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目的通过体内动物实验验证磁悬浮左心辅助装——China Heart VAD的运行可靠性及血液相容性,并观察China Heart VAD对实验动物主要终末器官的影响。方法择健康雄性绵羊6只,麻醉诱导、呼吸插管后开胸,将China Heart VAD植入体内。在心脏不停跳的情况下,形成由左心尖到辅助装置,再到降主动脉的辅助循环通路。术后常规护理并抗凝控制,术前和术后不同时间段分别做游离血红蛋白、血细胞和血液生化指标检查。术后连续监测辅助装置运行状况,待动物存活至预期时限进行安乐死手术,尸解做VAD内血栓探查及动物终末主要脏器的宏观和病理检查。结果 6例实验中,1台VAD在植入25d后停止运转,其余5台正常运转至实验结束;6例实验动物中有1例在术后第3天因肺部感染死亡,其余5例VAD植入后存活状态良好,术后细胞学和血液生化学检查结果均值在正常范围内;血浆中游离血红蛋白数值小于9.78mg/dL;因VAD停转行安乐死动物尸解时发现,血泵入口形成一个疑似来源于心肌内膜的增生组织,且叶片与泵壳之间同时附着一块血栓,其余5例装置内无任何附着物或血栓;组织病理学检查发现2例动物左肺贴近VAD装置部位均可见有小叶性肺炎,2例动物肾脏有局部坏死,其余终末脏器无明显病变发生。结论 China Heart VAD具有较好的可靠性,完全可以胜任长于一个月的连续心室辅助,且具有极优的血液相容性,对各主要终末脏器无显著影响。
Objective To validate the reliability and hemocompatibility of magnetic heart-assisted left heart accessory Chinese Heart VAD by in vivo animal experiments and observe the effect of China Heart VAD on the main terminal organ of experimental animals. Methods Six healthy male sheep were selected and anesthetized to induce thoracotomy after intubation. China Heart VAD was implanted into the body. In the case of heart beating, the formation of the auxiliary device from the left apex to the descending aorta auxiliary circulation path. Postoperative routine care and anticoagulation control, preoperative and postoperative different time intervals to do free hemoglobin, blood cells and blood biochemical indicators. After the operation, the operation condition of the auxiliary device was continuously monitored. After the animals survived to the expected time limit for euthanasia, the autopsy was done to detect the thrombus in the VAD and the macroscopic and pathological examination of the main organs of the animals. Results In 6 cases, one VAD was stopped after 25 days of implantation and the other five were operated normally until the end of the experiment. One of the six experimental animals died of pulmonary infection on the third day after operation. The remaining five VAD After implantation, the survival status was good. The mean values of postoperative cytology and blood biochemical test were within the normal range. The value of plasma free hemoglobin was less than 9.78 mg / dL. When the carotid artery was euthanized by VAD, it was found that the entrance of blood pump formed a Suspected to come from the endometrial hyperplasia tissue, and the leaves and the pump shell attached to a piece of thrombus at the same time, the remaining five cases without any attachment or thrombus; histopathological examination found that two animals left lung close to the VAD device parts are visible There lobular pneumonia, 2 cases of animal kidney necrosis, the remaining terminal organ no obvious lesions occur. Conclusion China Heart VAD has good reliability and is capable of performing continuous ventricular assist for more than one month. It has excellent hemocompatibility and no significant effect on major terminal organ.