【摘要】 目的研制能长期植入主动脉瓣位置的左心室辅助装置,以治疗晚期心脏疾病心力衰竭患者。方法研制出直径23 mm、重31g可植入的主动脉瓣膜泵,该装置包括一个转子(由驱动磁钢、叶轮组成)和一个定子(装有带铁芯的电机线圈、出口导叶),并被置于主动脉瓣位置,不占用额外的解剖空间。主动脉瓣膜泵能像自然心脏一样直接将血液由心室输送到主动脉,不需要连接管道和旁路管道,对自然生理循环的干扰可以降至最低程度。结果主动脉瓣膜泵流量由最大到零周期变化。血流动力学测试结果表明,当主动脉瓣膜泵转速为15 000 r/m in时,可以产生7L/m in的流量、压力可达50mmHg(1kPa=7.5mmHg);同一转速下,当流量为0 L/m in时,主动脉瓣膜泵能保持主动脉舒张压在80 mmHg以上。结论直径23mm、重31g可长期使用的主动脉瓣膜泵能同时满足可植入性和血流动力学特性两方面的要求,有望替代自然心脏移植。但对该装置的血液相容性和耐久性问题还需要作更深入的研究。更多还原

【Abstract】 Objective To investigate the feasibility of a long-term left ventricular assist device placed in the aortic valve annulus for terminal cardiopathy.Methods An implantable aortic valve pump(23mm outer diameter,weighing 31g) was developed.There were a central rotor and a stator in the device.The rotor was consisted of driven magnets and an impeller,the stator was consisted of a motor coil with an iron core and outflow guide vanes.The device was implanted identical to an aortic valve replacement,occupying no additional anatomic space.The blood was delivered directly from left ventricle to the aortic root by aortic valve pump like natural ventricle,neither connecting conduits nor "bypass" circuits were necessary,therefore physiologic disturbances of natural circulation was less.Results Aortic valve pump was designed to cycle between a peak flow and zero net flow to approximate systole and diastole.Bench testing indicated that a blood flow of 7L/min with 50 mmHg(1kPa=7.5mmHg) pressure could be produced by aortic valve pump at 15 000r/min.A diastole aortic pressure of 80mmHg could be maintained by aortic valve pump at 0L/min and the same rotating speed.Conclusions This paper exhibits the possibility that an aortic valve pump with sufficient hemodynamic capacity could be made in 23mm outer diameter, 31g and it could be implantable.This achievement is a great progress to extend the applications of aortic valve pump in clinic and finally in replacing the natural donor heart for heart transplantation.Meanwhile,this is only a little step,because many important problems,such as blood compatibility and durability, require further investigation.更多还原