Basic research on "Pericardial pumping" as a circulatory assist device

背景。由于缺乏一种简单且安全适用的治疗顽固性心力衰竭的手术策略，即直接对心室壁施加压力，因此我们修改了20世纪60年代提出的辅助杯，并开发了一种由环绕心脏的血压计袖套组成的系统。在12只家兔的两个心室周围包裹一个3cm宽的袖带，在诱发性心室颤动期间，以容积式呼吸器为动力单元，循环充气和放气。平均峰值左室压从对照组的62.1*23.5 mmHg增加到袖带辅助组的75.5*20.0 mmHg （p=0.054）。平均峰值主动脉流量由401.7*258.7 ml/min降至303.6*155.2 ml/min （p=0.070）。然而，平均脑卒中容积从0.38*0.26 ml增加到0.52*0.20 ml （p=0.025）。尸检未发现任何瘀斑或出血，结论。袖带辅助的优点包括简单，无需血管插管或与血液接触，由于材料的灵活性而具有优越的贴合性。此外，它有可能成为心肌恢复的桥梁。

Background. The lack of a simple and safely applicable surgical strategy for refractory heart failure, designed to apply forces directly to the ventricular walls, led us to revise the assister cup proposed in the 1960's and develop a system consisting of a sphygmomanorneter cuff wrapped around the heart.Methods. A cuff measuring 3 cm wide was wrapped around both ventricles in twelve rabbits and pneumatically inflated and deflated cyclically during induced ventricular fibrillation using a volume respirator as the power unit.Results. Mean peak left ventricular pressure increased from 62.1*23.5 mmHg at the control to 75.5*20.0 mmHg during cuff assistance (p=0.054). Mean peak aortic flow volume decreased from 401.7*258.7 ml/min to 303.6*155.2 ml/min (p=0.070). Mean stroke volume, however, increased from 0.38*0.26 ml to 0.52*0.20 ml (p=0.025). Post-mortem study did not show any ecchymosis or bleeding.Conclusions. Advantages in cuff assistance include simplicity without vessel cannulation or contact with blood and superior fitting due to the flexibility of the material. Moreover, it has potential as a bridge to myocardial recovery.