Karigyo Carlos J T, Biscegli José F, Bock Eduardo G P, Fonseca Jeison W G, Leme Juliana, Silva Bruno U, Andrade Aron J P
Centro de Engenharia em Assistência Circulatória, Instituto Dante Pazzanese de Cardiologia, São Paulo, São Paulo, Brazil.
Postgraduate Program in Medicine/Technology and Intervention in Cardiology, Universidade de São Paulo, São Paulo, São Paulo, Brazil.
Braz J Cardiovasc Surg. 2025 Jul 24;40(5):e20240209. doi: 10.21470/1678-9741-2024-0209.
Ventricular assist devices have been widely accepted as an alternative treatment for advanced heart failure, while heart transplantation is a limited procedure because of the shortage of donors. In face of a scarce availability of these devices, many centers around the world have developed their own technologies. We describe historical and general features of the main ventricular assist devices developed at the Instituto Dante Pazzanese de Cardiologia. The auxiliary total artificial heart is an electromechanical pulsatile blood pump with left and right chambers, being originally designed to work as a heterotopic artificial heart. The spiral pump is a disposable device and currently available for clinical use in cardiopulmonary bypass. It works through a combination of centrifugal and axial pumping principles coming from a conically shaped impeller. The implantable centrifugal blood pump was conceived for long-term circulatory assistance with a unique impeller design concept producing a mixed flow. The apico-aortic blood pump consists of a miniaturized centrifugal pump originally conceived for bridge to transplantation strategy. The temporary circulatory support device is a new centrifugal blood pump for temporary ventricular assistance developed with the purpose of bridge-to-decision or recovery strategies. Additionally, the hybrid cardiovascular simulator was developed as a tool to test blood pumps as they minimize the need for animal experiments. Brazil represents an important reference with a few academic groups with a considerable output in ventricular assist devices research and development. Notable devices produced at Instituto Dante Pazzanese de Cardiologia have demonstrated excellent results for clinical application.
心室辅助装置已被广泛接受为晚期心力衰竭的替代治疗方法，而心脏移植由于供体短缺是一种有限的治疗手段。面对这些装置的稀缺供应，世界各地的许多中心都开发了自己的技术。我们描述了但丁·帕扎内塞心脏病学研究所开发的主要心室辅助装置的历史和一般特征。辅助全人工心脏是一种带有左右腔室的机电搏动血泵，最初设计用作异位人工心脏。螺旋泵是一种一次性装置，目前可用于体外循环的临床应用。它通过来自锥形叶轮的离心和轴向泵送原理的组合来工作。植入式离心血泵采用独特的叶轮设计概念产生混合流，旨在提供长期循环辅助。心尖 - 主动脉血泵由最初为过渡到移植策略而设计的小型化离心泵组成。临时循环支持装置是一种新型离心血泵，用于临时心室辅助，旨在实现过渡到决策或恢复策略。此外，开发了混合心血管模拟器作为测试血泵的工具，因为它最大限度地减少了动物实验的需求。巴西是一个重要的参考对象，有几个学术团体在心室辅助装置的研发方面有相当多的成果。但丁·帕扎内塞心脏病学研究所生产的著名装置已在临床应用中显示出优异的效果。
