Fukamachi Kiyotaka, Karimov Jamshid H, Byram Nicole A, Sunagawa Gengo, Dessoffy Raymond, Miyamoto Takuma, Horvath David J
Department of Biomedical Engineering/ND20, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.
R1 Engineering, Euclid, OH, USA.
J Artif Organs. 2018 Sep;21(3):383-386. doi: 10.1007/s10047-018-1039-0. Epub 2018 Apr 3.
The purpose of this study was to assess the smallest possible body sizes of patients in whom the Cleveland Clinic continuous-flow total artificial heart for adult (CFTAH) and pediatric configurations (P-CFTAH) can fit. One of the most critical dimensions is the vertebra-to-sternum distance at the junction of the right atrium to the inferior vena cava (V-S distance). Our previous CFTAH anatomical fitting study suggested that the CFTAH would fit patients of V-S distance ≥ 7.5 cm and the P-CFTAH of V-S distance ≥ 5.25 cm (70% of 7.5 cm). To confirm this, we assessed the relationship between body surface area (BSA) and V-S distance in 15 adult patients (BSA 1.86-2.62 m) and 31 pediatric patients (BSA 0.17-1.80 m) whose computed tomography scans were available. We found a highly significant correlation between BSA and V-S distance (p < 1.0 × 10). It appears that the CFTAH will fit in most patients with BSA ≥ 1.0 m (corresponding height of ≥ 130 cm and age of 9 years) and the P-CFTAH in patients with BSA ≥ 0.3 m (corresponding height of ≥ 55 cm and age of 1 month). Further anatomical fitting studies are needed to evaluate the two pump models inside human chests to determine the smallest patient size/critical dimensions and device port configurations.
本研究的目的是评估可适配克利夫兰诊所成人连续流全人工心脏（CFTAH）和儿科配置（P-CFTAH）的患者的最小可能体型。最关键的尺寸之一是右心房与下腔静脉交界处的椎体至胸骨距离（V-S距离）。我们之前的CFTAH解剖适配研究表明，CFTAH适合V-S距离≥7.5 cm的患者，P-CFTAH适合V-S距离≥5.25 cm（7.5 cm的70%）的患者。为了证实这一点，我们评估了15名成年患者（体表面积1.86 - 2.62 m²）和31名儿科患者（体表面积0.17 - 1.80 m²）的体表面积（BSA）与V-S距离之间的关系，这些患者的计算机断层扫描图像可用。我们发现BSA与V-S距离之间存在高度显著的相关性（p < 1.0×10）。似乎CFTAH适合大多数体表面积≥1.0 m²（相应身高≥130 cm且年龄9岁）的患者，P-CFTAH适合体表面积≥0.3 m²（相应身高≥55 cm且年龄1个月）的患者。需要进一步的解剖适配研究来评估人体胸腔内的这两种泵模型，以确定最小患者体型/关键尺寸和设备端口配置。
