| Project/Area Number |
61480302
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| Research Category |
Grant-in-Aid for General Scientific Research (B)
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| Allocation Type | Single-year Grants |
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| Research Field |
Thoracic surgery
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| Research Institution | National Cardiovascular Center, Research Institute |
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Principal Investigator |
TAKANO Hisateru National Cardiovascular Center, Research Institute Department of Artificial Organs, その他, 研究員 (60028595)
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| Co-Investigator(Kenkyū-buntansha) |
UMEZU Mitsuo National Cardiovascular Center, Research Institute Department of Artificial Orga, 人工臓器部, 室長 (90132927)
IWATA Hiroo National Cardiovascular Center, Research Institute Department of Surgical Resear, 実験治療開発部, 室長 (30160120)
MATSUDA Takehisa National Cardiovascular Center, Research Institute Department of Biomedical Engi, 生体工学部, 部長 (60142189)
TAENAKA Yoshiyuki National Cardiovascular Center, Research Institute Department of Artificial Orga, 研究所・人工臓器部, 室長 (00142183)
AKUTSU Tetsuzo National Cardiovascular Center, Research Institute, 研究所, 副所長 (40150221)
野田 裕幸 国立循環器病センター, 研究所人工臓器部, 室員 (20183551)
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| Project Period (FY) |
1986 – 1987
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| Project Status |
Completed (Fiscal Year 1988)
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| Budget Amount *help |
¥6,700,000 (Direct Cost: ¥6,700,000)
Fiscal Year 1987: ¥3,000,000 (Direct Cost: ¥3,000,000)
Fiscal Year 1986: ¥3,700,000 (Direct Cost: ¥3,700,000)
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| Keywords | Ventricular assist device (VAD) / Cardiogenic shock / Bi-ventricular failure / Pediatric VAD / Pressure-flow relationship / 急性心筋梗塞 / 術後心不全 / 先天性心疾患 / 心筋保護 |
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| Research Abstract |
In this project, the following three tasks were performed.
(1) Therapeutic effect of VAD on bi-ventricular failure(BVF): the therapeutic effect of VAD on BVF were evaluated in experimental study. BVF was induced by aortic-clamping under normothermia in goats, and LVAD (8 goats) or BVAD (2 goats) was applied. Without the pulmonary hypertension, LVAD alone in combination with volume loading could maintain near normal circulation. In case of BVAD, it was easy to maintain the circulation without volume loading. The recovery possibility of BVF depends upon the severity of myocardial damage suffered before VAD application. (2) VAD for pediatric use; two sizes of airdriven, diaphrahm type VADs have been developed for pediatric use. Their stroke volumes were 20 ml and 40 ml. With mock loop test, sufficient output for pediatric use was obtained. In amimal experiment using dogs weighing from 10 to 20 kg, the conduit could be smoothly inserted into the left atrium and easily sutured to the aorta.
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(3) Development of a non-invasive and continuous monitoring method of cardiac output during LVAD pumping: In order to develop a method that can predict left ventricular stroke volume from arterial pulse pressure and pressue-flow relationship on the VAD, three methods were evaluated in a mock circulatory loop. As the pressure-flow relationship, arterial compliance, peripheral vascular resistance, and arterial impedance were used in the first, second, and third method, respectively. In comparison to electro-magnetic flowmetry, the 2nd and 3rd methods showed excellent correlation coefficient.
Based on the above results, VADs were applied for 16 patients with cardiogenic shock. In nine of them entire circulation was well maintained at normal level and LVAD was successfully removed. Although the natural heart could recover, the most patients died of multiple organ failure which developed during prolonged ischemia prior to LVAD assistance. In clinical situation, timely use of LVAD by right judgement is important. Less
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