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牛的 EVAHEART 2 离心式左心室辅助装置的临床前评估。

Preclinical Evaluation of the EVAHEART 2 Centrifugal Left Ventricular Assist Device in Bovines.

机构信息

From the Evaheart, Inc, Houston, Texas.

Texas A&M Institute for Preclinical Studies (TIPS), Texas A&M University, College Station, Texas.

出版信息

ASAIO J. 2019 Nov/Dec;65(8):845-854. doi: 10.1097/MAT.0000000000000869.

Abstract

The EVAHEART 1 left ventricular assist device was miniaturized to the EVAHEART 2, with a new inflow cannula designed to mitigate the risks of malposition. To evaluate the safety of the new double-cuff tipless inflow cannula, in vivo studies were performed in healthy bovines. Eight consecutive studies were done: five short-term studies of hematological adaptation and three long-term studies of tissue adaptation. Each inflow cannula was purposefully implanted in the worst-case setting with marked malposition. Two studies terminated early: one because of an animal-specific ancillary component and one because of an accidental radial fracture. Six studies reached the study endpoint without major adverse events. One animal could not achieve proper anticoagulation because of warfarin resistance. Pump speed and power were maintained within stable, normal ranges. There were no major organ dysfunction or suction events. Necropsy results showed two cases of pannus formation around the inflow ostium because of warfarin resistance and hyperinflammation at the inflow cuff suture line. There was one case of trivial pannus; four cases were pannus-free, with no evidence of ventricular wall suction. No wedge thrombus formation occurred. The EVAHEART 2 tipless inflow cannula may reduce adverse events attributable to the inflow cannula, such as stroke.

摘要

EVAHEART 1 左心室辅助装置被缩小为 EVAHEART 2,新的流入管旨在降低错位风险。为了评估新的双袖口无尖端流入管的安全性,在健康的牛中进行了体内研究。连续进行了八项研究:五项短期血液学适应性研究和三项长期组织适应性研究。每个流入管都故意以明显的错位植入最坏的情况。有两项研究提前终止:一项是因为动物特有的辅助组件,另一项是因为意外的桡骨骨折。六项研究达到研究终点,没有重大不良事件。由于华法林抵抗,一只动物无法实现适当的抗凝。泵速和功率保持在稳定、正常的范围内。没有主要的器官功能障碍或抽吸事件。尸检结果显示两例由于华法林抵抗和流入袖口缝线处的过度炎症而在流入口周围形成的假性瘤。有一例假性瘤较小;四例假性瘤无,无心室壁抽吸的证据。没有楔形血栓形成。EVAHEART 2 无尖端流入管可能会减少与流入管相关的不良事件,如中风。

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