von Segesser L K, Lachat M, Gallino A, Weiss B M, Leskosek B, Garcia E, Hänseler E, von Felten A, Turina M
Clinic for Cardiovascular Surgery, University Hospital, Zürich, Switzerland.
Thorac Cardiovasc Surg. 1990 Aug;38(4):224-8. doi: 10.1055/s-2007-1014022.
Heparin surface coating is one approach to improve the biocompatibility of existing blood pumps used for mechanical circulatory support. Experimental evaluation of centrifugal pumps with heparin surface coating was performed during open chest left heart bypass (3.7 L/min over 6 hours) in two series of bovine experiments. Eight calves (74 +/- 4 kg) were perfused either by heparin surface coated equipment without systemic heparinization or uncoated equipment with systemic heparinization (300 I. U,/kg bodyweight; ACT greater than 400 s). A standard battery of analyses was performed before and at regular intervals after onset of perfusion. At the end of perfusion all pump-heads were gently rinsed. There were no macroscopic clots for both groups whereas macroscopic clots were observed in uncoated tubings introduced for control in the group perfused without systemic heparinization. The hemodynamics were significantly better in the group perfused without systemic heparinization and maintained functional coagulation system. Clinical application of heparin surface coated equipment during resection of thoraco-abdominal aortic aneurysms is showing promising results in 12 patients.
肝素表面涂层是一种改善用于机械循环支持的现有血泵生物相容性的方法。在两组牛实验的开胸左心旁路手术(6小时内流量为3.7升/分钟)期间,对带有肝素表面涂层的离心泵进行了实验评估。八头小牛(74±4千克)分别使用未进行全身肝素化的肝素表面涂层设备或进行全身肝素化(300国际单位/千克体重;活化凝血时间大于400秒)的未涂层设备进行灌注。在灌注开始前和定期进行一组标准分析。灌注结束时,轻轻冲洗所有泵头。两组均未观察到肉眼可见的凝块,而在未进行全身肝素化灌注的组中,用于对照的未涂层管道中观察到了肉眼可见的凝块。未进行全身肝素化灌注的组血流动力学明显更好,且凝血系统保持功能正常。肝素表面涂层设备在胸腹主动脉瘤切除术中的临床应用在12例患者中显示出了有前景的结果。