第二章 HeartWare公司微型轴流式心室辅助装置.doc

HeartWare Miniature Axial-Flow Ventricular Assist Device HeartWare公司微型轴流式心室辅助装置 Pulsatile ventricular assist devices have successfully provided circulatory support for many patients throughout the past quarter century; however, persistent complications have hindered expanded clinical application of this technology. Although the use of smaller, continuous-flow ventricular assist device pumps has reduced the frequency and severity of some adverse events, design enhancement may further improve outcomes for patients who require long-term left ventricular support. One new product, the HeartWare, Inc., miniature ventricular assist device, features a wide-bladed rotor design in an axial-flow pump with a strong, passively suspended magnetic rotor. The operating range of 16,000 to 28,000 rpm can provide up to 10 L /min of flow. The wide blades portend minimal cel -lular trauma. 过去四分之一个世纪以来，对于许多患者来说，脉动式心室辅助装置已成功地为其提供了血液循环支持。然而，持续的并发症阻碍了这项技术的临床应用和推广。虽然使用了更小的、连续流动式的心室辅助泵，减少了并发症的频率和一些不良症状的严重程度。通过精心和巧妙的设计，可进一步改善患者长期左心室血液循环支持的效果。，HeartWare公司的一款新的产品——微型心室辅助装置，采用宽叶片的转子轴流式设计，采用了强劲的被动悬浮磁转子泵。该装置的工作范围为16000到28000 RPM，可以提供高达10 L/min的流量。宽叶片设计能够对血液细胞的最小伤。 This new device has not yet been approved for use in human beings. As a test, we implanted it in a calf, and we continuously monitored the device’s performance and the hemodynamic results over 30 days. No mechanical failure occurred, and no thrombi were noted upon explantation of the device. The animal’s circulation was stable during the test period, and no end-organ abnormalities were found upon autopsy. The potential benefits of this miniature ventricular assist device are its increased availability to a broader patient population, a lower risk of infection, simplified implantation procedures, and improved durability. Further in vivo testing is planned. Herein, we discuss the unique design of the HeartWare miniature ventricular assist device, our feasibility study of its performance, and the possibilities for its use in human beings.