Department of Internal Medicine I, University Hospital Jena, Friedrich Schiller University Jena, Jena, Germany.
EuroIntervention. 2018 Apr 6;13(18):e2116-e2121. doi: 10.4244/EIJ-D-17-00899.
Mechanical right ventricular (RV) support offers a treatment option for critically ill patients with RV failure (RVF). We developed an assist device for rapid percutaneous implantation. The aim of the present study was to investigate the implantation procedure, haemodynamic performance and possible side effects of the novel right ventricular assist device - PERKAT RV - in an animal model.
The PERkutane KATheterpumptechnologie RV (PERKAT RV) device consists of a nitinol chamber covered by foil containing inflow valves. An outlet tube is attached to its distal part. The system is designed for 18 Fr percutaneous implantation. The chamber is unfolded in the inferior vena cava while the outlet tube bypasses the right heart with the tip in the pulmonary trunk. An IABP balloon is placed inside. Balloon deflation generates blood flow into the chamber; during inflation, blood is guided into the pulmonary arteries. Acute RVF was induced by venous injection of Sephadex in seven sheep for evaluation of the device. The PERKAT RV was able to improve haemodynamics immediately generating a median increase in cardiac output of 59%. Longer pump support was evaluated in a second study. Four sheep were supported for eight hours without any problems.
The percutaneous implantation and explantation of the PERKAT RV device was possible in the designed way. The sheep studies proved beneficial haemodynamic effects in acute RVF. The system offers easy and safe treatment in acute RVF.
机械右心室(RV)支持为 RV 衰竭(RVF)的危重病患者提供了一种治疗选择。我们开发了一种用于快速经皮植入的辅助设备。本研究的目的是在动物模型中研究新型 RV 辅助装置 - PERKAT RV 的植入程序、血液动力学性能和可能的副作用。
PERkutane KATheterpumptechnologie RV(PERKAT RV)装置由覆盖有含流入阀箔片的镍钛诺腔室组成。一个出口管连接到其远端部分。该系统设计用于 18 Fr 经皮植入。腔室在腔静脉中展开,而出口管绕过右心,尖端位于肺动脉干中。在内部放置一个 IABP 球囊。球囊放气会产生血流进入腔室; 在充气期间,血液被引导进入肺动脉。在七只羊中通过静脉注射 Sephadex 诱导急性 RVF 以评估该设备。PERKAT RV 能够立即改善血液动力学,产生 59%的中位心输出量增加。在第二项研究中评估了更长时间的泵支持。四只羊在没有任何问题的情况下支持了 8 小时。
PERKAT RV 装置的经皮植入和取出是可行的。绵羊研究证明了在急性 RVF 中具有有益的血液动力学效果。该系统在急性 RVF 中提供了简单、安全的治疗方法。