Letsou George V, Bolch Christina M, Hord Erica C, Altman William C, Leschinsky Boris, Criscione John C
Baylor St. Luke's Medical Center, Houston, TX 77030, USA.
CorInnova, Inc., Houston, TX 77021, USA.
Rev Cardiovasc Med. 2022 Jun 9;23(6):211. doi: 10.31083/j.rcm2306211. eCollection 2022 Jun.
The CorInnova cardiac compression device (CorInnova, Inc., Houston, TX, USA) is designed to provide direct biventricular support, increase cardiac output, and improve ventricular unloading in patients with heart failure. Placed within the pericardium and surrounding both ventricles, the device has two concentric sets of thin-film polyurethane chambers: (1) inner (epicardial) saline-filled chambers that conform intimately to the epicardial surface, eradicating any gaps in the interface between the device and the heart; and (2) outer air-filled chambers cycled to provide epicardial compression during systole and negative epicardial pressure during diastole, consistent with physiological cardiac contraction and relaxation. A superelastic, collapsible Nitinol frame gives the device structure, enables minimally invasive self-deployment, and enhances diastolic filling. Preclinical testing has been extremely promising, with improvements in cardiac output and other cardiac parameters in animal heart failure models. This potentially transformative technology is moving rapidly toward first-in-human use. The CorInnova device may provide an effective device-based solution for patients with heart failure who currently have few or limited mechanical cardiac support options, including patients with biventricular cardiac failure, those with right heart failure, those who are older, and those who are of smaller size. It can be removed easily and requires minimal maintenance. An important, unique feature of this technology is that it provides mechanical cardiac assistance without blood contact or need for anticoagulation. The CorInnova device may be particularly important for those patients who have contraindications to anticoagulation due to allergy, neurological bleeds, or preexisting hemorrhage. No other mechanical circulatory support device addresses these underserved heart-failure populations.
CorInnova心脏按压装置（美国得克萨斯州休斯顿市的CorInnova公司）旨在为心力衰竭患者提供直接的双心室支持，增加心输出量，并改善心室卸载。该装置置于心包内并环绕两个心室，有两组同心的薄膜聚氨酯腔室：（1）内部（心外膜）充满盐水的腔室，紧密贴合心外膜表面，消除装置与心脏之间界面的任何间隙；（2）外部充满空气的腔室，在收缩期循环以提供心外膜按压，在舒张期提供心外膜负压，与生理性心脏收缩和舒张一致。一个超弹性、可折叠的镍钛诺框架赋予装置结构，使其能够微创自展开，并增强舒张期充盈。临床前测试前景极佳，动物心力衰竭模型的心输出量和其他心脏参数均有改善。这项具有潜在变革性的技术正迅速迈向首次人体应用。CorInnova装置可能为目前机械心脏支持选择很少或有限的心力衰竭患者提供一种基于装置的有效解决方案，包括双心室心力衰竭患者、右心衰竭患者、老年患者和体型较小的患者。它可以轻松移除，维护需求极少。这项技术的一个重要独特特征是，它在不接触血液或无需抗凝的情况下提供机械心脏辅助。对于因过敏、神经出血或既往出血而有抗凝禁忌的患者，CorInnova装置可能尤为重要。没有其他机械循环支持装置针对这些未得到充分治疗的心力衰竭人群。
