RESUMO
This paper describes the design of a ventricular assist device (VAD), its manufacturing, and testing. The VAD presented is pulsatile, with a free-floating membrane, smooth internal surfaces, and pericardial valves. It comprehends also a pneumatic driving unit capable of operating in the "full to empty," EKG synchronized or asynchronous modes. In vitro tests were performed to assess its mechanical durability, hydrodynamic performance, and hemolysis. To optimize cannulas and implant techniques, we performed in vivo tests in 22 sheep and 8 calves. In these tests, we also evaluated hemolysis and the device's capacity to normalize hemodynamic parameters during induced cardiac failure. The VAD worked for 4,000 h without failure in a mock circulatory loop. In full to empty mode, it displayed a rate-mediated "Starling-like" performance. Optimum output was achieved with a systole duration of 40% of the cycle. The in vitro hemolysis index (IH) was 6.7 +/- 2.1. Hemolysis in animal experiments was clinically nonsignificant. In calves with induced cardiac failure, the VAD was able to normalize hemodynamic parameters within 120 min.
Assuntos
Coração Auxiliar , Animais , Bovinos , Desenho de Equipamento , Hemodinâmica , Hemólise , Técnicas In Vitro , Fluxo Pulsátil , OvinosRESUMO
Tubular polymeric materials modified by radiation techniques can be used as vascular prosthesis and components of prosthetic devices. The biological interaction between these materials and blood was studied by in vitro and ex vivo methods. Silicone rubber tubes were copolymerized with acrylamide and N-vinylpyrrolidone by radiation-grafting techniques. The irradiation was performed with gamma-rays from a 60Co source at a constant dose rate (0.2 kGy/h) for various time intervals (4-15 h). To evaluate the antithrombogenicity of the grafted tubes, the surface adsorption of 125I-albumin and 125I-fibrinogen was studied. All graft copolymers show a preference for albumin, and the degree of preference appears to correlate with antithrombogenic tendency. In the ex vivo experiment with animals, tubes were implanted in the carotid artery of dogs and the blood flow in the graft copolymers was detected with an ultrasonic flow meter. The blood flow rate in the ungrafted implants decreased more rapidly (stopped completely after 15 to 210 min) compared to the flow rate in the grafted ones (decreased slowly from 38 to 35 ml/min and 70 to 60 ml/min). There was a direct relationship between both methods in the study of blood compatibility of the materials. The results suggest that the graft copolymers can be used as biomaterials for long-term use in cardiovascular systems.
Assuntos
Materiais Biocompatíveis , Prótese Vascular , Artérias Carótidas/fisiologia , Polímeros/efeitos da radiação , Acrilamidas/efeitos da radiação , Albuminas/metabolismo , Animais , Cães , Fibrinogênio/metabolismo , Pirrolidinonas/efeitos da radiação , Fluxo Sanguíneo Regional , Elastômeros de Silicone/efeitos da radiação , Propriedades de Superfície , Fatores de TempoRESUMO
Tubular polymeric materials modified by radiation techniques can be used as vascular prosthesis and components of prosthetic devices. The biological interction between these materials and blood was studied by in vitro and ex vivo methods. Silicone rubber tubes were copolymerized with acrylamide and N-vinylpyrrolidone by radiation-grafting techniques. The irradiation was performed with y-rays from a 60Co source at a constant dose rate (0.2 kGy/h) for various time intervals (4-15 h). To evaluate the antithrombogenicity of the grafted tubes, the surface adsorption of 125I-albumin and 125I-fibrinogen was studied. All graft copolymers show a preference for albumin, and the degree of preference appears to correlate with antithrombogenic tendency. In the ex vivo experiment with animals, tubes were implanted in the carotid artery of dogs and the blood flow in the graft copolymers was detected with an ultrasonic flow meter. The blood flow rate in the ungrafted implants decreased more rapidly (stopped completely after 15 to 210 min) compared to the flow rate in the grafted ones (decreased slowly from 38 to 35 ml/min and 70 to 60 ml/min). There was a direct relationship between both methods in the study of blood compatibility of the materials. The results suggest that the graft copolymers can be used as biomaterials for long-term use in cardiovascular systems
Assuntos
Animais , Cães , Artérias Carótidas/fisiologia , Materiais Biocompatíveis , Prótese Vascular , Polímeros/efeitos da radiação , Acrilamidas/efeitos da radiação , Albuminas/metabolismo , Elastômeros de Silicone/efeitos da radiação , Fibrinogênio/metabolismo , Pirrolidinonas/efeitos da radiação , Fluxo Sanguíneo Regional , Propriedades de Superfície , Fatores de TempoRESUMO
PURPOSE: To describe the design of a ventricular assist device (VAD), its manufacturing and testing. METHODS: The VAD is pulsatile, with a free floating membrane, smooth internal surfaces, and pericardium valves. It comprises also a pneumatic driving unit capable of operating in the "full to empty", EKG synchronized or asynchronous modes. The system was tested "in vitro" to assess its mechanical durability, hydrodynamic performance and hemolysis. "In vivo" tests were performed in 22 sheep and 8 calves aiming at optimizing cannulas and implant techniques. In these experiments, hemolysis and the device's capacity of restoring to normal hemodynamic parameters during induced cardiac failure were evaluated. RESULTS: The device was worked 4,000 hours without failure in a mock circulatory loop. Hydrodynamic performance was satisfactory for adult circulatory support. In "full to empty" mode it displayed a frequency mediated "Starling like" performance. Optimum output was achieved with a systole duration of 40% of the cycle. "In vitro" hemolysis index was 6.7 +/- 2.1. Hemolysis in animal experiments was clinically non significant. In calves under induced cardiac failure the VAD was able to normalize hemodynamic parameters within 120 minutes. CONCLUSION: This VAD is capable to circulatory assist for cardiogenic shock in conditions needed for an adult patient and the average time span anticipated for bridge to transplantation or post cardiotomy cardiogenic shock.
Assuntos
Coração Artificial , Coração Auxiliar , Animais , Bovinos , Ventrículos do Coração , Desenho de PróteseRESUMO
We analyzed the different effects of CO2, Nd-YAG, and argon lasers on aorta by using a Thermovision infrared system that registered the laser interaction with mongrel dog aorta. The images (thermograms) obtained were processed by a computer, which associated each area of the same temperature with a determined color. These thermograms were compared to histological analysis of the respective samples and the following results were obtained: (1) After the application of each laser there is very little propagation of heat in tissue. (2) The CO2 laser makes tissue reach 100 degrees C in less than 0.05 seconds. (3) The heat dissipation time was higher with the Nd-YAG laser due to higher scattering on tissue. Based on this research we conclude that the CO2 laser was best absorbed, the Nd-YAG laser penetrated human tissue with the best results, and the argon laser had the most significant backscattering.