Takano Tamaki, Schulte-Eistrup Sebastian, Kawahito Shinji, Maeda Tomohiro, Nonaka Kenji, Linneweber Joerg, Glueck Julie, Fujisawa Akira, Makinouchi Kenzo, Yokokawa Michihiro, Nosé Yukihiko
Department of Surgery, Baylor College of Medicine, Houston, Texas, USA.
Artif Organs. 2002 Jan;26(1):67-71. doi: 10.1046/j.1525-1594.2002.6849_5.x.
To design a miniaturized centrifugal blood pump, the impeller internal diameter (ID), which is a circle diameter on the inner edge of the vane, is considered one of the important aspects. Hydraulic performance, hemolysis, and thrombogenicity were evaluated with different impeller IDs. Two impellers were fabricated with an outer diameter of 35 mm, of which 1 had an 8 mm ID impeller and the other had a 12 mm ID. These impellers were combined with 2 different housings in which the inlet port was eccentrically positioned 3.8 and 4.5 mm offset from the center. The hydraulic performance and hemolysis were evaluated in a mock circuit, and thrombogenicity was evaluated in a 2 day ex vivo study with each impeller housing combination. Both impellers required 3,000 rpm in the 3.8 mm offset inlet to attain 5 L/min against 100 mm Hg (left ventricular assist device condition). The 8 mm ID impeller required 3,200 rpm, and the 12 mm ID impeller required 3,100 rpm in the 4.5 mm offset housing. The normalized index of hemolysis was 0.0080 +/- 0.0048 g/100 L in the 8 mm ID impeller with the 3.8 mm offset and 0.022 +/- 0.018 g/100 L with 4.5 mm offset. The 12 mm ID impeller had 0.068 +/- 0.028 g/100 L with the 3.8 mm offset and 0.010 +/- 0.002 g/100 L with the 4.5 mm offset. After the 2 day ex vivo study, no blood clot was formed around the top bearing in all the pump heads. The 8 mm ID impeller with 3.8 mm offset inlet and the 12 mm ID impeller with the 4.5 mm offset had less hemolysis compared to the other pump heads that were subjected to 14 day ex vivo and 10 day in vivo studies. The 8 mm ID impeller with the 3.8 mm offset inlet had a blood clot around the top bearing after the 14 day ex vivo study. No thrombus was found around the top bearing of the 12 mm ID impeller with the 4.5 mm offset in the 10 day in vivo study. These results suggest that the ID does not greatly change the hydraulic performance of a small centrifugal blood pump. The proper combination of the impeller ID and inlet port offset obtains less hemolysis. The larger impeller ID is considered to have less thrombogenicity around the top bearing.
为设计一种小型离心式血泵,叶轮内径(ID)(即叶片内边缘的圆直径)被视为重要方面之一。对不同叶轮内径的血泵进行了水力性能、溶血和血栓形成倾向评估。制作了两个外径为35 mm的叶轮,其中一个叶轮内径为8 mm,另一个叶轮内径为12 mm。这些叶轮与两种不同的外壳组合,其入口端口偏心位于偏离中心3.8 mm和4.5 mm处。在模拟回路中评估水力性能和溶血,在一项为期2天的体外研究中对每种叶轮-外壳组合评估血栓形成倾向。在入口偏移3.8 mm的情况下,两个叶轮均需3000转/分钟才能在100 mmHg(左心室辅助装置条件)下达到5 L/分钟。在入口偏移4.5 mm的外壳中,8 mm内径的叶轮需要3200转/分钟,12 mm内径的叶轮需要3100转/分钟。8 mm内径、入口偏移3.8 mm的叶轮溶血标准化指数为0.0080±0.0048 g/100 L,入口偏移4.5 mm时为0.022±0.018 g/100 L。12 mm内径的叶轮入口偏移3.8 mm时为0.068±0.028 g/100 L,入口偏移4.5 mm时为0.010±0.002 g/100 L。在为期2天的体外研究后,所有泵头的顶部轴承周围均未形成血凝块。与其他进行了14天体外和10天体内研究的泵头相比,入口偏移3.8 mm的8 mm内径叶轮和入口偏移4.5 mm的12 mm内径叶轮溶血较少。在为期14天的体外研究后,入口偏移3.8 mm的8 mm内径叶轮顶部轴承周围出现了血凝块。在为期10天的体内研究中,入口偏移4.5 mm的12 mm内径叶轮顶部轴承周围未发现血栓。这些结果表明,内径对小型离心式血泵的水力性能影响不大。叶轮内径和入口端口偏移的适当组合可减少溶血。较大的叶轮内径被认为在顶部轴承周围血栓形成倾向较小。