent surgery also known as coronary artery bypass surgery. Which he does at Upper Chesapeake Medical Center, or Sinaii Hospital. I learned the Use of the Cardiac stress test machine, Which is where a patient is put on a treadmill, with an increasing speed of the treadmill to get a Maximum level of exercise in order to increase the patient’s stress until the heart rate of the patient will not increase any higher. To give an accurate estimate of the target heart rate of that patient because when there is an increase in heart rate, it means that the heart is pumping a lot of blood and this exam will show pictures of the heart and tell if there is an artery that is not pumping out as much blood as the other arteries, which will then lead to a cardiac catheterization which is when the cardiologist will take a closer look at the artery to see if it needs opening (Tabrizchi).

Innovation

Innovation Description

My innovation focuses on coronary heart bypass surgeries, to innovate a new way to make it more officiant, and less complicated before, during, and after the angioplasty procedure. I want to show through a 3D model that I 3D printed a stent that represents a covering from the inside and out of Endothelial cells. This To make this model i used fusion 360, and designed a cylinder with holes to represent the cells covering it. The 3D printer, printed it out to make this model out of plastic. So the endothelial cells of a patient would be collected days before the procedure, from the cells that are in the artery that is being opened up, local cells. and then replicated using cell replication in a lab “Porcine aortic endothelial cells were isolated and maintained in Dulbecco’s modified Eagle’s medium (DME medium)/10% citrate-treated human plasma. They were stimulated by DME medium/10% human serum to grow from a density of 10,100 ± 500 per well to a final density of 83,000 ± 1,800 per well over a 9-day period”( Clemmons, 2017). This article states that the replication of endothelial cells is happening, and is happening successfully with making so many more copies, and that is enough to cover a stent that is less than 7mm long (Tabrizchi).  Dr. Tabrizchi taught me that after a surgery, there are many things a patient must follow and keep in mind. Such as always taking their blood thinners prescribed since the day of the procedure, such as plavix for about a year, but aspirin indefinitely. Also the stent should not be placed for no reason, so the patient must follow a strict diet to not have more cholesterol buildup (“What To Expect After a Stent Procedure – NHLBI, NIH”, 2017). We constantly were looking at patient’s EKG readings to determine the condition of the patient’s heart, and to see what other tests should be done if it is abnormal, so we can examine the patient more. And to see if a stent is necessary for a patient that needs opening of an artery. I learned so much from him and the process of putting a stent in and the complications such as rejection, rupture of the arteries, and restenosis could all occur, so that is when I had the creative idea to provide a stent that is covered in that person’s cells to be able to prevent that. This innovation addresses the problem of complications that come with this risky surgery.  The closest competitor would be drug-eluting stents, where the stents are covered with the drugs that are needed after surgery such as aspirin and plavix. But studies have shown that they have increased long-term thrombosis risk with these drug eluted stents (“Elsevier: Article Locator”, 2017). Which made me think what can be done to take away the need of medication after surgery, and the only solution for that would be to “trick” the body into thinking nothing changed. Legalities would be that you can’t put stents without patient approval, as well as getting their cells to be able to use for replication.  

By | 2017-05-24T19:53:44+00:00 May 24th, 2017|Biomed Capstone Project 2017|0 Comments

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