Mechanical Circulatory Support of a Univentricular Fontan Circulation with a Continuous Axial-Flow Pump in a Piglet Model
Mechanical Circulatory Support of a Univentricular Fontan Circulation with a Continuous Axial-Flow Pump in a Piglet Model
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仔猪模型中连续轴流泵单心 Fontan 循环的机械循环支持
DOI：
10.1097/mat.0000000000000172
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发表时间：
2015-03
期刊：
影响因子：
--
通讯作者：
Zhongjun J. Wu
中科院分区：
文献类型：
--
作者：
wei xufeng;Zhongjun J. Wu
尽管Fontan手术对复杂先天性心脏病的治疗做出了重大贡献，但许多患者进展为Fontan循环衰竭。使用脑室辅助装置为这些患者提供循环支持仍然具有挑战性。在目前的研究中，使用连续轴流泵来支持单室Fontan循环。在6头8-14公斤体重的约克夏仔猪上建立了改良的Fontan循环(房-肺连接法)。在不使用体外循环的情况下，构建了一条有两个分支的涤纶管道(12 Mm)，作为一个完整的心-肺连接。在5只动物身上，通过额外的聚四氟乙烯(PTFE)移植物将Impella泵插入管道中。在支持的Fontan循环下采集血流动力学数据6h。对照组动物在不依赖复苏的情况下启动Fontan循环后死亡。4只泵支持的动物在6小时内保持血流动力学稳定，泵速在18,000转/分到22,000转/分(P1-P3)之间。血氧饱和度维持在95%~100%之间。血气分析和生化检测显示脏器血流正常。连续的轴流泵可以作为心脏移植或恢复的“桥梁”，为衰竭的Fontan循环提供暂时的循环支持。
Despite the significant contribution of the Fontan procedure to the therapy of complex congenital heart diseases, many patients progress to failure of their Fontan circulation. The use of ventricular assist devices to provide circulatory support to these patients remains challenging. In the current study, a continuous axial-flow pump was used to support a univentricular Fontan circulation. A modified Fontan circulation (atrio-pulmonary connection) was constructed in six Yorkshire piglets (8-14 kg). A Dacron conduit (12 mm) with two branches was constructed to serve as a complete atrio-pulmonary connection without the use of cardiopulmonary bypass. The Impella pump was inserted into the conduit through an additional Polytetrafluoroethylene (PTFE) graft in five animals. Hemodynamic data were collected for 6 hours under the supported Fontan circulation. The control animal died after initiating the Fontan circulation independent of resuscitation. Four pump supported animals remained hemodynamically stable for 6 hours with pump speeds between 18,000 rpm and 22,000 rpm (P1-P3). Oxygen saturation was maintained between 95% and 100%. Normal organ perfusion was illustrated by blood gas analysis and biochemical assays. A continuous axial-flow pump can be used for temporal circulatory support to the failing Fontan circulation as "bridge" to heart transplantation or recovery.
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影响因子：
158.5
作者：
Rose, EA;Gelijns, AC;Meier, P
通讯作者：
Meier, P
影响因子：
120.7
作者：
Hernandez, Adrian F.;Shea, Alisa M.;Milano, Carmelo A.;Rogers, Joseph G.;Hammill, Bradley G.;O'Connor, Christopher M.;Schulman, Kevin A.;Peterson, Eric D.;Curtis, Lesley H.
通讯作者：
Curtis, Lesley H.
DOI：
10.1016/j.athoracsur.2005.06.063
发表时间：
2006
期刊：
The Annals of thoracic surgery
影响因子：
--
作者：
Cynthia D. Myers;Kelly D. Mattix;R. Presson;P. Vijay;Domingo Maynes;K. Litwak;John W. Brown;M. Rodefeld
通讯作者：
Cynthia D. Myers;Kelly D. Mattix;R. Presson;P. Vijay;Domingo Maynes;K. Litwak;John W. Brown;M. Rodefeld
Fontan 手术：现代技术改善了长期结果
DOI：
10.1016/s0084-3873(08)79246-0
发表时间：
2008
期刊：
Yearbook of Medicine
影响因子：
--
作者：
T. Graham
通讯作者：
T. Graham
影响因子：
37.8
作者：
Khairy, Paul;Fernandes, Susan M.;Landzberg, Michael J.
通讯作者：
Landzberg, Michael J.