Chronic In Vivo Test of a Right Heart Replacement Blood Pump for Failed Fontan Circulation
Chronic In Vivo Test of a Right Heart Replacement Blood Pump for Failed Fontan Circulation
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DOI：
10.1097/mat.0000000000000888
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发表时间：
2019-08-01
期刊：
影响因子：
4.2
通讯作者：
Rosenberg, Gerson
中科院分区：
文献类型：
--
作者：
Cysyk, Joshua;Clark, Joseph Brian;Rosenberg, Gerson
一种植入式旋转血泵被开发出来，为方坦循环衰竭的患者提供长期的机械右心支持。本研究的目的是在为期30天的绵羊体内研究中评估该泵。在研究期间，泵的转速设置为3900 rpm，泵的功率在4.3到4.6 W之间。在整个研究期间，上腔静脉（SVC）和下腔静脉（IVC）的泵入口压力分别为14 +/- 15和11 +/- 15毫米汞柱。红细胞压积稳定在30% +/- 4%。部分凝血活酶时间（PTT）从术前30秒稳定增加到术后第20天的59秒，而凝血酶原时间（PT）在研究期间保持在20 +/- 2秒。植入和术后恢复成功，动物表现出正常的生理性肺、静脉压和心输出量。在泵的检查中，IVC和SVC入口完全没有任何沉积物，但在三个转子叶片之间和两个蜗壳半分型线的20%处有小血栓（直径约0.5 mm）。进行了完整的右心旁路手术，术后恢复成功，泵显示出足够的循环支持和正常的生理性肺和静脉压。这项研究是第一次在慢性动物研究中成功测试右心替代装置。
An implantable rotary blood pump was developed to provide long-term mechanical right heart support for patients who have failing Fontan circulation. The objective of this study was to evaluate the pump in vivo in a 30 day sheep study. Pump speed was set at 3,900 rpm for the duration of the study, and pump power was between 4.3 and 4.6 W. The pump inlet pressures for the superior vena cava (SVC) and inferior vena cava (IVC) were 14 +/- 15 and 11 +/- 15 mm Hg, respectively, over the duration of the study. Hematocrit remained stable at 30% +/- 4%. Partial thromboplastin time (PTT) steadily increased from 30 s preoperatively to a high of 59 s on postoperative day 20, while prothrombin time (PT) remained at 20 +/- 2 s for the duration of the study. The implantation and postoperative recovery were successful, and the animal demonstrated normal physiologic pulmonary and venous pressures and cardiac output. On pump inspection, the IVC and SVC inlets were completely clear of any deposits, but there were small thrombi (approximately 0.5 mm diameter) between each of the three rotor blades and along 20% of the parting line of the two volute halves. A complete right heart bypass was performed, postoperative recovery was successful, and the pump demonstrated adequate circulatory support and normal physiologic pulmonary and venous pressures. This study was the first successful test of a right heart replacement device in a chronic animal study.