Kretzschmar Daniel, Schulze P Christian, Ferrari Markus W
From the *Department of Internal Medicine I, Division of Cardiology, Friedrich-Schiller-University Jena, Jena, Germany; and †HSK, Clinic of Internal Medicine I, Helios-Kliniken, Wiesbaden, Germany.
ASAIO J. 2017 Mar/Apr;63(2):123-127. doi: 10.1097/MAT.0000000000000464.
Acute right ventricular failure (RVF) is an increasing clinical problem and a life-threatening condition. Right ventricular assist devices represent a reasonable treatment option for patients with refractory RVF. We here present a novel percutaneously implantable device for right ventricular support. The PERKAT device is based on a nitinol stent cage, which is covered with valve-carrying foils. A flexible outlet trunk with a pigtail tip is connected to the distal part. The device is driven by an intra-aortic balloon pump (IABP) drive unit, which inflates/deflates a standard IABP-balloon placed within the stent cage. In-vitro evaluation was done in a liquid bath containing water or blood analog. The PERKAT device was tested in different afterload settings using two different IABP-balloons and varying inflation/deflation rates. We detected flow rates ranging from 1.97 to 3.93 L/min depending on the afterload setting, inflation/deflation rate, balloon size, and the medium used. Flow rates between water and blood analog were nearly comparable, and in the higher inflation/deflation rate settings slightly higher with water. Based on this promising in vitro data, the innovative percutaneously implantable PERKAT device has a potential to become a therapeutic option for patients with RVF refractory to medical treatment.
急性右心室衰竭（RVF）是一个日益严重的临床问题，也是一种危及生命的病症。右心室辅助装置是治疗难治性RVF患者的一种合理选择。我们在此展示一种新型的可经皮植入的右心室支持装置。PERKAT装置基于一个镍钛诺支架笼，上面覆盖着带有瓣膜的箔片。一个带有猪尾尖端的柔性出口管道连接到远端部分。该装置由主动脉内球囊泵（IABP）驱动单元驱动，该驱动单元对放置在支架笼内的标准IABP球囊进行充气/放气。在含有水或血液模拟物的液浴中进行体外评估。使用两种不同的IABP球囊并改变充气/放气速率，在不同后负荷设置下对PERKAT装置进行测试。根据后负荷设置、充气/放气速率、球囊大小和所使用的介质，我们检测到的流速范围为1.97至3.93升/分钟。水和血液模拟物之间的流速几乎相当，在较高的充气/放气速率设置下，水的流速略高。基于这些有前景的体外数据，创新的可经皮植入的PERKAT装置有可能成为药物治疗难治性RVF患者的一种治疗选择。
