An Intracardiac Soft Robotic Device for Augmentation of Blood Ejection from the Failing Right Ventricle.

An Intracardiac Soft Robotic Device for Augmentation of Blood Ejection from the Failing Right Ventricle.
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DOI:
10.1007/s10439-017-1855-z
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发表时间:
2017-09
影响因子:
3.8
通讯作者:
Vasilyev NV
Vasilyev NV
中科院分区:
工程技术2区
文献类型:
--
作者:
Horvath MA;Wamala I;Rytkin E;Doyle E;Payne CJ;Thalhofer T;Berra I;Solovyeva A;Saeed M;Hendren S;Roche ET;Del Nido PJ;Walsh CJ;Vasilyev NV

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我们推出了一种植入式心内软机器人右心室射血装置 (RVED),用于与心动周期同步动态逼近右心室 (RV) 游离壁和室间隔 (IVS),以增强右心衰竭 (RHF) 的血液射血。 RVED 专为安全有效的心内操作而设计,由部署在 IVS 上的锚定系统、RV 自由壁锚和横跨两个锚之间的 RV 腔的气动人工肌肉线性致动器组成。使用心室模拟器和定制控制器,我们描述了心室容量射血、针对不同负载的线性近似以及不同装置驱动周期对容量射血的影响。然后在成年猪体内测试 RVED(n = 5)。首先,我们在 3D 超声心动图引导下成功地将设备部署到跳动的心脏中 (n = 4)。接下来,我们进行了一项可行性研究,以评估该设备在 RHF 实验模型 (n = 1) 中增强 RV 弹射的能力。 RVED 驱动增强了 RHF 期间的 RV 弹射;而进一步的慢性动物研究将提供有关该支持装置功效的详细信息。这些结果证明了 RVED 的成功设计和实施及其在跳动心脏中的部署。这种软机器人弹射装置有潜力作为 RHF 机械循环辅助的快速部署系统。
We introduce an implantable intracardiac soft robotic right ventricular ejection device (RVED) for dynamic approximation of the right ventricular (RV) free wall and the interventricular septum (IVS) in synchrony with the cardiac cycle to augment blood ejection in right heart failure (RHF). The RVED is designed for safe and effective intracardiac operation and consists of an anchoring system deployed across the IVS, an RV free wall anchor, and a pneumatic artificial muscle linear actuator that spans the RV chamber between the two anchors. Using a ventricular simulator and a custom controller, we characterized ventricular volume ejection, linear approximation against different loads and the effect of varying device actuation periods on volume ejection. The RVED was then tested in vivo in adult pigs (n = 5). First, we successfully deployed the device into the beating heart under 3D echocardiography guidance (n = 4). Next, we performed a feasibility study to evaluate the device’s ability to augment RV ejection in an experimental model of RHF (n = 1). RVED actuation augmented RV ejection during RHF; while further chronic animal studies will provide details about the efficacy of this support device. These results demonstrate successful design and implementation of the RVED and its deployment into the beating heart. This soft robotic ejection device has potential to serve as a rapidly deployable system for mechanical circulatory assistance in RHF.
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