Development and Hydrodynamic Evaluation of a novel inflow cannula in a mechanical circulatory support system for bridge to decision.
Development and Hydrodynamic Evaluation of a novel inflow cannula in a mechanical circulatory support system for bridge to decision.
复制标题
机械循环支持系统中新型流入插管的开发和流体动力学评估，以作为决策的桥梁。
DOI：
10.1111/j.1525-1594.2011.01319.x
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发表时间：
2011
期刊：
影响因子：
2.4
通讯作者：
Tatsumi E.
中科院分区：
文献类型：
--
作者：
Sumikura H;Toda K;Takewa Y;Tsukiya T;Ohnuma K;Sasagawa M;Watanabe F;Ugawa J;Taenaka Y;Tatsumi E.
植入式旋转血泵开发的最新进展实现了长期机械循环支持（MCS），用于移植、恢复或目标治疗的桥梁。与此同时，短期 MCS 系统正在成为决策的桥梁。我们为短期 MCS 系统开发了一种新型流入插管，该插管在插入时提供足够的旁路流量且侵入最小，并评估了其流体动力学特性。这种新颖的流入插管名为 Lantern 插管，由弹性硅胶制成，并用金属丝加固。插管尖端侧面有六个狭缝。该插管尖端可以使用导引器向轴向延伸，并且可以减小直径，并且 Lantern 插管可以轻松插入左心室心尖，且侵入最小。由于压力损失低，可以获得足够的旁通流量。此外，这种灯笼形状还可以抵抗插管尖端周围的抽吸并发症。使用模拟循环测量通过 Lantern 插管的压力损失，并与两个市售静脉插管（Sarns4882，Terumo，东京，日本和 Stockert V122-28，Sorin Group，东京，日本）进行比较，这两个静脉插管的直径与 Lantern 插管几乎相同。此外，通过计算流体动力学（CFD）对插管尖端周围的流动模式进行了数值分析。还进行了急性动物实验以证实 Lantern 插管的实际效果。在体外实验中，与市售静脉插管相比，Lantern 插管的压力损失最低。 CFD分析结果表明，由于灯笼形状形成了较宽的流入孔面积和喇叭口，因此灯笼插管具有较低的压力损失。由于体内实验中脉动条件下的低压损失，在 Lantern 插管中获得了最高的旁路流量。由于其特殊设计的灯笼形状，灯笼插管在压力损失方面表现出与流入插管一样优越的流体动力学特性。
Recent progress in the development of implantable rotary blood pumps realized long‐term mechanical circulatory support (MCS) for bridge to transplant, bridge to recovery, or a destination therapy. Meanwhile, a short‐term MCS system is becoming necessary for bridge to decision. We developed a novel inflow cannula for the short‐term MCS system, which gives sufficient bypass flow with minimal invasion at insertion, and evaluated its hydrodynamic characteristics. The novel inflow cannula, named the Lantern cannula, is made of elastic silicone reinforced with metal wires. The cannula tip has six slits on the side. This cannula tip can be extended to the axial direction by using an introducer and can be reduced in diameter, and the Lantern cannula enables easy insertion into the left ventricle apex with minimal invasion. The sufficient bypass flow rate can be obtained due to low pressure loss. Moreover, this Lantern shape also resists suction complication around the cannula tip. The pressure loss through the Lantern cannula was measured using a mock circulation and compared with two commercially available venous cannulae (Sarns4882, Terumo, Tokyo, Japan and Stockert V122‐28, Sorin Group, Tokyo, Japan), which have almost same diameter as the Lantern cannula. Moreover, the flow patterns around the cannula tip were numerically analyzed by computational fluid dynamics (CFD). Acute animal experiment was also performed to confirm the practical effectiveness of the Lantern cannula. The pressure loss of the Lantern cannula was the lowest compared with those of the commercially available venous cannulae in in vitro experiment. CFD analysis results demonstrated that the Lantern cannula has low pressure loss because of wide inflow orifice area and a bell mouth, which were formed via Lantern shape. The highest bypass flow was obtained in the Lantern cannula because of the low pressure loss under pulsatile condition in in vivo experiments. The Lantern cannula demonstrated superior hydrodynamic characteristics as the inflow cannula in terms of pressure loss due to its specially designed Lantern shape.