A Hybrid Ventricular Assist Device with a cell-adhesive polymer

为了建立一种利用骨骼肌动力的心脏辅助装置治疗终末期心脏病的新手术途径，研制了一种使用细胞黏附聚合物(FC-106、44)来增强内皮细胞与泵内表面黏附的(骨骼肌-内皮细胞)混合型循环辅助泵。体外培养的犬动脉内皮细胞评价表明，在1.4×10~(-5)/cm~2/111-300微升的条件下，FC-44有足够的能力增强内皮细胞与泵内表面的黏附。左侧背阔肌移植物电预处理2~3个月，预处理肌构建锥形泵。几个月后，在模拟单个心脏的模型中，将泵连接到右心旁路，并通过植入式起搏器进行电刺激。在没有泵刺激的情况下出现严重的心力衰竭，而刺激骨骼肌则显示心输出量显著增加，并恢复了正常的右心功能。然而，血栓形成在泵的内表面，没有内皮细胞衬里。相反，通过使用细胞黏附聚合物将培养的自体内皮细胞覆盖在泵的内表面，显著避免了血栓的形成。

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.