Sasaki E, Nakatani T, Taenaka Y, Noda H, Tatsumi E, Akagi H, Masuzawa T, Goto M, Sakaki M, Matsuo Y
National Cardiovascular Center Research Institute, Department of Artificial Organs, Osaka, Japan.
ASAIO Trans. 1991 Jul-Sep;37(3):M280-1.
In a previous article, a left ventricular assist system (LVAS) with a percutaneous transseptal cannulation technique for easy application was described. This system was safe and efficient (maximum output greater than 3 L/min) and fitted between the intraaortic balloon pumping and LVAS with thoracotomy. But technical skill for placement was slightly complicated. The cannulation system has been improved. In the new system, the inlet cannula is initially used as a sheath introducer and is quickly inserted into the left atrium after transseptal puncture. The new inlet cannula is made of polyvinyl chloride (TM100, Toyobo, Co., Ltd., Osaka, Japan), which has excellent antithrombogenicity and low friction using a polyester plasticizer. The distal part is designed to be flexible with a spiral wire for easy manipulation. A sealing hub was installed to prevent bleeding at the proximal The simplicity and safety of the new system were examined in chronic animal experiments. The inlet cannula was placed into the left atrium within a few seconds after transseptal puncture. During 20 days of activation, there were no episodes of systemic or pulmonary embolism, although no anticoagulant was used. Under fluoroscopy, there was no thrombus formation around the cannula at removal. On the 14th day after removal, the puncture site of the septum had healed. This system is ready for clinical use and shows promise of satisfactory safety and manageability.
在前一篇文章中，描述了一种采用经皮经中隔插管技术以便于应用的左心室辅助系统（LVAS）。该系统安全且高效（最大输出大于3升/分钟），适用于主动脉内球囊反搏与开胸左心室辅助系统之间。但放置的技术操作略显复杂。插管系统已得到改进。在新系统中，入口插管最初用作鞘管引入器，经中隔穿刺后迅速插入左心房。新的入口插管由聚氯乙烯（TM100，日本大阪东洋纺株式会社）制成，其使用聚酯增塑剂具有出色的抗血栓形成性和低摩擦性。远端部分设计为带有螺旋丝的柔性结构，便于操作。在近端安装了密封接头以防止出血。在慢性动物实验中检验了新系统的简易性和安全性。经中隔穿刺后几秒钟内即可将入口插管置入左心房。在激活的20天内，尽管未使用抗凝剂，但未发生全身性或肺栓塞事件。在透视检查下，移除时插管周围未形成血栓。移除后第14天，中隔穿刺部位已愈合。该系统已准备好用于临床，显示出令人满意的安全性和可操作性。
