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A Physical Heart Failure Simulation System Utilizing the Total Artificial Heart and Modified Donovan Mock Circulation

机译:一种利用总人造心脏和改装唐诺万型循环的物理心力衰竭仿真系统

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With the growth and diversity of mechanical circulatory support (MCS) systems entering clinical use, a need exists for a robust mock circulation system capable of reliably emulating and reproducing physiologic as well as pathophysiologic states for use in MCS training and interdevice comparison. We report on the development of such a platform utilizing the SynCardia Total Artificial Heart and a modified Donovan Mock Circulation System, capable of being driven at normal and reduced output. With this platform, clinically relevant heart failure hemodynamics could be reliably reproduced as evidenced by elevated left atrial pressure (+112%), reduced aortic flow (-12.6%), blunted Starling-like behavior, and increased afterload sensitivity when compared with normal function. Similarly, pressure-volume relationships demonstrated enhanced sensitivity to afterload and decreased Starlinglike behavior in the heart failure model. Lastly, the platform was configured to allow the easy addition of a left ventricular assist device (HeartMate II at 9600 RPM), which upon insertion resulted in improvement of hemodynamics. The present configuration has the potential to serve as a viable system for training and research, aimed at fostering safe and effective MCS device use.
机译:随着机械循环支持(MCS)系统的生长和多样性进入临床用途,需要一种能够可靠地模拟和再现生理学以及病理生理状态的强大模拟循环系统,以用于MCS培训和互脱性比较。我们报告了利用Syncardia总人造心脏和改进的Donovan模拟循环系统的发展的开发,能够在正常和降低的输出时被驱动。利用该平台,可以可靠地再现临床相关的心力衰竭血液动力学,如左侧心房压力升高(+ 112%),减少主动脉率(-12.6%),垂直的椋鸟的行为,并且与正常功能相比增加了较高的升高灵敏度。类似地,压力体积关系表明,对心力衰竭模型中的与恒载性的敏感性增强了敏感性。最后,平台被配置为允许易于添加左心室辅助装置(9600 rpm的心脏II),这在插入后导致血流动力学的改善。目前的配置有可能作为培训和研究的可行系统,旨在培养安全有效的MCS设备使用。

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