Department of Mechanical Engineering, School of Engineering, Tokyo Institute of Technology, Meguro, Japan.
Artif Organs. 2019 Sep;43(9):849-859. doi: 10.1111/aor.13541. Epub 2019 Aug 22.
Mechanical circulatory support devices have been used clinically for patients with heart failure for over 10 years. However, thrombus formation inside blood pumps remains a risk to patient life, causing pump failure and contributing to neurological damage through embolization. In this article, we propose a method for preventing thrombus formation by applying vibrational excitation to the impeller. We evaluate the ability of this method to enhance the antithrombogenic properties of a magnetically levitated centrifugal blood pump and ensure that the impeller vibration does not cause undue hemolysis. First, 3 vibrational conditions were compared using an isolated pump without a mock circulation loop; the vibrational excitation frequencies and amplitudes for the impeller were set to (a) 0 Hz-0 μm, (b) 70 Hz-10 μm, and (c) 300 Hz-2.5 μm. The motor torque was measured to detect thrombus formation and obtain blood coagulation time by calculating the derivative of the torque. Upon thrombus detection, the pump was stopped and thrombi size were evaluated. The results showed an increase in the blood coagulation time and a decrease in the rate of thrombus formation in pumps with the impeller vibration. Second, an in vitro hemolysis test was performed for each vibrational condition to determine the effect of impeller vibration on hemolysis. The results revealed that there was no significant difference in hemolysis levels between each condition. Finally, the selected vibration based on the above test results and the non-vibration as control were compared to investigate antithrombogenic properties under the continuous flow condition. The blood coagulation time and thrombi size were investigated. As a result, vibrational excitation of the impeller at a frequency of 300 Hz and amplitude of 2.5 μm was found to significantly lengthen clotting time, decreasing the rate of pump thrombus compared to the non-vibration condition. We indicate the potential of impeller vibration as a novel mechanical antithrombogenic mechanism for rotary blood pumps.
机械循环支持装置在心力衰竭患者的临床治疗中已经使用了 10 多年。然而,血液泵内血栓的形成仍然是患者生命的风险,导致泵衰竭,并通过栓塞导致神经损伤。在本文中,我们提出了一种通过对叶轮施加振动激励来防止血栓形成的方法。我们评估了这种方法增强磁悬浮离心血泵抗血栓形成性能的能力,并确保叶轮振动不会引起不必要的溶血。首先,在没有模拟循环回路的情况下,使用隔离泵比较了 3 种振动条件;叶轮的振动激励频率和振幅分别设置为(a)0 Hz-0 μm、(b)70 Hz-10 μm 和(c)300 Hz-2.5 μm。通过测量电机扭矩来检测血栓形成,并通过计算扭矩的导数获得血液凝固时间。在检测到血栓后,停止泵并评估血栓的大小。结果表明,带有叶轮振动的泵的血液凝固时间增加,血栓形成率降低。其次,对每种振动条件进行了体外溶血试验,以确定叶轮振动对溶血的影响。结果表明,各条件之间的溶血水平没有显著差异。最后,根据上述测试结果选择的振动条件和非振动条件作为对照,在连续流动条件下比较抗血栓形成性能。研究了血液凝固时间和血栓大小。结果表明,叶轮以 300 Hz 的频率和 2.5 μm 的振幅进行振动激励,与非振动条件相比,明显延长了凝血时间,降低了泵血栓形成的速度。我们表明了叶轮振动作为旋转血泵新型机械抗血栓形成机制的潜力。