A Hybrid Ventricular Assist Device with a cell-adhesive polymer

为了建立一种新的骨骼肌心室辅助装置治疗终末期心脏病的手术方法，研制了一种复合型（骨骼肌-内皮细胞）循环辅助泵，该泵采用细胞粘附聚合物（FC-106，44）增强内皮细胞与泵内表面的粘附。体外培养的犬动脉内皮细胞评价结果表明，FC 44在1.4 × 10 ~ 5/cm ~ 2/111-300 μ L的条件下，有足够的促进内皮细胞与泵内表面粘附的能力。左侧背阔肌移植物经电预处理2-3个月后，再通过预处理肌移植物构建锥形泵。几个月后，将泵连接到模拟单心室模型的右心旁路电路上，并通过植入式起搏器进行电刺激。在没有泵刺激的情况下注意到严重的心力衰竭，而骨骼肌刺激显示心输出量显著增加，并恢复正常的右心室性能。然而，在泵的内表面观察到血栓形成，没有内皮细胞衬里。相反，通过使用细胞粘附聚合物，用培养的自体内皮细胞覆盖泵的内表面，可以明显避免血栓形成。

In order to establish a new surgical approach to treat end-stage cardiac diseases by the use of skeletal muscle-powered ventricular assist device, the hybrid (skeletal muscle-endothelial cell) circulatory assist pump was developed with cell-adhesive polymers (FC-106,44) to augment adhesion of endothelial cell to inner surface of the pump. In vitro evalustion by cultured endothelial cell from canine arteriesre revealed FC 44 had sufficent capacity to enhance endothelial cell adhesion to innner surface fo the pump under the condition of 1.4x10^5/cm2/111-300 micro L.Subsequentyl, sleletal muscle powered-asiist device was constructed in the canine thoracic cavity. Left latissimus dorsi muscle graft was electrically procondition for 2-3 months, and a cone-shape pump was constructed by precondition muscle graft. A few months later, pump was connected to the right heart bypass circuit in the model simulating single vemtricle and was electrically stimulated by implantable pacemeker. Profound heart failure was noted without pump stimulation, whereas stimulation of skeletal muscle showed significant augmentation of cardiac output and restored normal right heart ventricular performance. The thrombus formation was, however, noted at the inner surface of the pump without endothelial cell lining. Conversely, this thrombus formation was markedly avoided by the use fo covering the inner surface of the pump with cultured autologous endothelial cells by the use fo cell-adhesive polymers.