Billy G G, Miller C A, Pallone M N, Donachy J H, Pierce W S
Milton S. Hershey Medical Center, Department of Surgery, Pennsylvania State University, Hershey 17033, USA.
Artif Organs. 1995 Apr;19(4):339-43. doi: 10.1111/j.1525-1594.1995.tb02338.x.
Ventricular assist devices (VADs) required for cardiac support may produce clinically significant hemolysis. VAD valves differ in both mechanics and hemodynamics. Therefore, we examined a ball valve, a modified tilting disc (MTD) valve, a polyurethane trileaflet valve, and a Björk-Shiley monostrut valve to determine their degrees of hemolysis. The valves were tested in a Pierce-Donachy VAD which pumped fresh bovine blood through a mock loop. Blood samples were analyzed for hematocrit and plasma hemoglobin, from which the indices of hemolysis were calculated. A one-way analysis of variance indicated significant differences between certain valves. The MTD was the most hemolytic. No significant hemolytic difference was found between the trileaflet and monostrut valves despite their different designs. The monostrut valve and the MTD valve were hemolytically very different despite their similar design. This study suggests that the valve type significantly affects the hemolysis produced by the VAD.
心脏支持所需的心室辅助装置(VADs)可能会产生具有临床意义的溶血。VAD瓣膜在机械学和血液动力学方面都有所不同。因此,我们检查了一个球阀、一个改良倾斜盘(MTD)瓣膜、一个聚氨酯三叶瓣膜和一个 Björk-Shiley 单支柱瓣膜,以确定它们的溶血程度。这些瓣膜在 Pierce-Donachy VAD 中进行测试,该装置通过模拟回路泵送新鲜牛血。对血样进行血细胞比容和血浆血红蛋白分析,并据此计算溶血指标。单因素方差分析表明某些瓣膜之间存在显著差异。MTD瓣膜的溶血作用最强。尽管三叶瓣膜和单支柱瓣膜设计不同,但未发现它们之间存在显著的溶血差异。尽管单支柱瓣膜和MTD瓣膜设计相似,但它们在溶血方面差异很大。这项研究表明,瓣膜类型会显著影响VAD产生的溶血。