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Friday, October 13, 2023

Military engineering

From Wikipedia, the free encyclopedia
https://en.wikipedia.org/wiki/Military_engineering

Military engineer training in Ukraine, 2017

Military engineering is loosely defined as the art, science, and practice of designing and building military works and maintaining lines of military transport and military communications. Military engineers are also responsible for logistics behind military tactics. Modern military engineering differs from civil engineering. In the 20th and 21st centuries, military engineering also includes CBRN defense and other engineering disciplines such as mechanical and electrical engineering techniques.

According to NATO, "military engineering is that engineer activity undertaken, regardless of component or service, to shape the physical operating environment. Military engineering incorporates support to maneuver and to the force as a whole, including military engineering functions such as engineer support to force protection, counter-improvised explosive devices, environmental protection, engineer intelligence and military search. Military engineering does not encompass the activities undertaken by those 'engineers' who maintain, repair and operate vehicles, vessels, aircraft, weapon systems and equipment."

Military engineering is an academic subject taught in military academies or schools of military engineering. The construction and demolition tasks related to military engineering are usually performed by military engineers including soldiers trained as sappers or pioneers. In modern armies, soldiers trained to perform such tasks while well forward in battle and under fire are often called combat engineers.

In some countries, military engineers may also perform non-military construction tasks in peacetime such as flood control and river navigation works, but such activities do not fall within the scope of military engineering.

Etymology

The word engineer was initially used in the context of warfare, dating back to 1325 when engine’er (literally, one who operates an engine) referred to "a constructor of military engines". In this context, "engine" referred to a military machine, i. e., a mechanical contraption used in war (for example, a catapult).

As the design of civilian structures such as bridges and buildings developed as a technical discipline, the term civil engineering entered the lexicon as a way to distinguish between those specializing in the construction of such non-military projects and those involved in the older discipline. As the prevalence of civil engineering outstripped engineering in a military context and the number of disciplines expanded, the original military meaning of the word "engineering" is now largely obsolete. In its place, the term "military engineering" has come to be used.

History

Aerial view of Mulberry harbour "B" (27 October 1944)

In ancient times, military engineers were responsible for siege warfare and building field fortifications, temporary camps and roads. The most notable engineers of ancient times were the Romans and Chinese, who constructed huge siege-machines (catapults, battering rams and siege towers). The Romans were responsible for constructing fortified wooden camps and paved roads for their legions. Many of these Roman roads are still in use today.

The first civilization to have a dedicated force of military engineering specialists were the Romans, whose army contained a dedicated corps of military engineers known as architecti. This group was pre-eminent among its contemporaries. The scale of certain military engineering feats, such as the construction of a double-wall of fortifications 30 miles (48 km) long, in just 6 weeks to completely encircle the besieged city of Alesia in 52 B.C.E., is an example. Such military engineering feats would have been completely new, and probably bewildering and demoralizing, to the Gallic defenders. Vitruvius is the best known of these Roman army engineers, due to his writings surviving.

Examples of battles before the early modern period where military engineers played a decisive role include the Siege of Tyre under Alexander the Great, the Siege of Masada by Lucius Flavius Silva as well as the Battle of the Trench under the suggestion of Salman the Persian to dig a trench.

For about 600 years after the fall of the Roman empire, the practice of military engineering barely evolved in the west. In fact, much of the classic techniques and practices of Roman military engineering were lost. Through this period, the foot soldier (who was pivotal to much of the Roman military engineering capability) was largely replaced by mounted soldiers. It was not until later in the Middle Ages, that military engineering saw a revival focused on siege warfare.

Military engineers planned castles and fortresses. When laying siege, they planned and oversaw efforts to penetrate castle defenses. When castles served a military purpose, one of the tasks of the sappers was to weaken the bases of walls to enable them to be breached before means of thwarting these activities were devised. Broadly speaking, sappers were experts at demolishing or otherwise overcoming or bypassing fortification systems.

Working dress of the Royal Military Artificers in Gibraltar, 1795

With the 14th-century development of gunpowder, new siege engines in the form of cannons appeared. Initially military engineers were responsible for maintaining and operating these new weapons just as had been the case with previous siege engines. In England, the challenge of managing the new technology resulted in the creation of the Office of Ordnance around 1370 in order to administer the cannons, armaments and castles of the kingdom. Both military engineers and artillery formed the body of this organization and served together until the office's successor, the Board of Ordnance was disbanded in 1855.

In comparison to older weapons, the cannon was significantly more effective against traditional medieval fortifications. Military engineering significantly revised the way fortifications were built in order to be better protected from enemy direct and plunging shot. The new fortifications were also intended to increase the ability of defenders to bring fire onto attacking enemies. Fort construction proliferated in 16th-century Europe based on the trace italienne design.

French sappers during the Battle of Berezina in 1812

By the 18th century, regiments of foot (infantry) in the British, French, Prussian and other armies included pioneer detachments. In peacetime these specialists constituted the regimental tradesmen, constructing and repairing buildings, transport wagons, etc. On active service they moved at the head of marching columns with axes, shovels, and pickaxes, clearing obstacles or building bridges to enable the main body of the regiment to move through difficult terrain. The modern Royal Welch Fusiliers and French Foreign Legion still maintain pioneer sections who march at the front of ceremonial parades, carrying chromium-plated tools intended for show only. Other historic distinctions include long work aprons and the right to wear beards. In West Africa, the Ashanti army was accompanied to war by carpenters who were responsible for constructing shelters and blacksmiths who repaired weapons. By the 18th century, sappers were deployed in the Dahomeyan army during assaults against fortifications.

The Peninsular War (1808–14) revealed deficiencies in the training and knowledge of officers and men of the British Army in the conduct of siege operations and bridging. During this war low-ranking Royal Engineers officers carried out large-scale operations. They had under their command working parties of two or three battalions of infantry, two or three thousand men, who knew nothing in the art of siegeworks. Royal Engineers officers had to demonstrate the simplest tasks to the soldiers, often while under enemy fire. Several officers were lost and could not be replaced, and a better system of training for siege operations was required. On 23 April 1812 an establishment was authorised, by Royal Warrant, to teach "Sapping, Mining, and other Military Fieldworks" to the junior officers of the Corps of Royal Engineers and the Corps of Royal Military Artificers, Sappers and Miners.

The first courses at the Royal Engineers Establishment were done on an all ranks basis with the greatest regard to economy. To reduce staff the NCOs and officers were responsible for instructing and examining the soldiers. If the men could not read or write they were taught to do so, and those who could read and write were taught to draw and interpret simple plans. The Royal Engineers Establishment quickly became the centre of excellence for all fieldworks and bridging. Captain Charles Pasley, the director of the Establishment, was keen to confirm his teaching, and regular exercises were held as demonstrations or as experiments to improve the techniques and teaching of the Establishment. From 1833 bridging skills were demonstrated annually by the building of a pontoon bridge across the Medway which was tested by the infantry of the garrison and the cavalry from Maidstone. These demonstrations had become a popular spectacle for the local people by 1843, when 43,000 came to watch a field day laid on to test a method of assaulting earthworks for a report to the Inspector General of Fortifications. In 1869 the title of the Royal Engineers Establishment was changed to "The School of Military Engineering" (SME) as evidence of its status, not only as the font of engineer doctrine and training for the British Army, but also as the leading scientific military school in Europe.

A Bailey bridge being deployed in the Korean War to replace a bridge destroyed in combat.

The dawn of the internal combustion engine marked the beginning of a significant change in military engineering. With the arrival of the automobile at the end of the 19th century and heavier than air flight at the start of the 20th century, military engineers assumed a major new role in supporting the movement and deployment of these systems in war. Military engineers gained vast knowledge and experience in explosives. They were tasked with planting bombs, landmines and dynamite.

At the end of World War I, the standoff on the Western Front caused the Imperial German Army to gather experienced and particularly skilled soldiers to form "Assault Teams" which would break through the Allied trenches. With enhanced training and special weapons (such as flamethrowers), these squads achieved some success, but too late to change the outcome of the war. In early WWII, however, the Wehrmacht "Pioniere" battalions proved their efficiency in both attack and defense, somewhat inspiring other armies to develop their own combat engineers battalions. Notably, the attack on Fort Eben-Emael in Belgium was conducted by Luftwaffe glider-deployed combat engineers.

The need to defeat the German defensive positions of the "Atlantic wall" as part of the amphibious landings in Normandy in 1944 led to the development of specialist combat engineer vehicles. These, collectively known as Hobart's Funnies, included a specific vehicle to carry combat engineers, the Churchill AVRE. These and other dedicated assault vehicles were organised into the specialised 79th Armoured Division and deployed during Operation Overlord – 'D-Day'.

Other significant military engineering projects of World War II include Mulberry harbour and Operation Pluto.

Modern military engineering still retains the Roman role of building field fortifications, road paving and breaching terrain obstacles. A notable military engineering task was, for example, breaching the Suez Canal during the Yom Kippur War.

Education

Military engineers can come from a variety of engineering programs. They may be graduates of mechanical, electrical, civil, or industrial engineering.

Sub-discipline

Modern military engineering can be divided into three main tasks or fields: combat engineering, strategic support, and ancillary support. Combat engineering is associated with engineering on the battlefield. Combat engineers are responsible for increasing mobility on the front lines of war such as digging trenches and building temporary facilities in war zones. Strategic support is associated with providing service in communication zones such as the construction of airfields and the improvement and upgrade of ports, roads and railways communication. Ancillary support includes provision and distribution of maps as well as the disposal of unexploded warheads. Military engineers construct bases, airfields, roads, bridges, ports, and hospitals. During peacetime before modern warfare, military engineers took the role of civil engineers by participating in the construction of civil-works projects. Nowadays, military engineers are almost entirely engaged in war logistics and preparedness.

Explosives engineering

Explosives are defined as any system that produces rapidly expanding gases in a given volume in a short duration. Specific military engineering occupations also extend to the field of explosives and demolitions and their usage on the battlefield. Explosive devices have been used on the battlefield for several centuries, in numerous operations from combat to area clearance. Earliest known development of explosives can be traced back to 10th-century China where the Chinese are credited with engineering the world's first known explosive, black powder. Initially developed for recreational purposes, black powder later was utilized for military application in bombs and projectile propulsion in firearms. Engineers in the military who specialize in this field formulate and design many explosive devices to use in varying operating conditions. Such explosive compounds range from black powder to modern plastic explosives. This particular is commonly listed under the role of combat engineers who demolitions expertise also includes mine and IED detection and disposal. For more information, see Bomb disposal.

Military engineering by country

Military engineers are key in all armed forces of the world, and invariably found either closely integrated into the force structure, or even into the combat units of the national troops.

Slovak AM 50 laying a bridge over the Torysa river

Brazil

Brazilian Army engineers can be part of the Quadro de Engenheiros Militares, with its members trained or professionalized by the traditional Instituto Militar de Engenharia (IME) (Military Institute of Engineering), or the Arma de Engenharia, with its members trained by the Academia Militar das Agulhas Negras (AMAN) (Agulhas Negras Military Academy).

In the Brazil's Navy, engineers can occupy the Corpo de Engenheiros da Marinha, the Quadro Complementar de Oficiais da Armada and the Quadro Complementar de Oficiais Fuzileiros Navais. Officers can come from the Centro de Instrução Almirante Wandenkolk (CIAW) (Admiral Wandenkolk Instruction Center) and the Escola Naval (EN) (Naval School) which, through internal selection of the Navy, finish their graduation at the Universidade de São Paulo (USP) (University of São Paulo).

The Quadro de Oficias Engenheiros of the Brazilian Air Force is occupied by engineers professionalized by Centro de Instrução e Adaptação da Aeronáutica (CIAAR) (Air Force Instruction and Adaptation Center) and trained, or specialized, by Instituto Tecnológico de Aeronáutica (ITA) (Aeronautics Institute of Technology).

Russia

United Kingdom

The Royal School of Military Engineering is the main training establishment for the British Army's Royal Engineers. The RSME also provides training for the Royal Navy, Royal Air Force, other Arms and Services of the British Army, Other Government Departments, and Foreign and Commonwealth countries as required. These skills provide vital components in the Army's operational capability, and Royal Engineers are currently deployed in Afghanistan, Iraq, Cyprus, Bosnia, Kosovo, Kenya, Brunei, Falklands, Belize, Germany and Northern Ireland. Royal Engineers also take part in exercises in Saudi Arabia, Kuwait, Italy, Egypt, Jordan, Canada, Poland and the United States.

United States

The prevalence of military engineering in the United States dates back to the American Revolutionary War when engineers would carry out tasks in the U.S. Army. During the war, they would map terrain to and build fortifications to protect troops from opposing forces. The first military engineering organization in the United States was the Army Corps of Engineers. Engineers were responsible for protecting military troops whether using fortifications or designing new technology and weaponry throughout the United States' history of warfare. The Army originally claimed engineers exclusively, but as the U.S. military branches expanded to the sea and sky, the need for military engineering sects in all branches increased. As each branch of the United States military expanded, technology adapted to fit their respective needs.

Other nations

Thursday, October 12, 2023

Catapult

From Wikipedia, the free encyclopedia
https://en.wikipedia.org/wiki/Catapult
Basic diagram of an Onager, a type of catapult

A catapult is a ballistic device used to launch a projectile a great distance without the aid of gunpowder or other propellants – particularly various types of ancient and medieval siege engines. A catapult uses the sudden release of stored potential energy to propel its payload. Most convert tension or torsion energy that was more slowly and manually built up within the device before release, via springs, bows, twisted rope, elastic, or any of numerous other materials and mechanisms.

In use since ancient times, the catapult has proven to be one of the most persistently effective mechanisms in warfare. In modern times the term can apply to devices ranging from a simple hand-held implement (also called a "slingshot") to a mechanism for launching aircraft from a ship.

The earliest catapults date to at least the 7th century BC, with King Uzziah, of Judah, recorded as equipping the walls of Jerusalem with machines that shot "great stones". Catapults are mentioned in Yajurveda under the name "Jyah" in chapter 30, verse 7. In the 5th century BC the mangonel appeared in ancient China, a type of traction trebuchet and catapult. Early uses were also attributed to Ajatashatru of Magadha in his, 5th century BC, war against the Licchavis. Greek catapults were invented in the early 4th century BC, being attested by Diodorus Siculus as part of the equipment of a Greek army in 399 BC, and subsequently used at the siege of Motya in 397 BC.

Etymology

The word 'catapult' comes from the Latin 'catapulta', which in turn comes from the Greek Ancient Greek: καταπέλτης (katapeltēs), itself from κατά (kata), "downwards" and πάλλω (pallō), "to toss, to hurl". Catapults were invented by the ancient Greeks and in ancient India where they were used by the Magadhan Emperor Ajatashatru around the early to mid 5th century BC.

Greek and Roman catapults

Ancient mechanical artillery: Catapults (standing), the chain drive of Polybolos (bottom center), Gastraphetes (on wall)
Engraving illustrating a Roman catapult design, 1581
Roman "catapult-nest" in the Trajan's Dacian Wars

The catapult and crossbow in Greece are closely intertwined. Primitive catapults were essentially "the product of relatively straightforward attempts to increase the range and penetrating power of missiles by strengthening the bow which propelled them". The historian Diodorus Siculus (fl. 1st century BC), described the invention of a mechanical arrow-firing catapult (katapeltikon) by a Greek task force in 399 BC. The weapon was soon after employed against Motya (397 BC), a key Carthaginian stronghold in Sicily. Diodorus is assumed to have drawn his description from the highly rated history of Philistus, a contemporary of the events then. The introduction of crossbows however, can be dated further back: according to the inventor Hero of Alexandria (fl. 1st century AD), who referred to the now lost works of the 3rd-century BC engineer Ctesibius, this weapon was inspired by an earlier foot-held crossbow, called the gastraphetes, which could store more energy than the Greek bows. A detailed description of the gastraphetes, or the "belly-bow", along with a watercolor drawing, is found in Heron's technical treatise Belopoeica.

A third Greek author, Biton (fl. 2nd century BC), whose reliability has been positively reevaluated by recent scholarship, described two advanced forms of the gastraphetes, which he credits to Zopyros, an engineer from southern Italy. Zopyrus has been plausibly equated with a Pythagorean of that name who seems to have flourished in the late 5th century BC. He probably designed his bow-machines on the occasion of the sieges of Cumae and Milet between 421 BC and 401 BC. The bows of these machines already featured a winched pull back system and could apparently throw two missiles at once.

Philo of Byzantium provides probably the most detailed account on the establishment of a theory of belopoietics (belos = "projectile"; poietike = "(art) of making") circa 200 BC. The central principle to this theory was that "all parts of a catapult, including the weight or length of the projectile, were proportional to the size of the torsion springs". This kind of innovation is indicative of the increasing rate at which geometry and physics were being assimilated into military enterprises.

From the mid-4th century BC onwards, evidence of the Greek use of arrow-shooting machines becomes more dense and varied: arrow firing machines (katapaltai) are briefly mentioned by Aeneas Tacticus in his treatise on siegecraft written around 350 BC. An extant inscription from the Athenian arsenal, dated between 338 and 326 BC, lists a number of stored catapults with shooting bolts of varying size and springs of sinews. The later entry is particularly noteworthy as it constitutes the first clear evidence for the switch to torsion catapults, which are more powerful than the more-flexible crossbows and which came to dominate Greek and Roman artillery design thereafter. This move to torsion springs was likely spurred by the engineers of Philip II of Macedonia. Another Athenian inventory from 330 to 329 BC includes catapult bolts with heads and flights. As the use of catapults became more commonplace, so did the training required to operate them. Many Greek children were instructed in catapult usage, as evidenced by "a 3rd Century B.C. inscription from the island of Ceos in the Cyclades [regulating] catapult shooting competitions for the young". Arrow firing machines in action are reported from Philip II's siege of Perinth (Thrace) in 340 BC. At the same time, Greek fortifications began to feature high towers with shuttered windows in the top, which could have been used to house anti-personnel arrow shooters, as in Aigosthena. Projectiles included both arrows and (later) stones that were sometimes lit on fire. Onomarchus of Phocis first used catapults on the battlefield against Philip II of Macedon. Philip's son, Alexander the Great, was the next commander in recorded history to make such use of catapults on the battlefield as well as to use them during sieges.

The Romans started to use catapults as arms for their wars against Syracuse, Macedon, Sparta and Aetolia (3rd and 2nd centuries BC). The Roman machine known as an arcuballista was similar to a large crossbow. Later the Romans used ballista catapults on their warships.

Other ancient catapults

In chronological order:

  • 19th century BC, Egypt, walls of the fortress of Buhen appear to contain platforms for siege weapons.
  • c.750 BC, Judah, King Uzziah is documented as having overseen the construction of machines to "shoot great stones".
  • between 484 and 468 BC, India, Ajatashatru is recorded in Jaina texts as having used catapults in his campaign against the Licchavis.
  • between 500 and 300 BC, China, recorded use of mangonels. They were probably used by the Mohists as early as the 4th century BC, descriptions of which can be found in the Mojing (compiled in the 4th century BC). In Chapter 14 of the Mojing, the mangonel is described hurling hollowed out logs filled with burning charcoal at enemy troops. The mangonel was carried westward by the Avars and appeared next in the eastern Mediterranean by the late 6th century AD, where it replaced torsion powered siege engines such as the ballista and onager due to its simpler design and faster rate of fire. The Byzantines adopted the mangonel possibly as early as 587, the Persians in the early 7th century, and the Arabs in the second half of the 7th century. The Franks and Saxons adopted the weapon in the 8th century.

Medieval catapults

Replica of a Petraria Arcatinus
Petraria Arcatinus catapult in Mercato San Severino, Italy
Catapult 1 Mercato San Severino

Castles and fortified walled cities were common during this period and catapults were used as siege weapons against them. As well as their use in attempts to breach walls, incendiary missiles, or diseased carcasses or garbage could be catapulted over the walls.

Defensive techniques in the Middle Ages progressed to a point that rendered catapults largely ineffective. The Viking siege of Paris (885–6 A.D.) "saw the employment by both sides of virtually every instrument of siege craft known to the classical world, including a variety of catapults", to little effect, resulting in failure.

The most widely used catapults throughout the Middle Ages were as follows:

Ballista
Ballistae were similar to giant crossbows and were designed to work through torsion. The projectiles were large arrows or darts made from wood with an iron tip. These arrows were then shot "along a flat trajectory" at a target. Ballistae were accurate, but lacked firepower compared with that of a mangonel or trebuchet. Because of their immobility, most ballistae were constructed on site following a siege assessment by the commanding military officer.

Springald
The springald's design resembles that of the ballista, being a crossbow powered by tension. The springald's frame was more compact, allowing for use inside tighter confines, such as the inside of a castle or tower, but compromising its power.

Mangonel
This machine was designed to throw heavy projectiles from a "bowl-shaped bucket at the end of its arm". Mangonels were mostly used for “firing various missiles at fortresses, castles, and cities,” with a range of up to 1,300 ft (400 m). These missiles included anything from stones to excrement to rotting carcasses. Mangonels were relatively simple to construct, and eventually wheels were added to increase mobility.

Onager
Mangonels are also sometimes referred to as Onagers. Onager catapults initially launched projectiles from a sling, which was later changed to a "bowl-shaped bucket". The word Onager is derived from the Greek word onagros for "wild ass", referring to the "kicking motion and force" that were recreated in the Mangonel's design. Historical records regarding onagers are scarce. The most detailed account of Mangonel use is from “Eric Marsden's translation of a text written by Ammianus Marcellius in the 4th Century AD” describing its construction and combat usage.

Trebuchet
Mongol warriors using trebuchet to besiege a city
Trebuchets were probably the most powerful catapult employed in the Middle Ages. The most commonly used ammunition were stones, but "darts and sharp wooden poles" could be substituted if necessary. The most effective kind of ammunition though involved fire, such as "firebrands, and deadly Greek Fire". Trebuchets came in two different designs: Traction, which were powered by people, or Counterpoise, where the people were replaced with "a weight on the short end". The most famous historical account of trebuchet use dates back to the siege of Stirling Castle in 1304, when the army of Edward I constructed a giant trebuchet known as Warwolf, which then proceeded to "level a section of [castle] wall, successfully concluding the siege".

Couillard
A simplified trebuchet, where the trebuchet's single counterweight is split, swinging on either side of a central support post.

Leonardo da Vinci's catapult
Leonardo da Vinci sought to improve the efficiency and range of earlier designs. His design incorporated a large wooden leaf spring as an accumulator to power the catapult. Both ends of the bow are connected by a rope, similar to the design of a bow and arrow. The leaf spring was not used to pull the catapult armature directly, rather the rope was wound around a drum. The catapult armature was attached to this drum which would be turned until enough potential energy was stored in the deformation of the spring. The drum would then be disengaged from the winding mechanism, and the catapult arm would snap around. Though no records exist of this design being built during Leonardo's lifetime, contemporary enthusiasts have reconstructed it.

Modern use

Military

French troops using a catapult to throw hand grenades and other explosives during World War I

The last large scale military use of catapults was during the trench warfare of World War I. During the early stages of the war, catapults were used to throw hand grenades across no man's land into enemy trenches. They were eventually replaced by small mortars.

The SPBG (Silent Projector of Bottles and Grenades) was a soviet proposal anti-tank weapon that launched grenades from a spring loaded shuttle up to 100 m (330 ft).

In the 1840s, the invention of vulcanized rubber allowed the making of small hand-held catapults, either improvised from Y-shaped sticks or manufactured for sale; both were popular with children and teenagers. These devices were also known as slingshots in the United States.

Special variants called aircraft catapults are used to launch planes from land bases and sea carriers when the takeoff runway is too short for a powered takeoff or simply impractical to extend. Ships also use them to launch torpedoes and deploy bombs against submarines. Small catapults, referred to as "traps", are still widely used to launch clay targets into the air in the sport of clay pigeon shooting.

Entertainment

In the 1990s and early 2000s, a powerful catapult, a trebuchet, was used by thrill-seekers first on private property and in 2001–2002 at Middlemoor Water Park, Somerset, England, to experience being catapulted through the air for 100 feet (30 m). The practice has been discontinued due to a fatality at the Water Park. There had been an injury when the trebuchet was in use on private property. Injury and death occurred when those two participants failed to land onto the safety net. The operators of the trebuchet were tried, but found not guilty of manslaughter, though the jury noted that the fatality might have been avoided had the operators "imposed stricter safety measures." Human cannonball circus acts use a catapult launch mechanism, rather than gunpowder, and are risky ventures for the human cannonballs.

Early launched roller coasters used a catapult system powered by a diesel engine or a dropped weight to acquire their momentum, such as Shuttle Loop installations between 1977 and 1978. The catapult system for roller coasters has been replaced by flywheels and later linear motors.

Pumpkin chunking is another widely popularized use, in which people compete to see who can launch a pumpkin the farthest by mechanical means (although the world record is held by a pneumatic air cannon).

Other

In January 2011, a homemade catapult was discovered that was used to smuggle cannabis into the United States from Mexico. The machine was found 20 ft (6.1 m) from the border fence with 4.4 pounds (2.0 kg) bales of cannabis ready to launch.

Artificial heart valve

From Wikipedia, the free encyclopedia
 
Artificial heart valve
Different types of artificial heart valves
Specialtycardiology
In artificial heart valve is a one-way valve implanted into a person's heart to replace a heart valve that is not functioning properly (valvular heart disease). Artificial heart valves can be separated into three broad classes: mechanical heart valves, bioprosthetic tissue valves and engineered tissue valves.

The human heart contains four valves: tricuspid valve, pulmonary valve, mitral valve and aortic valve. Their main purpose is to keep blood flowing in the proper direction through the heart, and from the heart into the major blood vessels connected to it (the pulmonary artery and the aorta). Heart valves can malfunction for a variety of reasons, which can impede the flow of blood through the valve (stenosis) and/or let blood flow backwards through the valve (regurgitation). Both processes put strain on the heart and may lead to serious problems, including heart failure. While some dysfunctional valves can be treated with drugs or repaired, others need to be replaced with an artificial valve.

Background

3D Medical Animation still shot of Artificial Heart Valve
3D Medical Animation still shot of Artificial Heart Valve

A heart contains four valves (tricuspid, pulmonary, mitral and aortic valves) which open and close as blood passes through the heart. Blood enters the heart in the right atrium and passes through the tricuspid valve to the right ventricle. From there, blood is pumped through the pulmonary valve to enter the lungs. After being oxygenated, blood passes to the left atrium, where is it pumped through the mitral valve to the left ventricle. The left ventricle pumps blood to the aorta through the aortic valve.

There are many potential causes of heart valve damage, such as birth defects, age related changes, and effects from other disorders, such as rheumatic fever and infections causing endocarditis. High blood pressure and heart failure which can enlarge the heart and arteries, and scar tissue can form after a heart attack or injury.

The three main types of artificial heart valves are mechanical, biological (bioprosthetic/tissue), and tissue-engineered valves. In the US, UK and the European Union, the most common type of artificial heart valve is the bioprosthetic valve. Mechanical valves are more commonly used in Asia and Latin America. Companies that manufacture heart valves include Edwards Lifesciences, Medtronic, Abbott (St. Jude Medical), CryoLife, and LifeNet Health.

Mechanical valves

Mechanical valves come in three main types – caged ball, tilting-disc and bileaflet – with various modifications on these designs. Caged ball valves are no longer implanted. Bileaflet valves are the most common type of mechanical valve implanted in patients today.

Caged ball valves

Caged ball valve

The first artificial heart valve was the caged ball valve, a type of ball check valve, in which a ball is housed inside a cage. When the heart contracts and the blood pressure in the chamber of the heart exceeds the pressure on the outside of the chamber, the ball is pushed against the cage and allows blood to flow. When the heart finishes contracting, the pressure inside the chamber drops and the ball moves back against the base of the valve forming a seal.

In 1952, Charles A. Hufnagel implanted caged ball heart valves into ten patients (six of whom survived the operation), marking the first success in prosthetic heart valves. A similar valve was invented by Miles 'Lowell' Edwards and Albert Starr in 1960, commonly referred to as the Starr-Edwards silastic ball valve. This consisted of a silicone ball enclosed in a methyl metacrylate cage welded to a ring. The Starr-Edwards valve was first implanted in a human on August 25, 1960, and was discontinued by Edwards Lifesciences in 2007.

Caged ball valves are strongly associated with blood clot formation, so people who have one required a high degree of anticoagulation, usually with a target INR of 3.0–4.5.

Tilting-disc valves

tilting-disc valve

Introduced in 1969, the first clinically available tilting-disc valve was the Bjork-Shiley valve. Tilting‑disc valves, a type of swing check valve, are made of a metal ring covered by an ePTFE fabric. The metal ring holds, by means of two metal supports, a disc that opens when the heart beats to let blood flow through, then closes again to prevent blood flowing backwards. The disc is usually made of an extremely hard carbon material (pyrolytic carbon), enabling the valve to function for years without wearing out.

Bileaflet valves

Bileaflet valve

Introduced in 1979, bileaflet valves are made of two semicircular leaflets that revolve around struts attached to the valve housing. With a larger opening than caged ball or tilting-disc valves, they carry a lower risk of blood clots. They are, however, vulnerable to blood backflow.

Advantages of mechanical valves

The major advantage of mechanical valves over bioprosthetic valves is their greater durability. Made from metal and/or pyrolytic carbon, they can last 20–30 years.

Disadvantages of mechanical valves

One of the major drawbacks of mechanical heart valves is that they are associated with an increased risk of blood clots. Clots formed by red blood cell and platelet damage can block blood vessels leading to stroke. People with mechanical valves need to take anticoagulants (blood thinners), such as warfarin, for the rest of their life. Mechanical heart valves can also cause mechanical hemolytic anemia, a condition where the red blood cells are damaged as they pass through the valve. Cavitation, the rapid formation of microbubbles in a fluid such as blood due to a localized drop of pressure, can lead to mechanical heart valve failure, so cavitation testing is an essential part of the valve design verification process.

Many of the complications associated with mechanical heart valves can be explained through fluid mechanics. For example, blood clot formation is a side effect of high shear stresses created by the design of the valves. From an engineering perspective, an ideal heart valve would produce minimal pressure drops, have small regurgitation volumes, minimize turbulence, reduce prevalence of high stresses, and not create flow separations in the vicinity of the valve.

Implanted mechanical valves can cause foreign body rejection. The blood may coagulate and eventually result in a hemostasis. The usage of anticoagulation drugs will be interminable to prevent thrombosis.

Bioprosthetic tissue valves

Bioprosthetic valves are usually made from animal tissue (heterograft/xenograft) attached to a metal or polymer support. Bovine (cow) tissue is most commonly used, but some are made from porcine (pig) tissue. The tissue is treated to prevent rejection and calcification.

Alternatives to animal tissue valves are sometimes used, where valves are used from human donors, as in aortic homografts and pulmonary autografts. An aortic homograft is an aortic valve from a human donor, retrieved either after their death or from a heart that is removed to be replaced during a heart transplant. A pulmonary autograft, also known as the Ross procedure, is where the aortic valve is removed and replaced with the patient's own pulmonary valve (the valve between the right ventricle and the pulmonary artery). A pulmonary homograft (a pulmonary valve taken from a cadaver) is then used to replace the patient's own pulmonary valve. This procedure was first performed in 1967 and is used primarily in children, as it allows the patient's own pulmonary valve (now in the aortic position) to grow with the child.

Advantages of bioprosthetic heart valves

Bioprosthetic valves are less likely than mechanical valves to cause blood clots, so do not require lifelong anticoagulation. As a result, people with bioprosthetic valves have a lower risk of bleeding than those with mechanical valves.

Disadvantages of bioprosthetic heart valves

Tissue valves are less durable than mechanical valves, typically lasting 10–20 years. This means that people with bioprosthetic valves have a higher incidence of requiring another aortic valve replacement in their lifetime. Bioprosthetic valves tend to deteriorate more quickly in younger patients.

In recent years, scientists have developed a new tissue preservation technology, with the aim of improving the durability of bioprosthetic valves. In sheep and rabbit studies, tissue preserved using this new technology had less calcification than control tissue. A valve containing this tissue is now marketed, but long-term durability data in patients are not yet available.

Current bioprosthetic valves lack longevity, and will calcify over time. When a valve calcifies, the valve cusps become stiff and thick and cannot close completely. Moreover, bioprosthetic valves can't grow with or adapt to the patient: if a child has bioprosthetic valves they will need to get the valves replaced several times to fit their physical growth.

Tissue-engineered valves

For over 30 years researchers have been trying to grow heart valves in vitro. These tissue‑engineered valves involve seeding human cells on to a scaffold. The two main types of scaffold are natural scaffolds, such as decellularized tissue, or scaffolds made from degradable polymers. The scaffold acts as an extracellular matrix, guiding tissue growth into the correct 3D structure of the heart valve. Some tissue-engineered heart valves have been tested in clinical trials, but none are commercially available.

Tissue engineered heart valves can be person-specific and 3D modeled to fit an individual recipient 3D printing is used because of its high accuracy and precision of dealing with different biomaterials. Cells that are used for tissue engineered heart valves are expected to secrete the extracellular matrix (ECM). Extracellular matrix provides support to maintain the shape of the valves and determines the cell activities.

Scientists can follow the structure of heart valves to produce something that looks similar to them, but since tissue engineered valves lack the natural cellular basis, they either fail to perform their functions like natural heart valves, or function when they are implanted but gradually degrade over time. An ideal tissue engineered heart valve would be non‐thrombogenic, biocompatible, durable, resistant to calcification, grow with the surrounding heart, and exhibit a physiological hemodynamic profile. To achieve these goals, the scaffold should be carefully chosen—there are three main candidates: decellularized ECM (xenografts or homografts), natural polymers, and synthetic polymers.

Differences between mechanical and tissue valves

Mechanical and tissue valves are made of different materials. Mechanical valves are generally made of titanium and carbon. Tissue valves are made up of human or animal tissue. The valves composed of human tissue, known as allografts or homografts, are from donors' human hearts.

Mechanical valves can be a better choice for younger people and people at risk of valve deterioration due to its durability. It is also preferable for people who are already taking blood thinners and people who would be unlikely to tolerate another valve replacement operation.

Tissue valves are better for older age groups as another valve replacement operation may not be needed in their lifetime. Due to the risk of forming blood clots for mechanical valves and severe bleeding as a major side effect of taking blood-thinning medications, people who have a risk of blood bleeding and are not willing to take warfarin may also consider tissue valves. Other patients who may be more suitable for tissue valves are people who have other planned surgeries and unable to take blood-thinning medications. People who plan to become pregnant may also consider tissue valves as warfarin causes risks in pregnancy.

Functional requirements of artificial heart valves

An artificial heart valve should ideally function like a natural heart valve. The functioning of natural heart valves is characterized by many advantages:

  • Minimal regurgitation – This means that the amount of blood leaking backwards through the valve as it closes is small. Some degree of valvular regurgitation is inevitable and natural, up to around 5 ml per beat. However, several heart valve pathologies (e.g. rheumatic endocarditis) may lead to clinically significant valvular regurgitation. A desirable characteristic of heart valve prostheses is that regurgitation is minimal over the full range of physiological heart function.
  • Minimal transvalvular pressure gradient – Whenever a fluid flows through a restriction, such as a valve, a pressure gradient arises over the restriction. This pressure gradient is a result of the increased resistance to flow through the restriction. Natural heart valves have a low transvalvular pressure gradient as they present little obstruction to the flow through themselves, normally less than 16 mmHg. A desirable characteristic of heart valve prostheses is that their transvalvular pressure gradient is as small as possible.
  • Non-thrombogenic – Natural heart valves are lined with an endothelium comparable with the endothelium lining the heart chambers, so they are not normally thrombogenic (i.e. they don't cause blood clots). Blood clots can be hazardous because they can lodge in, and block, downstream arteries (e.g. coronary arteries, leading to heart attack [myocardial infarction]; or cerebral arteries, leading to stroke). A desirable characteristic of artificial heart valves is that they are non- or minimally thrombogenic.
  • Self-repairing – Valve leaflets retain some capacity for repair thanks to regenerative cells (e.g. fibroblasts) in the connective tissue from which the leaflets are composed. As the human heart beats approximately 3.4×109 times during a typical human lifespan, this limited but nevertheless present repair capacity is critically important. No heart valve prostheses can currently self-repair, but tissue-engineered valves may eventually offer such capabilities.

Artificial heart valve repair

Artificial heart valves are expected to last from 10 to 30 years.

The most common problems with artificial heart valves are various forms of degeneration, including gross billowing of leaflets, ischemic mitral valve pathology, and minor chordal lengthening. The repairing process of the artificial heart valve regurgitation and stenosis usually requires an open-heart surgery, and a repair or partial replacement of regurgitant valves is usually preferred.

Researchers are investigating catheter-based surgery that allows repair of an artificial heart valve without large incisions.

Researchers are investigating Interchangeable Prosthetic Heart Valve that allows redo and fast-track repair of an artificial heart valve. 

Additional images

 

Cardiac surgery

From Wikipedia, the free encyclopedia
 
Cardiac surgery
Two cardiac surgeons performing coronary artery bypass surgery. Note the use of a steel retractor to forcefully maintain the exposure of the heart.
ICD-9-CM35-37
MeSHD006348
OPS-301 code5-35...5-37
Cardiac surgery
SpecialtyCardiothoracic surgery

Cardiac surgery, or cardiovascular surgery, is surgery on the heart or great vessels performed by cardiac surgeons. It is often used to treat complications of ischemic heart disease (for example, with coronary artery bypass grafting); to correct congenital heart disease; or to treat valvular heart disease from various causes, including endocarditis, rheumatic heart disease, and atherosclerosis. It also includes heart transplantation.

History

19th century

The earliest operations on the pericardium (the sac that surrounds the heart) took place in the 19th century and were performed by Francisco Romero (1801) in the city of Almería (Spain), Dominique Jean Larrey (1810), Henry Dalton (1891), and Daniel Hale Williams (1893). The first surgery on the heart itself was performed by Axel Cappelen on 4 September 1895 at Rikshospitalet in Kristiania, now Oslo. Cappelen ligated a bleeding coronary artery in a 24-year-old man who had been stabbed in the left axilla and was in deep shock upon arrival. Access was through a left thoracotomy. The patient awoke and seemed fine for 24 hours but became ill with a fever and died three days after the surgery from mediastinitis.

20th century

Surgery on the great vessels (e.g., aortic coarctation repair, Blalock–Thomas–Taussig shunt creation, closure of patent ductus arteriosus) became common after the turn of the century. However, operations on the heart valves were unknown until, in 1925, Henry Souttar operated successfully on a young woman with mitral valve stenosis. He made an opening in the appendage of the left atrium and inserted a finger in order to palpate and explore the damaged mitral valve. The patient survived for several years, but Souttar's colleagues considered the procedure unjustified, and he could not continue.

Alfred Blalock, Helen Taussig, and Vivien Thomas performed the first successful palliative pediatric cardiac operation at Johns Hopkins Hospital on 29 November 1944, in a one-year-old girl with Tetralogy of Fallot.

Cardiac surgery changed significantly after World War II. In 1947, Thomas Sellors of Middlesex Hospital in London operated on a Tetralogy of Fallot patient with pulmonary stenosis and successfully divided the stenosed pulmonary valve. In 1948, Russell Brock, probably unaware of Sellors's work, used a specially designed dilator in three cases of pulmonary stenosis. Later that year, he designed a punch to resect a stenosed infundibulum, which is often associated with Tetralogy of Fallot. Many thousands of these "blind" operations were performed until the introduction of cardiopulmonary bypass made direct surgery on valves possible.

Also in 1948, four surgeons carried out successful operations for mitral valve stenosis resulting from rheumatic fever. Horace Smithy of Charlotte used a valvulotome to remove a portion of a patient's mitral valve, while three other doctors—Charles Bailey of Hahnemann University Hospital in Philadelphia; Dwight Harken in Boston; and Russell Brock of Guy's Hospital in London—adopted Souttar's method. All four men began their work independently of one another within a period of a few months. This time, Souttar's technique was widely adopted, with some modifications.

The first successful intracardiac correction of a congenital heart defect using hypothermia was performed by lead surgeon Dr. F. John Lewis (Dr. C. Walton Lillehei assisted) at the University of Minnesota on 2 September 1952. In 1953, Alexander Alexandrovich Vishnevsky conducted the first cardiac surgery under local anesthesia. In 1956, Dr. John Carter Callaghan performed the first documented open-heart surgery in Canada.

Types of cardiac surgery

Open-heart surgery

Open-heart surgery is any kind of surgery in which a surgeon makes a large incision (cut) in the chest to open the rib cage and operate on the heart. "Open" refers to the chest, not the heart. Depending on the type of surgery, the surgeon also may open the heart.

Dr. Wilfred G. Bigelow of the University of Toronto found that procedures involving opening the patient's heart could be performed better in a bloodless and motionless environment. Therefore, during such surgery, the heart is temporarily stopped, and the patient is placed on cardiopulmonary bypass, meaning a machine pumps their blood and oxygen. Because the machine cannot function the same way as the heart, surgeons try to minimize the time a patient spends on it.

Cardiac surgery at Gemelli Hospital in Rome

Cardiopulmonary bypass was developed after surgeons realized the limitations of hypothermia in cardiac surgery: Complex intracardiac repairs take time, and the patient needs blood flow to the body (particularly to the brain), as well as heart and lung function. In July 1952, Forest Dodrill was the first to use a mechanical pump in a human to bypass the left side of the heart whilst allowing the patient's lungs to oxygenate the blood, in order to operate on the mitral valve. In 1953, Dr. John Heysham Gibbon of Jefferson Medical School in Philadelphia reported the first successful use of extracorporeal circulation by means of an oxygenator, but he abandoned the method after subsequent failures. In 1954, Dr. Lillehei performed a series of successful operations with the controlled cross-circulation technique, in which the patient's mother or father was used as a "heart-lung machine". Dr. John W. Kirklin at the Mayo Clinic was the first to use a Gibbon-type pump-oxygenator.

Nazih Zuhdi performed the first total intentional hemodilution open-heart surgery on Terry Gene Nix, age 7, on 25 February 1960 at Mercy Hospital in Oklahoma City. The operation was a success; however, Nix died three years later. In March 1961, Zuhdi, Carey, and Greer performed open-heart surgery on a child, aged 3+12, using the total intentional hemodilution machine.

Modern beating-heart surgery

In the early 1990s, surgeons began to perform off-pump coronary artery bypass, done without cardiopulmonary bypass. In these operations, the heart continues beating during surgery, but is stabilized to provide an almost still work area in which to connect a conduit vessel that bypasses a blockage. The conduit vessel that is often used is the Saphenous vein. This vein is harvested using a technique known as endoscopic vessel harvesting (EVH).

Heart transplant

In 1945, the Soviet pathologist Nikolai Sinitsyn successfully transplanted a heart from one frog to another frog and from one dog to another dog.

Norman Shumway is widely regarded as the father of human heart transplantation, although the world's first adult heart transplant was performed by a South African cardiac surgeon, Christiaan Barnard, using techniques developed by Shumway and Richard Lower. Barnard performed the first transplant on Louis Washkansky on 3 December 1967 at Groote Schuur Hospital in Cape Town. Adrian Kantrowitz performed the first pediatric heart transplant on 6 December 1967 at Maimonides Hospital (now Maimonides Medical Center) in Brooklyn, New York, barely three days later. Shumway performed the first adult heart transplant in the United States on 6 January 1968 at Stanford University Hospital.

Coronary Artery Bypass Grafting (CABG)

Coronary artery bypass grafting, also called revascularization, is a common surgical procedure to create an alternative path to deliver blood supply to the heart and body, with the goal of preventing clot formation. This can be done in many ways, and the arteries used can be taken from several areas of the body. Arteries are typically harvested from the chest, arm, or wrist and then attached to a portion of the coronary artery, relieving pressure and limiting clotting factors in that area of the heart.

The procedure is typically performed because of coronary artery disease (CAD), in which a plaque-like substance builds up in the coronary artery, the main pathway carrying oxygen-rich blood to the heart. This can cause a blockage and/or a rupture, which can lead to a heart attack.

Minimally invasive surgery

As an alternative to open-heart surgery, which involves a five- to eight-inch incision in the chest wall, a surgeon may perform an endoscopic procedure by making very small incisions through which a camera and specialized tools are inserted.

In robot-assisted heart surgery, a machine controlled by a cardiac surgeon is used to perform a procedure. The main advantage to this is the size of the incision required: three small port holes instead of an incision big enough for the surgeon's hands. The use of robotics in heart surgery continues to be evaluated, but early research has shown it to be a safe alternative to traditional techniques.

Post-surgical procedures

As with any surgical procedure, cardiac surgery requires postoperative precautions to avoid complications. Incision care is needed to avoid infection and minimize scarring. Swelling and loss of appetite are common.

Recovery from open-heart surgery begins with about 48 hours in an intensive care unit, where heart rate, blood pressure, and oxygen levels are closely monitored. Chest tubes are inserted to drain blood around the heart and lungs. After discharge from the hospital, compression socks may be recommended in order to regulate blood flow.

Risks

The advancement of cardiac surgery and cardiopulmonary bypass techniques has greatly reduced the mortality rates of these procedures. For instance, repairs of congenital heart defects are currently estimated to have 4–6% mortality rates.

A major concern with cardiac surgery is neurological damage. Stroke occurs in 2–3% of all people undergoing cardiac surgery, and the rate is higher in patients with other risk factors for stroke. A more subtle complication attributed to cardiopulmonary bypass is postperfusion syndrome, sometimes called "pumphead". The neurocognitive symptoms of postperfusion syndrome were initially thought to be permanent, but turned out to be transient, with no permanent neurological impairment.

In order to assess the performance of surgical units and individual surgeons, a popular risk model has been created called the EuroSCORE. It takes a number of health factors from a patient and, using precalculated logistic regression coefficients, attempts to quantify the probability that they will survive to discharge. Within the United Kingdom, the EuroSCORE was used to give a breakdown of all cardiothoracic surgery centres and to indicate whether the units and their individuals surgeons performed within an acceptable range. The results are available on the Care Quality Commission website.

Another important source of complications are the neuropsychological and psychopathologic changes following open-heart surgery. One example is Skumin syndrome, described by Victor Skumin in 1978, which is a "cardioprosthetic psychopathological syndrome" associated with mechanical heart valve implants and characterized by irrational fear, anxiety, depression, sleep disorder, and weakness.

Risk reduction

Pharmacological and non-pharmacological prevention approaches may reduce the risk of atrial fibrillation after an operation and reduce the length of hospital stays, however there is no evidence that this improves mortality.

Non-pharmacologic approaches

Preoperative physical therapy may reduce postoperative pulmonary complications, such as pneumonia and atelectasis, in patients undergoing elective cardiac surgery and may decrease the length of hospital stay by more than three days on average. There is evidence that quitting smoking at least four weeks before surgery may reduce the risk of postoperative complications.

Pharmacological approaches

Beta-blocking medication is sometimes prescribed during cardiac surgery. There is some low certainty evidence that this perioperative blockade of beta-adrenergic receptors may reduce the incidence of atrial fibrillation and ventricular arrhythmias in patients undergoing cardiac surgery.

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