Karimov Jamshid H, Horvath David J, Byram Nicole, Sunagawa Gengo, Grady Patrick, Sinkewich Martin, Moazami Nader, Sale Shiva, Golding Leonard A R, Fukamachi Kiyotaka
Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic.
Perfusion Services, Miller Family Heart and Vascular Institute, Cleveland Clinic.
Artif Organs. 2017 Jun;41(6):568-572. doi: 10.1111/aor.12775. Epub 2016 Sep 22.
The unique device architecture of the Cleveland Clinic continuous-flow total artificial heart (CFTAH) requires dedicated and specific air-removal techniques during device implantation in vivo. These procedures comprise special surgical techniques and intraoperative manipulations, as well as engineering design changes and optimizations to the device itself. The current study evaluated the optimal air-removal techniques during the Cleveland Clinic double-ended centrifugal CFTAH in vivo implants (n = 17). Techniques and pump design iterations consisted of developing a priming method for the device and the use of built-in deairing ports in the early cases (n = 5). In the remaining cases (n = 12), deairing ports were not used. Dedicated air-removal ports were not considered an essential design requirement, and such ports may represent an additional risk for pump thrombosis. Careful passive deairing was found to be an effective measure with a centrifugal pump of this design. In this report, the techniques and design changes that were made during this CFTAH development program to enable effective residual air removal and prevention of air embolism during in vivo device implantation are explained.
克利夫兰诊所连续流全人工心脏（CFTAH）独特的设备架构要求在体内植入设备期间采用专门且特定的排气技术。这些程序包括特殊的手术技术和术中操作，以及对设备本身的工程设计更改和优化。本研究评估了克利夫兰诊所双端离心式CFTAH体内植入（n = 17）期间的最佳排气技术。技术和泵设计迭代包括为设备开发一种灌注方法，并在早期病例（n = 5）中使用内置排气口。在其余病例（n = 12）中，未使用排气口。专用排气口不被视为一项基本设计要求，并且此类端口可能代表泵血栓形成的额外风险。发现对于这种设计的离心泵，仔细的被动排气是一种有效的措施。在本报告中，解释了在该CFTAH开发计划期间为在体内设备植入过程中实现有效去除残留空气和预防空气栓塞而进行的技术和设计更改。
