Tsukiya Tomonori
Department of Artificial Organs, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shinmachi, Suita, Osaka, 5648565, Japan.
J Artif Organs. 2025 Jan 8. doi: 10.1007/s10047-024-01492-6.
This review traces the evolution of centrifugal blood pumps in mechanical circulatory support (MCS) systems. Initially met with concerns over blood damage and thrombus formation, centrifugal pumps have become crucial components in ventricular assist devices (VADs) and extracorporeal membrane oxygenation (ECMO) due to their simplified drive mechanisms and adaptability. This paper outlines three generations of centrifugal pump development: first-generation pumps with sealing components, second-generation pumps utilizing pivot bearings, and third-generation pumps employing contactless bearings. Each iteration addressed previous limitations, particularly regarding thrombus formation and durability. Current regulatory challenges surrounding the duration of pump use in MCS are examined, highlighting the discrepancy between approved usage times and clinical needs. This paper notes ongoing efforts to extend approved use periods, citing examples of pumps cleared for extended use in various jurisdictions. This historical perspective provides insights into the technological advancements that have enhanced the safety, efficacy, and durability of centrifugal blood pumps in MCS applications.
本综述追溯了离心式血泵在机械循环支持（MCS）系统中的发展历程。离心式血泵最初因担心血液损伤和血栓形成而受到关注，但其驱动机制简化且适应性强，已成为心室辅助装置（VAD）和体外膜肺氧合（ECMO）中的关键部件。本文概述了离心式血泵的三代发展：第一代带有密封部件的泵，第二代采用枢轴轴承的泵，以及第三代采用非接触式轴承的泵。每次迭代都解决了先前的局限性，特别是在血栓形成和耐用性方面。本文研究了当前围绕MCS中泵使用时长的监管挑战，突出了批准使用时间与临床需求之间的差异。本文指出了为延长批准使用期限而正在进行的努力，并列举了在不同司法管辖区获批延长使用的泵的例子。这一历史视角为了解增强离心式血泵在MCS应用中的安全性、有效性和耐用性的技术进步提供了见解。
