Cavopulmonary assist for the univentricular Fontan circulation: von Kármán viscous impeller pump.
Cavopulmonary assist for the univentricular Fontan circulation: von Kármán viscous impeller pump.
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DOI：
10.1016/j.jtcvs.2010.04.037
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发表时间：
2010-09
影响因子：
6
通讯作者：
Frankel, Steven H.
中科院分区：
文献类型：
--
作者：
Rodefeld, Mark D.;Coats, Brandon;Fisher, Travis;Giridharan, Guruprasad A.;Chen, Jun;Brown, John W.;Frankel, Steven H.
在单心室 Fontan 循环中，适度增加现有的腔肺压头 (2-5 mmHg) 将降低全身静脉压，增加心室充盈，从而显着改善循环状态。提供机械腔肺支持的理想方法并不存在。我们假设基于冯·卡门粘性泵原理的粘性叶轮泵最适合此角色。创建了总腔肺连接的 3 维计算模型。叶轮表示为沿腔静脉轴旋转的光滑两侧锥形致动器盘。在 3 种条件下对流动进行建模：1）无盘的被动流动； 2) 非旋转盘的被动流，以及 3) 盘旋转（0–5K rpm）的诱导流。对每种情况的流动模式和水力性能进行了检查。通过在实验室模拟回路中测量 0–7K rpm 范围内的压力上升和诱导流量来评估叶片式叶轮的水力性能。非旋转执行器盘可稳定腔肺血流，将功率损失减少 88%。圆盘旋转（从 4.4 L/min 的基线动态流量开始）导致压力上升 0.03 mmHg。在实验室模拟回路中，使用叶片式叶轮以 0-7K rpm 的速度进一步增加 5-20 mmHg 的压力和 0-5 L/min 的流量。单个粘性叶轮泵可在所需压力范围内稳定并增强 4 个方向的腔肺血流，而不会阻塞静脉通路。它适用于现有的分阶段方案，作为已建立的单心室 Fontan 循环中恢复或移植的临时桥梁。它还可以实现单心室的压缩姑息治疗，无需中间手术分期或使用全身至肺动脉分流。
In a univentricular Fontan circulation, modest augmentation of existing cavopulmonary pressure head (2–5 mmHg) would reduce systemic venous pressure, increase ventricular filling, and thus, substantially improve circulatory status. An ideal means of providing mechanical cavopulmonary support does not exist. We hypothesized that a viscous impeller pump, based on the von Kármán viscous pump principle, is optimal for this role. A 3-dimensional computational model of the total cavopulmonary connection was created. The impeller was represented as a smooth 2-sided conical actuator disk with rotation in the vena caval axis. Flow was modeled under 3 conditions: 1) passive flow with no disc; 2) passive flow with a non-rotating disk, and 3) induced flow with disc rotation (0–5K rpm). Flow patterns and hydraulic performance were examined for each case. Hydraulic performance for a vaned impeller was assessed by measuring pressure rise and induced flow over 0–7K rpm in a laboratory mock loop. A nonrotating actuator disc stabilizes cavopulmonary flow, reducing power loss by 88%. Disk rotation (from baseline dynamic flow of 4.4 L/min) resulted in a pressure rise of 0.03 mmHg. A further increase of pressure of 5–20 mmHg and 0–5 L/min flow were obtained with a vaned impeller at 0–7K rpm in a laboratory mock loop. A single viscous impeller pump stabilizes and augments cavopulmonary flow in 4 directions, in the desired pressure range, without venous pathway obstruction. It applies to the existing staged protocol as a temporary bridge-to-recovery or –transplant in established univentricular Fontan circulations. It may also enable compressed palliation of single ventricle without need for intermediary surgical staging or use of a systemic-to-pulmonary arterial shunt.
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影响因子：
6
作者：
Ashburn, DA;McCrindle, BW;Blackstone, EH
通讯作者：
Blackstone, EH
DOI：
10.1115/1.1632523
发表时间：
2003-12-01
影响因子：
1.7
作者：
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通讯作者：
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影响因子：
4.2
作者：
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通讯作者：
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影响因子：
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作者：
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通讯作者：
Rodefeld, Mark D.
影响因子：
4.2
作者：
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通讯作者：
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