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Anatomic fitting of total artificial hearts for in vivo evaluation

机译：体内评价总人造心的解剖学拟合

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摘要

Successful anatomic fitting of a total artificial heart (TAH) is vital to achieve optimal pump hemodynamics after device implantation. Although many anatomic fitting studies have been completed in humans prior to clinical trials, few reports exist that detail the experience in animals for in vivo device evaluation. Optimal hemodynamics are crucial throughout the in vivo phase to direct design iterations and ultimately validate device performance prior to pivotal human trials. In vivo evaluation in a sheep model allows a realistically sized representation of a smaller patient, for which smaller third-generation TAHs have the potential to treat. Our study aimed to assess the anatomic fit of a single device rotary TAH in sheep prior to animal trials and to use the data to develop a three-dimensional, computer-aided design (CAD)-operated anatomic fitting tool for future TAH development. Following excision of the native ventricles above the atrio-ventricular groove, a prototype TAH was inserted within the chest cavity of six sheep (28-40kg). Adjustable rods representing inlet and outlet conduits were oriented toward the center of each atrial chamber and the great vessels, with conduit lengths and angles recorded for future analysis. A three-dimensional, CAD-operated anatomic fitting tool was then developed, based on the results of this study, and used to determine the inflow and outflow conduit orientation of the TAH. The mean diameters of the sheep left atrium, right atrium, aorta, and pulmonary artery were 39, 33, 12, and 11mm, respectively. The center-to-center distance and outer-edge-to-outer-edge distance between the atria, found to be 39±9mm and 72±17mm in this study, were identified as the most critical geometries for successful TAH connection. This geometric constraint restricts the maximum separation allowable between left and right inlet ports of a TAH to ensure successful alignment within the available atrial circumference.
机译：成功的解剖学拟合总人造心脏（TAH）对于在设备植入后实现最佳的泵血流动力学至关重要。虽然在临床试验之前，人类在人体中完成了许多解剖学拟合研究，但很少有报道将在体内设备评估中详细介绍了动物的经验。最佳血液动力学在整个体内阶段至关重要，以指导设计迭代并最终在枢转人体试验之前验证设备性能。在绵羊模型中的体内评估允许较小的患者的现实尺寸的表示，较小的第三代TAHS具有潜力的治疗。我们的研究旨在在动物试验之前评估单个器件旋转TAH的解剖结构，并利用数据开发用于未来TAH发育的三维，计算机辅助设计（CAD）的解剖配合工具。在大天然沟槽上方的本地心室切除后，将原型TAH插入六只绵羊（28-40kg）的胸腔内。表示入口和出口导管的可调节杆朝向每个心房室和大容器的中心定向，导管长度和角度记录为未来的分析。然后基于本研究的结果开发了三维，CAD操作的解剖配合工具，并用于确定TAH的流入和流出导管定向。绵羊左心房，右心房，主动脉和肺动脉的平均直径分别为39,33,12和11mm。该研究中，ATRIA之间的中心到中心距离和外边缘到外边缘距离，在本研究中发现为39±9mm和72±17mm，被确定为成功的TAH连接的最关键几何形状。该几何约束限制了TAH的左侧和右入口之间允许的最大分离，以确保在可用的心房周长内成功对齐。

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  • 来源
    《Artificial Organs》 |2013年第8期|共7页
  • 作者

    GregoryS.D.; LoechelN.; PearcyM.J.; FraserJ.; ParnisS.; CohnW.E.; TimmsD.;

  • 作者单位

    Medical Device Domain Institute of Health and Biomedical Innovation Queensland University of;

    Medical Device Domain Institute of Health and Biomedical Innovation Queensland University of;

    Medical Device Domain Institute of Health and Biomedical Innovation Queensland University of;

    Critical Care Research Group The Prince Charles Hospital Brisbane QLD Australia Innovative;

    Center for Cardiac Support Texas Heart Institute St. Luke's Episcopal Hospital Houston TX;

    Center for Cardiac Support Texas Heart Institute St. Luke's Episcopal Hospital Houston TX;

    BiVACOR Pty Ltd. Brisbane QLD Australia;

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  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 器官移植术;
  • 关键词

    Anatomic fit; Cardiac surgery; Heart failure; Total artificial heart;

    机译：解剖拟合;心脏手术;心力衰竭;总人造心脏;

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