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植入式直接心脏按压装置的机械性心脏支持:概念验证。

Mechanical Cardiac Support With an Implantable Direct Cardiac Compression Device: Proof of Concept.

机构信息

Baylor St Luke's Medical Center, Houston, Texas; Department of Surgery, Texas Heart Institute, Houston, Texas.

CorInnova, Inc, Houston, Texas.

出版信息

Ann Thorac Surg. 2022 Nov;114(5):1944-1950. doi: 10.1016/j.athoracsur.2022.06.052. Epub 2022 Jul 31.

Abstract

PURPOSE

We examined the hemodynamic effects of a new, implantable, direct cardiac assist device in an ovine heart failure model.

DESCRIPTION

The device, which encompasses both left and right ventricles, is inserted through the pericardial apex and self-expands to encompass the heart without suturing. The intact pericardium anchors the device in place. The device has 2 concentric chamber layers: an internal chamber layer filled with fluid to conform to the heart and an external chamber layer filled with air that provides external compression and negative pressure to aid relaxation.

EVALUATION

The device was implanted in 7 sheep with heart failure induced by microsphere embolization. Cardiac performance was assessed for 6 to 8 hours. The cardiac assist device provided cardiac systolic and diastolic assistance, as shown by pressure tracings of the left ventricle and aorta, pulmonary artery flow, and +dP/dt. Central venous pressure decreased during cardiac assistance. No anatomic damage was noted postmortem.

CONCLUSIONS

Systolic and diastolic cardiac assistance can be achieved with this device that compresses and relaxes in synchrony with the native cardiac cycle.

摘要

目的

我们在羊心衰模型中研究了一种新型植入式直接心脏辅助装置的血液动力学效应。

描述

该装置包含左右心室,通过心包尖部插入并自行扩张,无需缝合即可覆盖心脏。完整的心包将装置固定在适当的位置。该装置有 2 个同心腔层:内部腔层充满液体以顺应心脏,外部腔层充满空气,提供外部压缩和负压以帮助放松。

评估

该装置被植入 7 只因微球栓塞引起心力衰竭的绵羊中。心脏性能评估持续 6 至 8 小时。左心室和主动脉的压力轨迹、肺动脉流量和 + dP/dt 显示,心脏辅助装置提供了心脏收缩和舒张辅助。在心脏辅助期间,中心静脉压下降。死后未发现解剖损伤。

结论

该装置可以实现心脏的收缩和舒张辅助,其压缩和舒张与原生心脏周期同步。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e81/9610996/f1f302642652/gr1.jpg

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