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Early Feasibility Testing and Engineering Development of a Sutureless Beating Heart (SBH) Connector for Left Ventricular Assist Devices (LVAD)

机译:用于左心室辅助装置(LVAD)的无缝合搏动心(SBH)连接器的早期可行性测试和工程开发

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摘要

APK Advanced Medical Technologies (Atlanta, GA) is developing a sutureless beating heart (SBH) left ventricular assist device (LVAD) connector system consisting of anchoring titanium coil, titanium cannula with integrated silicone hemostatic valve, coring and delivery tool, and LVAD locking mechanism to facilitate LVAD inflow surgical procedures. Feasibility testing was completed in human cadavers (n=4) under simulated normal and hypertensive conditions using saline to observe seal quality in degraded human tissue and assess anatomic fit; acutely in ischemic heart failure (IHF) bovine model (n=2) to investigate short-term performance and ease of use; and chronically for 30-days in healthy calves (n=2) implanted with HeartWare HVAD to evaluate performance and biocompatibility. Complete hemostasis was achieved in human cadavers and animals at LV pressures up to 170 mmHg. In animals, off pump (no cardiopulmonary bypass) anchoring of the connector was accomplished in less than 1 minute with no residual bleeding after full delivery and locking of the LVAD; and implant of connector and LVAD were successfully completed in under 10 minutes with total procedure blood loss less than 100mL. In chronic animals prior to necropsy, no signs of leakage or disruption at the attachment site were observed at systolic LV pressures >200 mmHg.
机译:APK Advanced Medical Technologies(佐治亚州亚特兰大)正在开发无缝合的跳动心脏(SBH)左心室辅助设备(LVAD)连接器系统,该系统由锚定钛线圈,带集成硅胶止血阀的钛套管,取芯和输送工具以及LVAD锁定机构组成促进LVAD流入手术程序。在模拟的正常和高血压条件下,使用生理盐水在人类尸体(n = 4)中完成可行性测试,以观察退化的人体组织中的密封质量并评估解剖结构;急性缺血性心力衰竭(IHF)牛模型(n = 2)以研究短期表现和易用性;在植入了HeartWare HVAD的健康小牛(n = 2)中进行30天的长期评估,以评估其性能和生物相容性。人类尸体和动物在LV压力高达170 mmHg时实现了完全止血。在动物中,在不超过1分钟的时间内完全释放并锁定LVAD,在不超过1分钟的时间内完成泵的连接器(无心肺旁路)锚固操作;在不到10分钟的时间内,成功完成了连接器和LVAD的植入以及LVAD的全过程失血,少于100mL。在尸检前的慢性动物中,当收缩压> 200 mmHg时,在附着部位未观察到渗漏或破裂的迹象。

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