Szycher M, Clay W, Gernes D, Sherman C
Thermedics, Inc., Woburn, MA 01888-1799.
J Biomater Appl. 1986 Jul;1(1):39-105. doi: 10.1177/088532828600100103.
Temporary and permanent ventricular assist systems, developed by Thermedics, Inc., are described, including rationale, design, operation and surgical applications. Clinical data are presented for pneumatically driven temporary left ventricular assist devices (LVAD). Usefulness of this device rests on the assumption that tissue of a weakened heart can recover if relieved for a time by an LVAD. The surgical implantation of an LVAD is reported in a case where the patient later received a heart transplant. The concept and technology of the subsystems of a permanent ventricular assist system (VAS), now ready for preclinical trials, are discussed. Design of a low-speed, torque-motor driven blood pump is described. Details are presented on transcutaneous energy transmission by means of a transformer, one of whose coils is embedded under the skin. Though less efficient than percutaneous transmission, the method eliminates infection risk. Special types of polyurethanes are analyzed in respect to their biocompatibility. It is concluded that flocking of the polyurethane surface allows the growth of a biological lining which is highly antithrombogenic. Sintered metal powders are found to be most efficient for fabrication of rigid pump components. A lenticular pump design is proposed to solve the problem of pressure differentials in the sealed device. Cardiac endocrine functions are cited in support of using assist devices that leave the heart in place.
介绍了由Thermedics公司开发的临时性和永久性心室辅助系统,包括其原理、设计、操作和外科应用。给出了气动驱动临时性左心室辅助装置(LVAD)的临床数据。该装置的有效性基于这样一种假设,即如果通过LVAD使衰弱心脏的组织得到一段时间的缓解,它就能恢复。报告了1例LVAD手术植入病例,该患者后来接受了心脏移植。讨论了现已准备好进行临床前试验的永久性心室辅助系统(VAS)子系统的概念和技术。描述了一种低速、扭矩电机驱动的血泵设计。介绍了通过变压器进行经皮能量传输的细节,其中一个线圈埋于皮下。该方法虽然不如经皮传输有效,但消除了感染风险。分析了特殊类型的聚氨酯的生物相容性。得出的结论是,聚氨酯表面植绒可促进具有高度抗血栓形成能力的生物内膜生长。发现烧结金属粉末最适合用于制造刚性泵部件。提出了一种双凸透镜形泵设计,以解决密封装置中的压力差问题。引用心脏内分泌功能来支持使用使心脏留在原位的辅助装置。