Martinez Thomas, Jahren Silje Ekroll, Walter Armando, Chavanne Jonathan, Clavica Francesco, Ferrari Lorenzo, Heinisch Paul Philipp, Casoni Daniela, Haeberlin Andreas, Luedi Markus M, Obrist Dominik, Carrel Thierry, Civet Yoan, Perriard Yves
Integrated Actuators Laboratory (LAI), École polytechnique fédérale de Lausanne (EPFL) Neuchâtel Switzerland.
ARTORG Center for Biomedical Engineering Research University of Bern Bern Switzerland.
Bioeng Transl Med. 2022 Aug 22;8(2):e10396. doi: 10.1002/btm2.10396. eCollection 2023 Mar.
Although heart transplant is the preferred solution for patients suffering from heart failures, cardiac assist devices remain key substitute therapies. Among them, aortic augmentation using dielectric elastomer actuators (DEAs) might be an alternative technological application for the future. The electrically driven actuator does not require bulky pneumatic elements (such as conventional intra-aortic balloon pumps) and conforms tightly to the aorta thanks to the manufacturing method presented here. In this study, the proposed DEA-based device replaces a section of the aorta and acts as a counterpulsation device. The feasibility and validation of in vivo implantation of the device into the descending aorta in a porcine model, and the level of support provided to the heart are investigated. Additionally, the influence of the activation profile and delay compared to the start of systole is studied. We demonstrate that an activation of the DEA just before the start of systole (30 ms at 100 bpm) and deactivation just after the start of diastole (0-30 ms) leads to an optimal assistance of the heart with a maximum energy provided by the DEA. The end-diastolic and left ventricular pressures were lowered by up to 5% and 1%, respectively, compared to baseline. The early diastolic pressure was augmented in average by up to 2%.
尽管心脏移植是心力衰竭患者的首选治疗方案,但心脏辅助装置仍是重要的替代疗法。其中,使用介电弹性体驱动器(DEA)进行主动脉增强可能是未来一种替代性的技术应用。这种电动驱动器不需要庞大的气动元件(如传统的主动脉内球囊泵),并且由于本文介绍的制造方法,它能紧密贴合主动脉。在本研究中,所提出的基于DEA的装置替代了一段主动脉,并作为一种反搏装置。研究了该装置在猪模型中植入降主动脉的体内可行性和有效性,以及对心脏提供的支持水平。此外,还研究了与收缩期开始相比,激活曲线和延迟的影响。我们证明,在收缩期开始前(心率100次/分时为30毫秒)激活DEA,在舒张期开始后(0 - 30毫秒)停用DEA,可导致心脏获得最佳辅助,且DEA提供的能量最大。与基线相比,舒张末期压力和左心室压力分别降低了5%和1%。舒张早期压力平均增加了2%。