Miyamoto Takuma, Kado Yuichiro, Horvath David J, Kuban Barry D, Sale Shiva, Fukamachi Kiyotaka, Karimov Jamshid H
Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio.
R1 Engineering, Euclid, Ohio.
JTCVS Open. 2020 Jun 20;3:140-148. doi: 10.1016/j.xjon.2020.06.006. eCollection 2020 Sep.
The Advanced ventricular assist device (Advanced VAD) is designed as a universal pump intended to prevent backflow in the event of pump stoppage, to maintain physiological pulse pressure, and to be used as both a left and right VAD. The purpose of this study was to evaluate the performance of the Advanced VAD as both a left and right VAD in an acute in vivo study in calves.
The Advanced VAD was implanted through a median sternotomy in 5 healthy calves (weight, 71.4-91.2 kg) as a left VAD (n = 3) or a right VAD (n = 2). After implantation, hemodynamic parameters, including general performance and pump stoppage, were evaluated.
The Advanced VAD was successfully implanted as a left and right VAD without cardiopulmonary bypass. The speed range of the Advanced VAD was 2500 to 3500 rpm as a left VAD and 2000 to 2500 rpm as a right VAD. Up to 4.3 L/min was achieved for both left and right VAD configurations. To demonstrate the automatic shut-off feature, the pump was stopped without clamping the outflow graft. The outflow graft was then clamped, which produced no significant changes in the arterial pressure waveform. The pulse pressures under the left VAD configuration were 38 mm Hg, 17 mm Hg, 14 mm Hg, and 16 mm Hg at baseline, 2500 rpm, 3000 rpm, and 3500 rpm, respectively.
This acute in vivo study demonstrated the pump performance, anatomical fitting as both left VAD and right VAD, and regurgitant flow shut-off feature of the Advanced VAD.
先进心室辅助装置(Advanced VAD)被设计为一种通用泵,旨在防止泵停止工作时出现逆流,维持生理脉压,并可同时用作左心室辅助装置和右心室辅助装置。本研究的目的是在一项针对小牛的急性体内研究中评估Advanced VAD作为左心室辅助装置和右心室辅助装置的性能。
通过正中胸骨切开术将Advanced VAD植入5头健康小牛(体重71.4 - 91.2千克)体内,作为左心室辅助装置(n = 3)或右心室辅助装置(n = 2)。植入后,评估包括总体性能和泵停止工作在内的血流动力学参数。
Advanced VAD成功作为左心室辅助装置和右心室辅助装置植入,无需体外循环。作为左心室辅助装置时,Advanced VAD的转速范围为2500至3500转/分钟,作为右心室辅助装置时为2000至2500转/分钟。左心室辅助装置和右心室辅助装置配置下的流量均达到了4.3升/分钟。为了演示自动关闭功能,在不夹闭流出道移植物的情况下停止泵。然后夹闭流出道移植物,动脉压波形未发生显著变化。左心室辅助装置配置下,基线、2500转/分钟、3000转/分钟和3500转/分钟时的脉压分别为38毫米汞柱、17毫米汞柱、14毫米汞柱和16毫米汞柱。
这项急性体内研究证明了Advanced VAD的泵性能、作为左心室辅助装置和右心室辅助装置的解剖适配性以及反流关闭功能。