Department of Surgery, University of Michigan Health System, Ann Arbor, Michigan 48109, USA.
Ann Thorac Surg. 2012 Jan;93(1):141-6. doi: 10.1016/j.athoracsur.2011.09.014. Epub 2011 Nov 23.
Blood pumps used for temporary circulatory support have limitations. We propose a novel device designed for short-term extracorporeal support that is intrinsically volume responsive, afterload insensitive, and incapable of cavitation or excessive hemolysis. After in vitro testing, we performed the initial in vivo implantations and assessments.
The BioVAD prototype (MC3, Inc, Ann Arbor, MI) was implanted in 6 adult male sheep (60.2±2.8 kg) through the left ventricular apex and descending thoracic aorta. Arterial, left and right atrial, and pump inlet and outlet pressures and BioVAD flow were measured and recorded. The animals were volume loaded to assess volume responsiveness, and the inlet lines were abruptly clamped during maximum support to observe for cavitation. An acute heart failure model was created with rapid ventricular pacing, and the animals were supported for 4 hours.
Peak flow was 3.19±0.56 L/min and increased to 3.71±0.53 L/min with 20 mm Hg vacuum-assisted drainage. Without manual changes in pump settings, pump flow increased 17.5% with volume loading. During acute venous line occlusion, there was no evidence of cavitation, and inlet suction was minimal. Hemodynamics were maintained for 4 hours during acute heart failure.
The BioVAD provided adequate flow in an acute in vivo model. Its design may be superior for short-term extracorporeal support.
用于临时循环支持的血泵存在局限性。我们提出了一种新型装置，设计用于短期体外支持，具有固有体积反应性、无后负荷敏感性、不能产生空化或过度溶血的特点。在进行体外测试后，我们进行了初步的体内植入和评估。
BioVAD 原型机（MC3，Inc，密歇根州安阿伯）通过左心室心尖部和降主动脉植入 6 只成年雄性绵羊（60.2±2.8kg）。测量并记录动脉、左心房、右心房和泵入口及出口压力以及 BioVAD 流量。通过容量加载来评估容量反应性，并在最大支持时突然夹住入口管路以观察空化。通过快速心室起搏创建急性心力衰竭模型，并支持 4 小时。
峰值流量为 3.19±0.56L/min，在 20mmHg 真空辅助引流时增加到 3.71±0.53L/min。在没有手动更改泵设置的情况下，容量加载使泵流量增加了 17.5%。在急性静脉管路阻塞期间，没有证据表明有空化现象，入口吸力很小。在急性心力衰竭期间，血流动力学维持了 4 小时。
BioVAD 在急性体内模型中提供了足够的流量。其设计可能更适合短期体外支持。
