Acoustic Characterization of Axial Flow Left Ventricular Assist Device Operation In Vitro and In Vivo
Acoustic Characterization of Axial Flow Left Ventricular Assist Device Operation In Vitro and In Vivo
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DOI：
10.1097/mat.0000000000000307
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发表时间：
2016-01-01
期刊：
影响因子：
4.2
通讯作者：
Tatooles, Antone J.
中科院分区：
文献类型：
--
作者：
Yost, Gardner L.;Royston, Thomas J.;Tatooles, Antone J.
左心室辅助装置（LVAD）的使用，用于补充心输出量的植入式泵，已成为晚期心力衰竭越来越常见和有效的治疗方法。尽管现代连续流LVAD比心力衰竭的医疗管理更能改善生活质量和生存率，但器械故障仍然是一个常见问题。需要改进评估LVAD功能的无创方法来检测设备并发症。使用电子听诊器记录体外和体内HeartMate II轴流泵的声音。然后将数据上传到计算机，并使用两种类型的声学分析软件进行分析。量化左心室辅助装置声学，并与泵速、声学环境以及流入和流出移植物通畅性相关。发现在体内测量的峰值频率值与预测值和体外测量值都强烈相关（r > 0.999）。通过积分超过50 Hz增量获得的声谱曲线下的面积图显示了体内和体外测量之间的强相关性（r > 0.966）。在2例接受手术器械更换的患者中，发现器械血栓形成与LVAD声振幅降低相关。
The use of left ventricular assist devices (LVADs), implantable pumps used to supplement cardiac output, has become an increasingly common and effective treatment for advanced heart failure. Although modern continuous-flow LVADs improve quality of life and survival more than medical management of heart failure, device malfunction remains a common concern. Improved noninvasive methods for assessment of LVAD function are needed to detect device complications. An electronic stethoscope was used to record sounds from the HeartMate II axial flow pump in vitro and in vivo. The data were then uploaded to a computer and analyzed using two types of acoustic analysis software. Left ventricular assist device acoustics were quantified and were related to pump speed, acoustic environment, and inflow and outflow graft patency. Peak frequency values measured in vivo were found to correlate strongly with both predicted values and in vitro measurements (r > 0.999). Plots of the area under the acoustic spectrum curve, obtained by integrating over 50 Hz increments, showed strong correlations between in vivo and in vitro measurements (r > 0.966). Device thrombosis was found to be associated with reduced LVAD acoustic amplitude in two patients who underwent surgical device exchange.