Yokoyama Yoshimasa, Kawaguchi Osamu, Shinshi Tadahiko, Steinseifer Ulrich, Takatani Setsuo
Department of Artificial Organs, Institute of Biomaterials and Bioengineering, Tokyo Medical and Dental University, 2-3-10 Surugadai, Kanda, Chiyoda-ku, Tokyo, 101-0062, Japan.
J Artif Organs. 2010 Dec;13(4):189-96. doi: 10.1007/s10047-010-0518-8. Epub 2010 Sep 28.
A new pulse duplicator was designed for evaluation of the performance of ventricular assist devices through pressure-volume (P-V) diagrams of the native heart. A linear drive system in combination with a pusher-plate mechanism was designed as a drive system to implement the passive fill mechanism during diastole of the mock ventricle. The compliances of the native heart during both diastole and systole were simulated by placing a ventricle sack made of soft latex rubber in a sealed chamber and by varying the air-to-fluid volume ratio inside the chamber. The ratio of the capacities of the systemic venous and pulmonary circuits was adjusted to properly reflect the effects of volume shift between them. As the air-to-fluid volume ratio was varied from 1:12.3 to 1:1.58, the contractility of the ventricle expressed by E (max) varied from 1.75 to 0.56 mmHg/ml with the mean V (0) of 4.58 ml closely mimicking those of native hearts (p < 0.05). Because the E (max) value of the normal human heart ranges from 1.3 to 1.6, with a value below 1.0 indicating heart failure, the mock ventricle is applicable in simulating the dynamics of the normal heart and the sick heart. The P-V diagram changes seen with rotary blood pump assistance revealed changes similar to those reported by other workers. The effects of the ventricular assist device, either pulsatile or continuous flow, on cardiac dynamics can be easily simulated with this system to derive design criteria for clinical circulatory assist devices.
设计了一种新型脉搏复制器,用于通过天然心脏的压力-容积(P-V)图评估心室辅助装置的性能。设计了一种线性驱动系统与推板机构相结合的驱动系统,作为在模拟心室舒张期实现被动充盈机制的驱动系统。通过将由软乳胶制成的心室袋放置在密封腔室中,并改变腔室内空气与液体的体积比,来模拟天然心脏在舒张期和收缩期的顺应性。调整体循环静脉和肺循环的容量比,以适当反映它们之间的容量转移效应。随着空气与液体的体积比从1:12.3变化到1:1.58,以E(max)表示的心室收缩力从1.75变化到0.56 mmHg/ml,平均V(0)为4.58 ml,与天然心脏的情况非常相似(p < 0.05)。由于正常人心脏的E(max)值范围为1.3至1.6,低于1.0的值表示心力衰竭,因此该模拟心室可用于模拟正常心脏和患病心脏的动力学。在旋转血泵辅助下观察到的P-V图变化与其他研究人员报告的变化相似。使用该系统可以轻松模拟搏动性或连续流式心室辅助装置对心脏动力学的影响,从而得出临床循环辅助装置的设计标准。