Atrial and Ventricular Cannulation for Biventricular Circulatory Support With Double-Ended Centrifugal Pump: In Vitro Evaluation.

IF 2.2 3区 医学 Q3 ENGINEERING, BIOMEDICAL
Christine R Flick, Chihiro Miyagi, Barry D Kuban, Anthony R Polakowski, Kiyotaka Fukamachi, Taiyo Kuroda, Jamshid H Karimov
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引用次数: 0

Abstract

Background: In patients with biventricular heart failure, a biventricular assist device (BVAD) may be necessary for hemodynamic support. BVAD inflows can be established through cannulation of the atrial (AC) and/or ventricular (VC) chambers, but no consensus exists on optimal cannulation techniques. This study aimed to characterize BVAD performance related to cannulation types (AC and VC) using a continuous-flow total artificial heart (CFTAH) as the BVAD.

Methods: Both methods of cannulation (AC and VC) were tested on a mock loop using dual pulsatile ventricles with valves (AB5000; Abiomed) paired as the native ventricles and a double-ended centrifugal pump with two volutes, CFTAH, as a BVAD. Pressures were collected at the inlet and outlets of the AB5000 (LAP, RAP, AoP, and PAP) and the CFTAH (Lin, Rin, Lout, and Rout). The left and right flows exiting the CFTAH (LPF and RPF) and total flow (TF), exiting systemic resistance, were monitored. Several heart failure conditions were simulated with adjustment of the pneumatic pressures (AB5000).

Results: Trends between the AC and VC are similar where RAP, Lin, and Lout decreased, and AoP, PAP, TF, LPF, and RPF increased with increased support. The trends differ in LAP with an increase during AC as opposed to a decrease during VC. As a result, with this setup, left-right balance is more easily achieved during VC. TF is higher with AC, even though LPF and RPF are lower. This signifies the flow going through the aortic valve (TF-LPF) and pulmonary valve (TF-RPF) is higher with AC.

Conclusions: The increased TF and valvular flow favored AC for introducing a CFTAH as BVAD to the native heart in these conditions.

双端离心泵用于双心室循环支持的心房和心室插管:体外评价。
背景:在双心室心力衰竭患者中,双心室辅助装置(BVAD)可能是必要的血液动力学支持。BVAD流入可以通过心房(AC)和/或心室(VC)室插管建立,但对于最佳插管技术尚无共识。本研究旨在利用连续血流全人工心脏(CFTAH)作为BVAD,表征与插管类型(AC和VC)相关的BVAD性能。方法:采用带瓣膜的双搏动心室(AB5000;Abiomed)配对为原生心室,双蜗壳双端离心泵CFTAH作为BVAD。在AB5000 (LAP、RAP、AoP和PAP)和CFTAH (Lin、Rin、Lout和route)的进出口处收集压力。监测流出CFTAH的左右流量(LPF和RPF)和流出全身阻力的总流量(TF)。通过调节气压(AB5000)模拟了几种心力衰竭情况。结果:AC和VC之间的趋势相似,RAP、Lin、Lout随支持度的增加而降低,AoP、PAP、TF、LPF、RPF随支持度的增加而增加。LAP的变化趋势不同,在AC期间增加,而在VC期间减少。因此,通过这种设置,在VC期间更容易实现左右平衡。尽管LPF和RPF较低,但与AC相比,TF更高。这表明AC时通过主动脉瓣(TF- lpf)和肺动脉瓣(TF- rpf)的流量更高。结论:在这些情况下,TF和瓣膜流量的增加有利于AC将CFTAH作为BVAD引入原生心脏。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Artificial organs
Artificial organs 工程技术-工程:生物医学
CiteScore
4.30
自引率
12.50%
发文量
303
审稿时长
4-8 weeks
期刊介绍: Artificial Organs is the official peer reviewed journal of The International Federation for Artificial Organs (Members of the Federation are: The American Society for Artificial Internal Organs, The European Society for Artificial Organs, and The Japanese Society for Artificial Organs), The International Faculty for Artificial Organs, the International Society for Rotary Blood Pumps, The International Society for Pediatric Mechanical Cardiopulmonary Support, and the Vienna International Workshop on Functional Electrical Stimulation. Artificial Organs publishes original research articles dealing with developments in artificial organs applications and treatment modalities and their clinical applications worldwide. Membership in the Societies listed above is not a prerequisite for publication. Articles are published without charge to the author except for color figures and excess page charges as noted.
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