CN106310411A - 升主动脉型心室辅助装置 - Google Patents
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- A61M60/148—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body implantable via, into, inside, in line, branching on, or around a blood vessel in line with a blood vessel using resection or like techniques, e.g. permanent endovascular heart assist devices
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Abstract
本发明公开了一种升主动脉型心室辅助装置，其包括内、外两层，外层两端连接人工血管，该装置顶部由人工瓣膜封闭或术中连接人工瓣膜；且所述内、外两层间通过管道与气泵连接，借由该气泵及与气泵相连的起搏导线可对该两层间的部分进行与心脏同步的充气或吸气；其中，该外层为硬质硅胶材料，内层为软质囊性材料。借由本发明的升主动脉型心室辅助装置能够增加冠脉血供、提高终末期心脏病患者的心脏功能、延长此类患者的生存时间、改善此类患者的生活质量。
Description
技术领域
本发明涉及心室辅助装置，特别是涉及一种升主动脉型心室辅助装置。
背景技术
目前临床上公认有效的治疗终末期心脏病的手段之一是心脏移植，但是由于心脏供体严重稀缺，很难满足临床需要，同时移植术后患者自身的免疫排斥反应等诸多问题难以解决，心脏移植治疗始终无法成为最常用的治疗手段。近年来，随着关于人工心脏的技术日渐成熟，加上其无伦理问题、无免疫排斥及抗排斥药带来的各种问题等多种优势，人工心脏已成为心脏移植的重要替代方法。人工心脏按用途可分为全人工心脏和心室辅助装置两种，其中全人工心脏由于体积大、植入技术复杂、术后并发症如感染、栓塞、溶血及多脏器衰竭的发生率高，耐久性差等缺陷，限制了其在临床的推广和应用，而现在应用的心室辅助装置也同样存在着植入时破坏心脏原有心肌组织，装置工作时无搏动性血流、血细胞破坏、左心房和左心室始终处于充盈状态以及内置泵故障后无法及时更换等缺点。另一种临床上较常用于改善心脏功能的手段是应用主动脉内球囊反搏(IABP)，但是由于其球囊容量有限，出血事件发生率较高，需要股动脉内置管，限制活动，还可能引起动脉穿孔、夹层以及周围动脉血栓使其只能成为短期、临时的治疗方法，而无法长期使用。最近，由美国Sunshineheart公司生产的一款名为C-Pulse的心室辅助装置，其原理是由主动脉周围充气气囊规律性的压迫升主动脉产生搏动性血流进而提高心输出量，尽管该装置较好地解决了之前心室辅助装置可能出现的各种问题，但因升主动脉周围结构较为紧密，植入手术时可操作空间小，固定较困难；并且由于该装置工作时隔着主动脉血管壁使其搏出量大打折扣，同时如果患者的主动脉壁存在钙化等固有损伤，C-Pulse工作时难免会对其造成进一步损伤。
由此，亟需一种新型的治疗装置或者方法在不降低治疗效果情况下治疗终末期心脏病，同时能够降低使用中的不良事件发生率、减轻或者避免各种可能出现的问题，进而提高终末期心脏病患者的治疗效果，并能够一定程度上延长心脏辅助装置的使用时间。
发明内容
鉴于上述的各种问题，本发明要解决的技术问题是提供一种新型结构的心脏辅助装置从而提高终末期心脏病患者的治疗效果。
为达上述目的，本发明提供了一种升主动脉型心室辅助装置，包括内、外两层，外层两端连接人工血管，以便与病人的大血管连接，该装置顶部由人工瓣膜封闭或术中连接人工瓣膜；且所述内、外两层间通过管道与气泵连接，借由该气泵及与气泵相连的起搏导线可对该两层间的部分进行与心脏同步的充气或吸气；其中，该外层为硬质硅胶材料，内层为软质囊性材料。
其中，使用时，所述气泵设于体外；该装置设置人工瓣膜封闭或术中连接人工瓣膜的一端配置为与升主动脉的远心端吻合；该装置未设置人工瓣膜的一端配置为与升主动脉的近心端吻合。
本发明与现有技术不同之处在于本发明取得了如下技术效果：本发明的升主动脉型心室辅助装置具有植入过程中无心肌手术损伤，装置工作时血流为搏动性、无需抗凝，血细胞无破坏、左心房和左心室间歇性空置状态，外置泵可备用，故障后易于及时更换，可长期安置，局部解剖空间基本满足装置植入，不用游离正常的周围组织，对主动脉壁血管条件无苛刻要求的优点。同时，如果是全心衰的病人，还可进行肺动脉主干的新型升主动脉型心室辅助装置的安置手术来改善右心功能。最终，通过新型升主动脉型心室辅助装置的应用能够增加冠脉血供、提高终末期心脏病患者的心脏功能、延长此类患者的生存时间、改善此类患者的生活质量。如果病人经过一段时间的治疗，心功能恢复正常，可随时停用该装置，恢复正常循环。
下面结合附图对本发明的升主动脉型心室辅助装置作进一步说明。
附图说明
图1为本发明升主动脉型心室辅助装置的剖视结构示意图；
图2为使用本发明升主动脉型心室辅助装置时的放气状态示意图；
图3为使用本发明升主动脉型心室辅助装置时的充气状态示意图。
附图标记说明：100‐升主动脉型心室辅助装置；102‐外层；104‐内层；103‐内、外层间部分；105‐人工瓣膜；106‐人工血管；107‐管道；108‐气泵；200‐升主动脉；300‐主动脉瓣；400‐头臂干；600‐左颈总动脉；800‐左锁骨下动脉。
具体实施方式
以下结合实施例，对本发明上述的和另外的技术特征和优点作更详细的说明。
请参阅图1，本发明的升主动脉型心室辅助装置100，包括硬质硅胶材料外层102、软质囊性材料内层104，外层102两端连接人工血管106，用于和自体血管进行吻合。装置100顶部由人工瓣膜105封闭或术中连接人工瓣膜；并且内、外两层间通过管道107与气泵108连接，借由气泵108及与气泵相连的起搏导线可对该两层间的部分103进行与心脏同步的充气或吸气。
可通过下述方法将本发明的升主动脉型心室辅助装置植入患者体内：患者在静脉和吸入复合全身麻醉下，经胸正中切口。建立体外循环，将主动脉阻断钳尽量远的夹在升主动脉200远心端近头臂干400的位置。主动脉根部灌注心脏停跳液使心脏停跳后切除升主动脉200，使用本发明的升主动脉型心室辅助装置100将升主动脉200进行替换。本发明升主动脉型心室辅助装置近心端(即未设置人工瓣膜的一端)与升主动脉近心端吻合；远心端(即设置人工瓣膜或术中连接人工瓣膜的一端)与升主动脉远心端进行吻合，空气管道107通过患者左侧第二肋间近胸骨开口处引出体外与气泵108相连。
请参阅图2和图3，分别为使用本发明升主动脉型心室辅助装置时的放气和充气状态示意图。当心脏收缩时，该装置通过体外的气泵108进行吸气，使主动脉内形成一定的负压，可以最大程度上降低心脏的后负荷，更好的维护心脏功能，同时由于人工瓣膜的存在，可避免因气泵吸气导致的主动脉远端血液逆流；当心脏舒张时，装该置通过体外的气泵108进行充气，主动脉瓣300关闭，人工瓣膜105处于开放状态，将内层104的囊性材料向内压缩使该装置内部的血液向前推动，给心脏在收缩期射入主动脉内的血进行加压和推进，增加主动脉远端和冠状动脉的血供。
以上所述的实施例仅仅是对本发明的优选实施方式进行描述，并非对本发明的范围进行限定，在不脱离本发明设计精神的前提下，本领域普通技术人员对本发明的技术方案作出的各种变形和改进，均应落入本发明权利要求书确定的保护范围内。
Claims (4)
1.一种升主动脉型心室辅助装置，其特征在于包括内、外两层，外层两端连接人工血管，该装置顶部由人工瓣膜封闭或术中连接人工瓣膜；且所述内、外两层间通过管道与气泵连接，借由该气泵及与气泵相连的起搏导线可对该两层间的部分进行与心脏同步的充气或吸气；其中，该外层为硬质硅胶材料，内层为软质囊性材料。
2.如权利要求1所述的升主动脉型心室辅助装置，其特征在于使用时，所述气泵设于体外。
3.如权利要求1所述的升主动脉型心室辅助装置，其特征在于该装置由人工瓣膜封闭或术中连接人工瓣膜的一端配置为与升主动脉的远心端吻合。
4.如权利要求1或3所述的升主动脉型心室辅助装置，其特征在于该装置未设置瓣膜的一端配置为与升主动脉的近心端吻合。
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Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
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| CN110124133A (zh) * | 2019-05-13 | 2019-08-16 | 青岛大学附属医院 | 一种难治性心力衰竭左心室功能辅助装置 |
| CN110812553A (zh) * | 2019-11-07 | 2020-02-21 | 武汉唯柯医疗科技有限公司 | 一种主动脉内植入式机械循环辅助装置 |
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| EP1070511A1 (en) * | 1998-04-06 | 2001-01-24 | Fujio Miyawaki | Auxiliary mechanical heart promoting the restoration of heart function |
| CN1256157A (zh) * | 1999-11-22 | 2000-06-14 | 李树文 | 气动式血泵、组合式气动心肺机、气动式人工心脏 |
| KR20100096474A (ko) * | 2009-02-24 | 2010-09-02 | 미토테크 주식회사 | 체내 이식형 심실 보조 장치 |
| CN105517590A (zh) * | 2013-06-21 | 2016-04-20 | 科万维公司 | 人造心室 |
| CN204864258U (zh) * | 2015-07-29 | 2015-12-16 | 上海市东方医院 | 主动脉旁反搏装置 |
Cited By (3)
| Publication number | Priority date | Publication date | Assignee | Title |
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| CN110124133A (zh) * | 2019-05-13 | 2019-08-16 | 青岛大学附属医院 | 一种难治性心力衰竭左心室功能辅助装置 |
| CN110124133B (zh) * | 2019-05-13 | 2024-04-26 | 青岛大学附属医院 | 一种难治性心力衰竭左心室功能辅助装置 |
| CN110812553A (zh) * | 2019-11-07 | 2020-02-21 | 武汉唯柯医疗科技有限公司 | 一种主动脉内植入式机械循环辅助装置 |
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