左室辅助装置中脉动流产生装置的血流动力学评价

A. Buchnev, A. P. Kuleshov, O. Y. Esipova, A. Drobyshev, N. V. Grudinin
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摘要

目的:探讨一种用于左室辅助装置的恒速轴流泵运行时产生脉动流的装置的效率。材料和方法。脉动流发生装置,以下简称“脉动器”,由壳体形式的可变液压阻力组成。在其内部安装一根内径为11毫米的弹性生物相容性材料管。在左心室收缩期,由于收缩压,弹性管完全打开,使血液喷射阻力最小化。在舒张期,由于流量泵不断旋转的吸入作用,弹性管部分关闭,对血液流动产生额外的水力阻力,从而导致舒张期主动脉压降低。在模拟心血管系统的流体动力学台上,对轴流泵在脉动和非脉动模式下的运行进行了对比评估。计算动脉压脉动(Ip)、泵内流量脉动(AQ)、能量等效压力(EEP)和剩余血流动力学能(SHE)。对比轴流泵在脉动和连续模式下运行时,动脉压脉动指数、泵内脉动指数和SHE指数分别增加了2.13±0.2倍、3.2±0.2倍和2.7±0.15倍,而EER指数保持不变。
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Hemodynamic evaluation of pulsatile-flow generating device in left ventricular assist devices
Objective: to investigate the efficiency of a device that generates pulsatile flow during constant-speed axial-flow pump operation for use in left ventricular assist devices.Materials and methods. The pulsatile flow-generating device, hereinafter referred to as «pulsator», consists of a variable hydraulic resistance made in the form of a hull. A tube of elastic biocompatible material featuring an inner diameter of 11 mm is installed inside it. In the systolic phase of the left ventricle, due to systolic pressure, the elastic tube is fully opened, minimizing resistance to blood ejection. In the diastolic phase, due to suction action of the flow pump operating in constant revolutions, the elastic tube partially closes, creating additional hydraulic resistance to blood flow, which leads to reduced diastolic aortic pressure. Comparative assessment of axial-flow pump operation in pulsating and non-pulsating modes was carried out on a hydrodynamic stand that simulated the cardiovascular system. The following indices were calculated: arterial pressure pulsation (Ip), in-pump flow pulsation (AQ), energy equivalent pressure (EEP) and surplus hemodynamic energy (SHE).Results. When comparing axial-flow pump operation in pulsatile and continuous mode, arterial pressure pulsation index, in-pump pulsation index, and SHE index increased by 2.13 ± 0.2, 3.2 ± 0.2, and 2.7 ± 0.15 times, respectively, while EER index remained unchanged.
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