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目的研究我国自主研发的第3代完全磁悬浮心室辅助装置(CH-VAD)对于心衰患者的循环辅助效果。方法建立一套体外模拟循环系统(mock circulatory system,MCS)。该系统能够模拟人体健康休息状态以及心力衰竭状态,并与CH-VAD协同工作,测试CH-VAD在连续流状态下的辅助效果。另外,对CH-VAD的搏动流控制方法进行测试,该模式采用正弦波速度波形,使CH-VAD的运行与MCS心室周期同步。结果 CH-VAD在正常连续流状态下能够使心衰状态的血流动力学参数(动脉压、心排量)恢复到正常范围。初步的搏动流测试结果显示,当前的速度搏动幅值对血流动力学影响较小,搏动流状态下与连续流状态所对应的平均动脉压、动脉脉压、平均心排量与心排量波形等差异不大。结论 CH-VAD能够通过搏动控制器产生一定程度的速度搏动,提供足够的心室辅助,并可以进一步改良优化,提供符合生理条件的搏动血流。所研制的MCS能够提供心室辅助装置以及其他机械循环辅助装置一个有效、可控的体外测试平台,是机械循环辅助装置设计、优化和验证的重要工具。
Objective To study the circulatory assist effects of CH-VAD (3rd generation fully magnetic ventricular assist device) independently developed in China for patients with heart failure. Methods To establish a mock circulatory system (MCS). The system can simulate the state of human health and heart failure, and work together with CH-VAD to test the auxiliary effect of CH-VAD in continuous flow state. In addition, the pulsatile flow control method of CH-VAD was tested using sinusoidal wave velocity waveforms to synchronize CH-VAD operation with the MCS ventricular cycle. Results In normal continuous flow regime, CH-VAD could restore the hemodynamic parameters (arterial pressure and cardiac output) of heart failure to the normal range. The preliminary pulsatile flow test results show that the current velocity pulsatile amplitude has little effect on hemodynamics. The mean arterial pressure, arterial pressure, mean cardiac output and cardiac output Waveform is not very different. Conclusion The CH-VAD was pulsatile by pulsatile controller to provide ample ventricular assist and further improved optimization to provide pulsatile flow in physiological conditions. The MCS developed provides an effective and controlled in vitro testing platform for ventricular assist devices and other mechanical circulation aids, an important tool for the design, optimization and verification of mechanical circulation aids.