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磁性活性心脏补片作为一种无需系绳、不与血液接触的心室辅助装置。

Magnetically Active Cardiac Patches as an Untethered, Non-Blood Contacting Ventricular Assist Device.

作者信息

Gu Hongri, Bertrand Thibaud, Boehler Quentin, Chautems Christophe, Vasilyev Nikolay V, Nelson Bradley J

机构信息

Institute of Robotics and Intelligent Systems ETH Zurich Zurich CH-8092 Switzerland.

Department of Cardiac Surgery Boston Children's Hospital Harvard Medical School Boston MA 02115 USA.

出版信息

Adv Sci (Weinh). 2020 Nov 27;8(1):2000726. doi: 10.1002/advs.202000726. eCollection 2020 Jan.

Abstract

Patients suffering from heart failure often require circulatory support using ventricular assist devices (VADs). However, most existing VADs provide nonpulsatile flow, involve direct contact between the blood flow and the device's lumen and moving components, and require a driveline to connect to an external power source. These design features often lead to complications such as gastrointestinal bleeding, device thrombosis, and driveline infections. Here, a concept of magnetically active cardiac patches (MACPs) that can potentially function as non-blood contacting, untethered pulsatile VADs inside a magnetic actuationsystem is reported. The MACPs, which are composed of permanent magnets and 3D-printed patches, are attached to the epicardial surfaces, thus avoiding direct contact with the blood flow. They provide powerful actuation assisting native heart pumping inside a magnetic actuation system. In ex vivo experiments on a healthy pig's heart, it is shown that the ventricular ejection fractions are as high as 37% in the left ventricle and 63% in the right ventricle. Non-blood contacting, untethered VADs can eliminate the risk of serious complications associated with existing devices, and provide an alternative solution for myocardial training and therapy for patients with heart failure.

摘要

心力衰竭患者通常需要使用心室辅助装置(VAD)来进行循环支持。然而,大多数现有的VAD提供非搏动性血流,涉及血流与装置内腔及运动部件之间的直接接触,并且需要一条驱动线连接到外部电源。这些设计特点常常导致诸如胃肠道出血、装置血栓形成和驱动线感染等并发症。在此,报道了一种磁活性心脏贴片(MACP)的概念,其在磁驱动系统中有可能作为非血液接触、无束缚的搏动性VAD发挥作用。由永磁体和3D打印贴片组成的MACP附着于心外膜表面,从而避免与血流直接接触。它们在磁驱动系统中提供强大的驱动作用,辅助心脏的自然泵血。在对健康猪心脏进行的体外实验中,结果表明左心室的心室射血分数高达37%,右心室高达63%。非血液接触、无束缚的VAD可以消除与现有装置相关的严重并发症风险,并为心力衰竭患者的心肌训练和治疗提供替代解决方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5813/7788498/7d00f272bb8a/ADVS-8-2000726-g001.jpg

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