Chronic in vivo testing of the Penn State infant ventricular assist device.
Chronic in vivo testing of the Penn State infant ventricular assist device.
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DOI：
10.1097/mat.0b013e318239feb4
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发表时间：
2012-01
期刊：
影响因子：
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通讯作者：
Pierce WS
中科院分区：
文献类型：
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作者：
Weiss WJ;Carney EL;Clark JB;Peterson R;Cooper TK;Nifong TP;Siedlecki CA;Hicks D;Doxtater B;Lukic B;Yeager E;Reibson J;Cysyk J;Rosenberg G;Pierce WS
Penn State Infant Ventricular Assist Device是一种12-14 ml的每搏输出量双驱动泵，配有定制的Björk-Shiley单支柱阀，在国家心肺血液研究所（NHLBI）儿科循环支持项目下开发。在本报告中，我们描述了在幼龄绵羊模型中进行的7项最新的婴儿VAD慢性动物研究，平均体重为23.5 +/- 4.1 kg。7项研究中有5项达到了4-6周生存期的目标，支持持续时间范围为5 - 41天;平均26.1天。使用普通肝素完成抗凝，并将研究动物分为2个方案组：第一组基于1.5至2倍正常值的目标活化部分凝血活酶时间，第二组使用2倍正常值的目标血栓弹性描记术R-时间。第二组所需的肝素显著减少，这通过几乎检测不到的肝素活性（抗Xa）得到验证。在两组中，除了一只动物出现慢性感染和发热外，没有血栓栓塞的证据。器械血栓极少，并且通过引入定制瓣膜进一步减少。这些结果与成人VAD动物试验结果一致，并且考虑到第二组中抗凝水平极低，这些结果令人鼓舞。
The Penn State Infant Ventricular Assist Device is a 12-14 ml stroke volume pneumatically actuated pump, with custom Björk-Shiley monostrut valves, developed under the National Heart, Lung, and Blood Institute (NHLBI) Pediatric Circulatory Support program. In this report we describe the 7 most recent chronic animal studies of the Infant VAD in the juvenile ovine model, with a mean body weight of 23.5 +/- 4.1 kg. The goal of 4-6 weeks survival was achieved in 5 of 7 studies, with support duration ranging from 5 to 41 days; mean 26.1 days. Anticoagulation was accomplished using unfractionated heparin, and study animals were divided into 2 protocol groups: the first based on a target activated partial thromboplastin time of 1.5 to 2 times normal, and a second group using a target thromboelastography R-time of 2 times normal. The second group required significantly less heparin, which was verified by barely detectable heparin activity (anti-Xa). In both groups, there was no evidence of thromboembolism except in one animal with a chronic infection and fever. Device thrombi were minimal, and were further reduced by introduction of the custom valve. These results are consistent with results of adult VAD testing in animals, and are encouraging given the extremely low levels of anticoagulation in the second group.