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轴流心室辅助装置的研发:体外和体内评估

Development of an axial flow ventricular assist device: in vitro and in vivo evaluation.

作者信息

Mizuguchi K, Damm G, Benkowsky R, Aber G, Bacak J, Svjkovsky P, Glueck J, Takatani S, Nosé Y, Noon G P

机构信息

Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA.

出版信息

Artif Organs. 1995 Jul;19(7):653-9. doi: 10.1111/j.1525-1594.1995.tb02397.x.

DOI:10.1111/j.1525-1594.1995.tb02397.x
PMID:8572968
Abstract

A collaborative effort between Baylor College of Medicine and NASA/Johnson Space Center is underway to develop an axial flow ventricular assist device (VAD). We evaluated inducer/impeller component designs in a series of in vitro hemolysis tests. As a result of computational fluid dynamic analysis, a flow inducer was added to the front of the pump impeller. According to the surface pressure distribution, the flow inducer blades were connected to the impeller long blades. This modification eliminated high negative pressure areas at the leading edge of the impeller. Comparative studies were performed between inducer blade sections that flowed smoothly into the impeller blades (continuous blades) and those that formed discrete separate pumping sections (discontinuous blades). The inducer/impeller with continuous blades showed significantly (p < 0.003) lower hemolysis with a normalized index of hemolysis (NIH) of 0.018 +/- 0.007 g/100 L (n = 3), compared with the discontinuous model, which demonstrated an NIH of 0.050 +/- 0.007 g/100 L (n = 3). The continuous blade model was evaluated in vivo for 2 days with no problems. One of the pumps evaluated ran for 5 days in vivo although thrombus formation was recognized on the flow straightener and the inducer/impeller. As a result of this study, the pump material was changed from polyether polyurethane to polycarbonate. The fabrication method was also changed to a computer numerically controlled (CNC) milling process with a final vapor polish. These changes resulted in an NIH of 0.0029 +/- 0.0009 g/100 L (n = 4), which is a significant (p < .0001) value 6 times less than that of the previous model.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

贝勒医学院与美国国家航空航天局/约翰逊航天中心正在合作研发一种轴流式心室辅助装置(VAD)。我们在一系列体外溶血试验中评估了诱导轮/叶轮组件设计。经过计算流体动力学分析,在泵叶轮前端增加了一个导流器。根据表面压力分布,导流器叶片与叶轮长叶片相连。这种改进消除了叶轮前缘的高负压区域。对能顺利流入叶轮叶片的诱导轮叶片部分(连续叶片)和形成离散独立泵送部分的诱导轮叶片部分(间断叶片)进行了对比研究。连续叶片的诱导轮/叶轮的溶血水平显著更低(p < 0.003),溶血标准化指数(NIH)为0.018 +/- 0.007 g/100 L(n = 3),而间断模型的NIH为0.050 +/- 0.007 g/100 L(n = 3)。连续叶片模型在体内评估了2天,未出现问题。所评估的其中一台泵在体内运行了5天,不过在整流器以及诱导轮/叶轮上发现了血栓形成。这项研究的结果是,泵材料从聚醚聚氨酯改为聚碳酸酯。制造方法也改为计算机数控(CNC)铣削工艺并进行最终的蒸汽抛光。这些改变使NIH达到了0.0029 +/- 0.0009 g/100 L(n = 4),这是一个显著(p <.0001)的值,比之前模型低6倍。(摘要截选至250字)

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