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用于脉动式心室辅助装置的原创聚氨酯花瓣阀的设计、制造技术及体外评估

Design, Manufacturing Technology and In-Vitro Evaluation of Original, Polyurethane, Petal Valves for Application in Pulsating Ventricular Assist Devices.

作者信息

Major Roman, Gawlikowski Maciej, Sanak Marek, Lackner Juergen M, Kapis Artur

机构信息

Institute of Metallurgy and Materials Science, Polish Academy of Sciences, Reymonta Str. 25, 30-059 Cracow, Poland.

Department of Biosensors and Processing of Biomedical Signals, Faculty of Biomedical Engineering, Silesian University of Technology, Roosevelt Str. 40, 41-800 Zabrze, Poland.

出版信息

Polymers (Basel). 2020 Dec 15;12(12):2986. doi: 10.3390/polym12122986.

Abstract

Minimizing of the life-threatening thrombo-emboli formation in pulsatile heart assist devices by a new biomimetic heart valve design is presently one of the most important problems in medicine. As part of this work, an original valve structure was proposed intended for pneumatic, extracorporeal ventricular assist devices. The valve design allows for direct integration with other parts of the pulsating blood pump. Strengthening in the form of the titanium or steel frame has been introduced into the polyurethane lagging, which allows for maintaining material continuity and eliminating the risk of blood clotting. The prototype of the valve was made by the injection molding method assisted by numerical simulation of this process. The prototype was introduced into a modified pulsating, extracorporeal heart assist pump ReligaHeart EXT (developed for tilting disc valves) and examined in-vitro using the "artificial patient" model in order to determine hydrodynamic properties of the valve in the environment similar to physiological conditions. Fundamental blood tests, like hemolysis and thrombogenicity have been carried out. Very low backflow through the closed valve was observed despite their slight distortion due to pressure. On the basis of immunofluorescence tests, only slight activation of platelets was found on the inlet valve and slight increased risk of clotting of the outlet valve commissures as a result of poor valve leaflets assembling in the prototype device. No blood hemolysis was observed. Few of the clots formed only in places where the valve surfaces were not smooth enough.

摘要

通过一种新型仿生心脏瓣膜设计将搏动性心脏辅助装置中危及生命的血栓形成降至最低,是目前医学上最重要的问题之一。作为这项工作的一部分,提出了一种用于气动体外心室辅助装置的原始瓣膜结构。该瓣膜设计允许与搏动性血泵的其他部件直接集成。在聚氨酯衬里中引入了钛或钢框架形式的加强结构,这有助于保持材料的连续性并消除血液凝固的风险。瓣膜原型通过注射成型方法制造,并辅以该过程的数值模拟。将该原型引入经过改进的搏动性体外心脏辅助泵ReligaHeart EXT(专为倾斜盘式瓣膜开发),并使用“人工患者”模型进行体外测试,以确定该瓣膜在类似于生理条件的环境中的流体动力学特性。已经进行了诸如溶血和血栓形成等基本血液测试。尽管由于压力导致瓣膜略有变形,但通过关闭的瓣膜观察到非常低的回流。基于免疫荧光测试,在原型装置中,仅在入口瓣膜上发现血小板有轻微激活,并且由于瓣膜小叶组装不良,出口瓣膜连合处的凝血风险略有增加。未观察到血液溶血现象。仅在瓣膜表面不够光滑的地方形成了少量血栓。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c792/7765235/933f4e4872cc/polymers-12-02986-g001.jpg

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