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微创经皮部署无线左心室辅助装置的设计与开发:早期原型和可行性测试。

Design and Development of a Miniaturized Percutaneously Deployable Wireless Left Ventricular Assist Device: Early Prototypes and Feasibility Testing.

出版信息

ASAIO J. 2018 Mar/Apr;64(2):147-153. doi: 10.1097/MAT.0000000000000669.

Abstract

The current left ventricular assist devices (LVADs) are limited by a highly invasive implantation procedure in a severely unstable group of advanced heart failure patients. Additionally, the current transcutaneous power drive line acts as a nidus for infection resulting in significant morbidity and mortality. In an effort to decrease this invasiveness and eliminate drive line complications, we have conceived a wireless miniaturized percutaneous LVAD, capable of being delivered endovascularly with a tether-free operation. The system obviates the need for a transcutaneous fluid purge line required in existing temporary devices by utilizing an incorporated magnetically coupled impeller for a complete seal. The objective of this article was to demonstrate early development and proof-of-concept feasibility testing to serve as the groundwork for future formalized device development. Five early prototypes were designed and constructed to iteratively minimize the pump size and improve fluid dynamic performance. Various magnetic coupling configurations were tested. Using SolidWorks and ANSYS software for modeling and simulation, several geometric parameters were varied. HQ curves were constructed from preliminary in vitro testing to characterize the pump performance. Bench top tests showed no-slip magnetic coupling of the impeller to the driveshaft up to the current limit of the motor. The pump power requirements were tested in vitro and were within the appropriate range for powering via a wireless energy transfer system. Our results demonstrate the proof-of-concept feasibility of a novel endovascular cardiac assist device with the potential to eventually offer patients an untethered, minimally invasive support.

摘要

当前的左心室辅助装置(LVAD)受到严重不稳定的晚期心力衰竭患者高度侵袭性植入程序的限制。此外,当前的经皮动力传动线作为感染的根源,导致发病率和死亡率显著增加。为了降低这种侵袭性并消除传动线并发症,我们设计了一种无线微型经皮 LVAD,能够通过无绳操作经血管内输送。该系统通过使用内置的磁耦合叶轮来实现完全密封,从而避免了现有临时设备所需的经皮液体清除线。本文的目的是展示早期开发和概念验证可行性测试,为未来的正式设备开发奠定基础。设计并制造了五个早期原型机,以逐步缩小泵的尺寸并提高流体动力学性能。测试了各种磁耦合配置。使用 SolidWorks 和 ANSYS 软件进行建模和仿真,对各种几何参数进行了变化。根据初步的体外测试构建了 HQ 曲线,以表征泵的性能。台架测试表明,在电机的当前电流限制内,叶轮与驱动轴之间存在无滑动的磁耦合。体外测试了泵的功率要求,其在通过无线能量传输系统供电的合适范围内。我们的结果证明了一种新型经皮心脏辅助装置的概念验证可行性,该装置有可能最终为患者提供无束缚、微创的支持。

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