DEVELOPMENT OF BIOMECHANICAL PUMP SYSTEM USING SKELETAL MUSCLE: EXAMINATION OF COMPONENTS

我们设计了一种完全可植入的循环辅助装置，该装置由一个由骨骼肌室和一个混合人工心内膜组成的混合型人工脑室组成。这种混合型人工心内膜由聚亚安酯多孔膜、血管碎片和胶原凝胶组成的结构基质组成。为了阐明骨骼肌作为能量来源的能力，评价了心肌成形术对心功能的影响。本实验用4只正常山羊的左背阔肌(LDM)进行实验。电刺激6~8周后，将带蒂LDM顺时针缝合于脑室周围，用自制的小型电刺激器同步刺激。评价…刺激前后心功能、肺动脉收缩压(SPAP)、右室射血分数(RVEF)、心输出量(CO)、左心室收缩压和最大收缩末期容积阻抗(Ees)的变化测量了更多的n。虽然Spap、RVEF和CO的变化不大，但有增加的趋势。我们使用胶原凝胶和碎裂的山羊颈动脉静脉在体外进行杂交人工心内膜的构建。为了体内构建混合人工心内膜，我们使用了一种改良的组织碎片方法用于血管假体。我们用破碎的山羊颈动脉静脉与胶原凝胶制备组织碎片的悬浮液。我们使用高渗透性的织物血管假体作为结构基质，将组织碎片包裹在假体的外表面，然后将假体植入4只成年山羊的颈动脉。在移植后1个月和3个月的标本中，来自碎裂组织的细胞在假体的内表面再生了一层内皮样单分子层。在80 mm Hg的后负荷和20 mm Hg的预负荷下，生物人工脑室的产量达到920ml/min。根据这些数据，作者认为生物人工脑室对改善右心功能具有重要的作用，是一种具有良好抗凝血性的植入性装置。较少

We designed a totally implantable circulatory assist device consisting of a hybrid artificial ventricle composed of a skeletal muscle ventricle lined with a hybrid artificial endocardium. This hybrid artificial endocardium consist of a structural matrix made of a polyurethane porous membrane, fragment blood vessel, and collagen gel.To clarify the ability of skeletal muscle as energy source, the effect of cardiomyoplasty on ventricular function was evaluated. The experiment was performed with the left latissimus dorsi muscle (LDM) in 4 normal heart goats. After electrically conditioned for 6 to 8 weeks, the pedicled LDM were sutured around the ventricle clockwise and stimulated synchronously with our compact electrical stimulator. To evaluated the ventricular function,systolic pulmonary arterial pressure (sPAP), right ventricular ejection fraction (RVEF), cardiac output (CO), systolic left ventricular pressure ; and maximal end-systolic volume-elactance (Ees) with and without stimulatio … More n were measured. Although no significant changes were observed in these data, sPAP RVEF, and CO showed a tendency to increase.We prepared the polyurethane porous membrane by solvent cocasting with salt powder. We used collagen gel with fragmented goat carotid vein to perform in vitro construction of the hybrid artificial endocardium. For in vivo construction of the hybrid artificial endocardium, we used a modified version of the tissue fragment method for vascular prostheses. We prepared suspensions of tissue fragments using collagen gel with fragmented goat carotid vein. We used a highly porous fabric vascular prosthesis as a structural matrix; tissue fragments were entrapped on the outer surface of the prosthesis, and the prostheses then was implanted into the carotid artery of four adult goats.In specimens 1 and 3 months postimplantation, cells from the fragmented tissue regenerated an endothelium-like monolayer sheet on the inner suface of the prosthese. Output of a prototype bioaritifical ventricle reached 920 ml/min at an afterload of 80 mmHg and a preload of 20 mmHg.Based on these data, the authors concluded the bioartificial ventricle cound play an important part to improve the right ventricular function and is promising as an implantable device with excellent antithrombogenicity. Less