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人工心脏瓣膜血流循环三个阶段中的相对血液损伤。

Relative blood damage in the three phases of a prosthetic heart valve flow cycle.

作者信息

Lamson T C, Rosenberg G, Geselowitz D B, Deutsch S, Stinebring D R, Frangos J A, Tarbell J M

机构信息

Applied Research Library, Pennsylvania State University, University Park 16802.

出版信息

ASAIO J. 1993 Jul-Sep;39(3):M626-33.

PMID:8268614
Abstract

Blood flow through a prosthetic heart valve operating in a ventricular assist device can be subdivided into three phases: a) forward flow through an open valve, b) rapid valve closure, and c) regurgitant back flow through a closed valve. Recent studies of fluid stresses in the Penn State Electric Left Ventricular Assist Device (PS LVAD) operating under physiologic conditions indicate that Reynolds stresses of possibly hemolytic magnitude may exist in the valve area. Although several studies have been made of the fluid stresses seen in forward flow through an open valve, few have looked at valve closure or backflow, and none have related these stresses directly to blood damage. In this study, novel in vitro blood flow loops were developed to allow for the separate analysis of the three flow phases of a Bjork-Shiley monostrut Delrin disk valve operating in a PS LVAD. Forward flow through fully open aortic and mitral valves and backflow through closed valves are studied separately in flow loops driven by a roller pump with the LVAD acting as a valve housing and compliance vessel. Valve closure is investigated with a PS LVAD operating in a low volume mock circulatory loop characterized by cavitation potential through stroboscopic videography of this mock loop, using saline as the working fluid. Rate of hemolysis, characterized by the index of hemolysis, IH, is determined for each of the three flow loops charged with fresh porcine blood.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

流经心室辅助装置中人工心脏瓣膜的血流可分为三个阶段

a) 通过开放瓣膜的正向血流;b) 瓣膜快速关闭;c) 通过关闭瓣膜的反流。最近对宾夕法尼亚州立大学电动左心室辅助装置(PS LVAD)在生理条件下运行时流体应力的研究表明,瓣膜区域可能存在具有溶血程度的雷诺应力。尽管已经对通过开放瓣膜的正向血流中的流体应力进行了多项研究,但很少有人研究瓣膜关闭或反流情况,而且没有人将这些应力与血液损伤直接联系起来。在本研究中,开发了新型体外血流回路,以便能够单独分析在PS LVAD中运行的Bjork-Shiley单支柱聚甲醛盘式瓣膜的三个血流阶段。通过完全开放的主动脉瓣和二尖瓣的正向血流以及通过关闭瓣膜的反流,在由滚轴泵驱动的血流回路中分别进行研究,其中LVAD充当瓣膜外壳和顺应性血管。使用盐水作为工作流体,通过对这个模拟回路的频闪摄影,在具有空化潜力的低容量模拟循环回路中运行PS LVAD来研究瓣膜关闭情况。对于充满新鲜猪血的三个血流回路中的每一个,都测定以溶血指数IH为特征的溶血速率。(摘要截断于250字)

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