|
您當(dāng)前的位置：電子期刊欄目→論著>>正文 |
|
ChinaHeart左心輔助裝置的體內(nèi)動物實驗評估 In vivo survival evaluation of the ChinaHeart ventricular assist device |
| 作者： 藺嫦燕 吳廣輝 劉修健 徐創(chuàng)業(yè) 侯曉彤 李海洋 陳琛 楊朋 渠文波 |
| 單位：首都醫(yī)科大學(xué)附屬北京安貞醫(yī)院（北京100029） |
| 關(guān)鍵詞： ChinaHeart VAD；左心室輔助；磁懸浮血泵；在體實驗；評估 |
| 分類號： |
| 出版年·卷·期（頁碼）：2013·32·5（472-478） |
| 摘要： |
|
目的通過體內(nèi)動物實驗驗證磁懸浮左心輔助裝置——ChinaHeart VAD的運行可靠性及血液相容性，并 觀察ChinaHeart VAD對實驗動物主要終末器官的影響。方法擇健康雄性綿羊6只，麻醉誘導(dǎo)、呼吸插管后開 胸，將ChinaHeart VAD植入體內(nèi)。在心臟不停跳的情況下，形成由左心尖到輔助裝置，再到降主動脈的輔助 循環(huán)通路。術(shù)后常規(guī)護理并抗凝控制，術(shù)前和術(shù)后不同時間段分別做游離血紅蛋白、血細胞和血液生化指標(biāo) 檢查。術(shù)后連續(xù)監(jiān)測輔助裝置運行狀況，待動物存活至預(yù)期時限進行安樂死手術(shù)，尸解做VAD內(nèi)血栓探查及 動物終末主要臟器的宏觀和病理檢查。結(jié)果6例實驗中，1臺VAD在植入25d后停止運轉(zhuǎn)，其余5臺正常運轉(zhuǎn)至 實驗結(jié)束；6例實驗動物中有1例在術(shù)后第3天因肺部感染死亡，其余5例VAD植入后存活狀態(tài)良好，術(shù)后細胞 學(xué)和血液生化學(xué)檢查結(jié)果均值在正常范圍內(nèi)；血漿中游離血紅蛋白數(shù)值小于 9.78mg/dL；因VAD停轉(zhuǎn)行安樂 死動物尸解時發(fā)現(xiàn)，血泵入口形成一個疑似來源于心肌內(nèi)膜的增生組織，且葉片與泵殼之間同時附著一塊血 栓，其余5例裝置內(nèi)無任何附著物或血栓；組織病理學(xué)檢查發(fā)現(xiàn)2例動物左肺貼近VAD裝置部位均可見有小葉 性肺炎，2例動物腎臟有局部壞死，其余終末臟器無明顯病變發(fā)生。結(jié)論ChinaHeart VAD具有較好的可靠性 ，完全可以勝任長于一個月的連續(xù)心室輔助，且具有極優(yōu)的血液相容性，對各主要終末臟器無顯著影響。 |
|
Objective To evaluate the reliability hemocompatibility，and end-organ effects of the ChinaHeart VAD, a magnetic left ventricular assist device, by in vivo experimental investigation．Methods Under anesthesia，via left lateral thoracotomy and ventilator assisted breathing，every one of 6 healthy male sheep was completed as such model, in which the inflow cannula was inserted into the left ventricular apex on beating hearts，and the outflow graft was anastomosed to the descending aorta．Postoperative nursing and anticoagulating were completed routinely, the hematologic and biochemical tests were performed preoperatively and postoperatively to evaluate peripheral organ functions．ChinaHeart VAD operating parameters were recorded continuously until termination of the experiment．At the end of the experimental period the sheep was humanely killed，and the end-organs were examined macroscopically and histopathologically．Results Only one of six VADs stopped running at 25th day postoperatively because of thrombus between impeller and housing, and all of others was working until in vivo experiment terminated. One sheep died at 3rd day because of respiratory failure, others survived and their hematological and biochemical data showed no evidence of organ dysfunction during the experimental period．The maximum value of free hemoglobin in plasma was 9.78mg/dL. In this VAD which stopped running at 25th day postoperatively, we found a piece of hyperplasia tissue suspiciously from myocardial intima blocking at entrance, thrombus between impeller and shell, other pump’s inner, inflow and outflow conduits were free of thrombus at terminal autopsy. Histopathological examination revealed two sheep with lobular pneumonia at left lung where closed to device, and two sheep with kidney local necrosis, however the other end organs without obvious pathological changes. Conclusions The ChinaHeart VAD system demonstrated excellent reliability and hemocompatibility during more than thirty-five days supporting continuously，and had no significant side effect on the major end-organs. |
| 參考文獻： |
|
|
| 服務(wù)與反饋： |
| 【文章下載】【加入收藏】 |
| 提示：您還未登錄，請登錄！點此登錄 |
|
|||||||||||||||||
|
|||||||||||||||||
|
|
地址：北京安定門外安貞醫(yī)院內(nèi)北京生物醫(yī)學(xué)工程編輯部 電話：010-64456508 傳真：010-64456661 電子郵箱：[email protected] |