Shear stress, energy losses, and costs: a resolved dilemma of pulsatile cardiac assist devices.

Shear stress, energy losses, and costs: a resolved dilemma of pulsatile cardiac assist devices.
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DOI:
10.1155/2014/651769
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发表时间:
2014
影响因子:
--
通讯作者:
Chachques JC
Chachques JC
中科院分区:
生物学3区
文献类型:
--
作者:
Nour S;Liu J;Dai G;Carbognani D;Yang D;Wu G;Wang Q;Chachques JC

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心脏辅助装置(CAD)会导致内皮功能障碍,并导致相当高的发病率。由于灌注曲线和成本不足,脉动 CAD 的使用仍然存在争议。或者,我们提出了一种新的脉动 CAD 概念,该概念基于对整个循环系统的根本修改,符合病理生理学和物理定律。它涉及一种双腔一次性管装置,可适用于传统的心肺旁路(CPB)和/或CAD,用于诱导具有较低能量损失的均匀下游脉动灌注模式。在这项研究中,该设备的原型在模拟传统儿科 CPB 回路中进行了能量损失测试,并在缺血仔猪模型中作为左心室辅助装置 (LVAD) 进行了内皮剪切应力 (ESS) 评估。总之,根据研究结果,脉动管能够成功地将传统的 CPB 和/或 CAD 稳定流转变为脉动灌注模式,具有接近生理的脉压和较低的能量损失。这代表了一种具有成本效益、有前途的方法,死亡率和发病率低,特别是对于脆弱的心脏病患者。
Cardiac assist devices (CAD) cause endothelial dysfunction with considerable morbidity. Employment of pulsatile CAD remains controversial due to inadequate perfusion curves and costs. Alternatively, we are proposing a new concept of pulsatile CAD based on a fundamental revision of the entire circulatory system in correspondence with the physiopathology and law of physics. It concerns a double lumen disposable tube device that could be adapted to conventional cardiopulmonary bypass (CPB) and/or CAD, for inducing a homogenous, downstream pulsatile perfusion mode with lower energy losses. In this study, the device's prototypes were tested in a simulated conventional pediatric CPB circuit for energy losses and as a left ventricular assist device (LVAD) in ischemic piglets model for endothelial shear stress (ESS) evaluations. In conclusion and according to the study results the pulsatile tube was successfully capable of transforming a conventional CPB and/or CAD steady flow into a pulsatile perfusion mode, with nearly physiologic pulse pressure and lower energy losses. This represents a cost-effective promising method with low mortality and morbidity, especially in fragile cardiac patients.
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