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切换左心和右心:一种新的双心室机械支策略,节省了原生单心室

Emrah Şişli¹, Canberk Yıldırım², İbrahim Başar Aka³

¹Pediatric Cardiovascular Surgery, Department of Cardiovascular Surgery, Osmangazi University Faculty of Medicine, Büyükdere District, Campus of Meşelik, Tepebaşı, 26480, Eskisehir, Turkey. emrah.sisli@ogu.edu.tr.

Annals of biomedical engineering

|August 27, 2023

概括

这项研究引入了一种新的双心室机械循环支持 (MCS) 配置,用于失败的Fontan循环. 这种创新方法利用原生单心室 (SV) 进行静脉回流,为当前的MCS策略提供了更生理的替代方案.

科学领域:

心血管工程心血管工程
医疗器械医疗器械
儿童心脏病学儿童心脏病学

背景情况:

末期Fontan患者单心室 (SV) 循环通常需要机械循环支持 (MCS) 作为通往心脏移植的桥梁.
捐献器官的稀缺性和SV循环的复杂生理需要创新的MCS解决方案.
目前的双心室MCS配置为失败的Fontan患者带来了挑战.

研究的目的:

为失败的Fontan患者引入和分析一种新的双心室MCS配置.
研究一种独特的方法,其中左心室和右心室被切换,将静脉循环委托给本地SV.
使用in silico和in vitro方法评估这种配置的可行性和性能.

主要方法:

开发一款即备的双心室MCS概念,涉及心室切换.
使用一个多隔间块参数心血管模型 (LPM) 模拟八种SV故障模式.
使用Medtronic-HeartWare VAD.使用Fontan患者的脉动模拟流环测量对LPM的实验验证.

主要成果:

拟议的配置保持了健康的心脏指数 (3-3.5 L/min/m2) 和正常的平均系统动脉压.
在模拟的系统性Fontan故障 (低射出分数) 中,系统实现了显著的静脉/肺波形振幅和降低的中央静脉压力 (CVP).
该模型证明了可接受的肺动脉平均压力和肺血管阻力衰竭模式的CVP减轻的潜在益处.

结论:

新的双心室MCS配置显示,作为一种低成本,更生理的替代方案,对于失败的Fontan循环更有希望.
这种方法节省了本土的SV,重新利用它来提供必要的静脉流脉动性.
建议对动物进行进一步的研究,以验证这些令人鼓舞的体外和体内发现.

关键词:

心血管循环理论心血管循环理论生产性心脏手术是一种先天性心脏手术.在Fontan流通的流通.血液动力学血液动力学一次性参数建模的一次性参数建模.机械循环支持机械循环支持模拟流动循环的模型单心室生理学单心室生理学腹腔辅助器件可以帮助心室.

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