BASIC RESEARCH ABOUT THE CLINICAL APPLICATION OF THE ARTIFICIAL HEART FOR THE BRIDGING USE OF THE HEART TRANSPLANTATION

人工心脏作为心脏移植桥接用途的临床应用基础研究

• 批准号: 63570656
• 负责人: NITTA Shin-ichi
• 金额: $ 1.34万
• 依托单位: Tohoku University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for General Scientific Research (C)
• 财政年份: 1988
• 资助国家: 日本
• 起止时间: 1988 至 1989
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-63570656/
• 关键词: Heart Transplantation; Ventricular Assist Device; Total Artificial Heart; Bridge Use; Renal Sympathetic Nerve Activity; Automatic Control System for the Artificial Heart; 人 工心臓の自動制御システム

We have been engaged in the development and evaluation of clinical ventricular assist device including micro sensors and optimal automatic drive system for bridge use of heart transplantation. Our sac-type air driven VAD was composed of sac, inflow and outflow cannulae and valve-built-in connector which connects sac and cannula. So we can always develop, improve and exchange any parts independently once some disadvantageous episode happens. Recently, we have been evaluating silatic ball valve for VAD in the chronic animal experiments for 2-3 month and in the mock circulation for over 6 month showing any thrombus formation and any breakage of entire VAD. The flow behavior within our different several types of ventricular assist devices (VADs) had been analyzed with the numerical method based on the quantitative flow visualization technique.In the in vitro and chronic animal experiments for more than a week, reliable stability and sensitively without any thrombus formation on the blood c … More ontacting surface of the sensors were recognized. After chronic experiments, the sensors were recognized. After chronic experiments, the sensors were reevaluated in the mock circulatory system as compare to reference value. The relationship between the output of the micro-sensors and the reference value were linear and correlated well.As an automatic control system, a new hemodynamic measurement system has been developed using micro pressure sensors on the wall of both inflow and outflow cannulae to have an adaptive controller of VAD system. With this automatic control system, we newly designed the wean-off method without any volume administration and any cease of VAD drive by changing the drive phase from diastole to systole automatically which resulted in increase of LV outflow impedance. This new method was evaluated in the 7 animal experiments to obtain a LV pressure-volume loop by pressure sensor and conductance catheter in the LV cavity which revealed the usefulness to estimate the cardiac function during bridge used VAD pumping.To determine the effect of Left Ventricular Assist Device(LAVD) pumping on sympathetic nerve activity, Renal Sympathetic Nerve Activity(RSNA) was detected in acute animal experiments.During LVAD pumping, RSNA decreased in parallel to the increase in aortic pressure and pulmonary artery flow and decrease in left atrial pressure. These data suggest that LVAD has an effect on the sympathetic nerve system by increase or decrease in tone which mediated by the aortic and cardiopulmonary baroreflex system.We conclude that our VAD system may offer complete cardiac function for replacing a failing heart until a donor heart can be used as a VAD or a total artificial heart. Less

我们一直致力于开发和评估临床心室辅助装置，包括微传感器和最佳自动驱动系统，用于心脏移植桥接使用。我们的气囊式气动VAD由气囊、流入和流出导管以及连接气囊和导管的内置阀式连接器组成。因此，一旦出现一些不利的情况，我们总是可以独立开发、改进和交换任何部分。最近，我们在2-3个月的慢性动物实验和超过6个月的模拟循环中评估了硅质球阀对VAD的治疗效果，结果显示没有血栓形成和整个VAD的破裂。采用基于定量血流可视化技术的数值方法，对几种不同类型心室辅助装置（VADs）内的血流特性进行了分析。在一周以上的体外和慢性动物实验中，稳定性可靠，灵敏度高，未在血液表面形成血栓。经过长期的实验，传感器被识别出来了。经过长期实验，传感器在模拟循环系统中重新评估，与参考值进行比较。微传感器输出值与参考值呈良好的线性关系。作为一种自动控制系统，我们开发了一种新型的血流动力学测量系统，该系统在流入和流出管壁上都安装了微压力传感器，具有VAD系统的自适应控制器。在这个自动控制系统中，我们新设计了不需要任何体积管理和停止VAD驱动的关闭方法，通过将驱动阶段从舒张期自动改变为收缩期，从而导致低压流出阻抗的增加。在7个动物实验中对该方法进行了评价，通过压力传感器和导管在左室腔内获得左室压力-容积环路，揭示了该方法在桥式VAD泵送心功能评估中的实用性。为了确定左心室辅助装置（LAVD）泵送对交感神经活动的影响，在急性动物实验中检测了肾交感神经活动（RSNA）。在LVAD泵送过程中，RSNA随主动脉压、肺动脉流量的增加和左房压的降低而平行下降。这些数据表明LVAD通过主动脉和心肺压力反射系统介导的张力的增加或减少对交感神经系统有影响。我们的结论是，我们的VAD系统可以提供完整的心脏功能来取代衰竭的心脏，直到供体心脏可以用作VAD或全人工心脏。少

项目成果

仁田新一: "補助人工心臓による生体循環-駆動タイミングを変化させた時の生体心への影響-" 第1回バイオエンジニアリングシンポジウム-計測と力学、生体への応用-. No.900-4. 27-28 (1990)

Shinichi Nita：“使用辅助人工心脏的生物循环 - 改变驱动时序时对生物心脏的影响”第一届生物工程研讨会 - 测量和力学，对生物体的应用 - No.900-4（1990）。

吉澤誠他: "計測および解析機能を有する補助人工心臓適応制御システム" BME. 3. 32-40 (1989)

Makoto Yoshizawa 等人：“具有测量和分析功能的心室辅助装置的自适应控制系统”BME 3. 32-40 (1989)。

吉澤誠、他: "計測および解析機能を有する補助人工心臓適応制御システム" BME. 3. 32-40 (1989)

Makoto Yoshizawa 等人：“具有测量和分析功能的心室辅助装置的自适应控制系统”BME 3. 32-40 (1989)。

Shin-ichi Nitta, et al: "An Appraisal of Wean-Off Methods from Cardiac Assistance -In the aspect of newly designed left ventricular outflow impedance control method-" The Japanese Circulation Society, 1989.

Shin-ichi Nitta 等人：“心脏辅助断奶方法的评估 - 在新设计的左心室流出阻抗控制方法方面 -”日本循环学会，1989 年。

山家智之、他: "左心補助人工心臓駆動下の腎交感神経活動についての実験的研究" 自律神経. 26. 373-379 (1989)

Tomoyuki Yamaga 等：“左心室辅助装置驱动下肾交感神经活动的实验研究”自主神经。 26. 373-379 (1989)