Deleuze P, Okude J, Leandri J, Rey P, Loisance D
Centre de Recherches Chirurgicales, CNRS UA 591, C.H.U. Henri Mondor, Créteil, France.
ASAIO Trans. 1989 Jul-Sep;35(3):442-4. doi: 10.1097/00002480-198907000-00087.
Cannulae for paracorporeal ventricular assist devices have been clinically shown to be limiting factors in optimal circulatory support. A new inflow cannula has been manufactured according to an original silicone rubber molding process, permitting a hemocompatible inner surface. The cannula is 200 mm in length, with a 10 mm internal diameter. The wall is 3 mm thick and reinforced by a stainless steel spiral spring embedded in the silicone. An external ring permits adequate interface between the cannula and the endocardial surface of the atrium. A compliant external segment on the inflow cannula, free of any spiral spring, allows adjustment of vacuum to optimal values, thus avoiding inflow obstruction. The cannula has been tested during 1 to 5 days of left ventricular bypass in calves (n = 15). A Symbion AVAD, Utah 85 VAD, or Centrimed pumps were used. Adequate heparinization was maintained throughout. Paracorporeal flow was 0.045 L min-1 kg-1. In vivo evaluation was made by hemodynamic studies and the incidence of thromboembolism. The cardiac cavities, cannulae, and peripheral vessels were carefully searched for thrombi and emboli at autopsy. The atrium, the interface between atrium and silicone cannula, and the cannula itself were found free of any deposit. This aspect differed from that observed previously with available PU or PVC cannulae.
体外心室辅助装置的插管在临床上已被证明是实现最佳循环支持的限制因素。一种新的流入插管是根据原始的硅橡胶成型工艺制造的,其内部表面具有血液相容性。该插管长度为200毫米,内径为10毫米。管壁厚度为3毫米,由嵌入硅橡胶的不锈钢螺旋弹簧加固。一个外环使插管与心房的心内膜表面之间有足够的界面。流入插管上的一个顺应性外部段没有任何螺旋弹簧,可将真空调节到最佳值,从而避免流入阻塞。该插管在小牛的左心室旁路手术中进行了1至5天的测试(n = 15)。使用了Symbion AVAD、犹他85 VAD或Centrimed泵。在整个过程中保持了充分的肝素化。体外血流量为0.045 L min-1 kg-1。通过血流动力学研究和血栓栓塞的发生率进行体内评估。在尸检时仔细检查心脏腔、插管和外周血管是否有血栓和栓子。发现心房、心房与硅橡胶插管之间的界面以及插管本身没有任何沉积物。这一点与以前使用的聚氨酯或聚氯乙烯插管的情况不同。