Development of Novel Cardiovascular Assisting Device For Patients With Total Cavopulmonary Connection (TCPC)

本项目的目的是开发一种辅助全腔静脉连接患者循环的器械，全腔静脉连接是先天性单心室心脏缺损Fontan手术后典型的血液循环改变形式。虽然Fontan手术具有数十年的成功历史，但由于单心室生理学而导致的脉动泵送功率的缺乏导致患者的健康在手术后数年内下降，通常以静脉高血压的形式。因此，我们的目标是设计和开发一种装置，为减弱的循环提供额外的驱动支持。该器械将使用常用的外科移植物，即膨胀聚四氟乙烯（ePTFE）管，并通过使用移植物外部的可收缩金属元件进行受控扩张来产生前向流。这种新的方法也是安全的，因为即使在收缩元件失效的情况下，移植物仍然作为管道工作。设计参数将使用计算流体动力学（CFD）进行探索，以快速确定高效流动驱动机制的最佳设计。然后将在体外模拟循环系统中测试所开发的模型。一个经过充分验证的工作原型预计将在项目结束时，这将作为进一步发展的跳板临床翻译。

The aim of this project is to develop a device that will assist the circulation of patients with total cavopulmonary connection, which is a typical surgically-altered form of circulation after the Fontan procedure on congenital single ventricle defect of the heart. While the Fontan procedure has a successful history over decades, lack of pulsatile pumping power due to the single ventricle physiology causes a patient's health to decline over the years after the surgery, typically in a form of venous hypertension. The goal, therefore, is to design and develop a device that produces additional driving support to the weakened circulation. The device will utilise the commonly-used surgical graft, expanded polytetrafluroethylene (ePTFE) tube, and a forward flow will be generated by controlled peristalsis using contractile metallic elements from the outside of the graft. This novel approach is also safe, because even in case of contractile element failure, the graft still works as a conduit. Design parameters will be explored using computational fluid dynamics (CFD) for fast identification of optimal design for an efficient flow-driving mechanism. The developed model will then be tested in an in vitro mock circulatory system. A well-validated working prototype is expected in the end of the project, which will work as a springboard for further development towards clinical translation.