CN102038979B - Heart impulse assisting system - Google Patents
Heart impulse assisting system Download PDFInfo
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- CN102038979B CN102038979B CN 200910177974 CN200910177974A CN102038979B CN 102038979 B CN102038979 B CN 102038979B CN 200910177974 CN200910177974 CN 200910177974 CN 200910177974 A CN200910177974 A CN 200910177974A CN 102038979 B CN102038979 B CN 102038979B
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Abstract
The invention relates to a heart impulse assisting device which comprises a heart ventricle capacity regulating device used for regulating the heart ventricle capacity, a synchronizer used for acquiring a heart ventricle contracting signal, and a control device used for receiving the heart ventricle contracting signal acquired by the synchronizer, wherein a sensor of the synchronizer is connected to the heart; the synchronizer is internally provided with an automatic defibrillation device and a synchronization treatment device, a defibrillation electrode of the automatic defibrillation device is connected to the heart, and a pacing electrode of the synchronization treatment device is planted into the heart. The heart ventricle capacity regulating device of the heart impulse assisting device has small volume, thus the heart impulse assisting device can be planted inside the heart, can fully simulate the heart ventricle pressure capacity change rule and the heart synchronous impulse works, and can be used for assisting the heart impulse acting to treat the cardiac failure, form the heart ventricle and repair the perforation of ventricular septum.
Description
Technical field
The present invention relates to a kind of medical treatment device, particularly a kind of heartbeat aid system.
Background technology
Heart failure is a kind of syndrome that various heart diseases cause cardiac dysfunction to cause.Its reason is that myocardial contraction descends and to cause the heart blood volume of fighting can not satisfy the needs of organism metabolism, sludging makes relaxing period chambers of the heart internal pressure raise and chambers of the heart expansion at heart simultaneously, myocardial contraction is descended, increase the weight of cardiac insufficiency, cause body circulation and pulmonary circulation obstruction of blood return, body, pulmonary circulatory stasis cause body circulatory function obstacle and organism metabolic disorder occurs.When heart failure took place, heart contraction row blood ability drop caused blood to remain in the heart, ventricular diastole pressure was increased and chambers of the heart distortion expansion, was outstanding with the apex enlargement deformation usually, made ventricle expand and developed to spherical direction.This variation makes myocardium keto consumption obviously increase, and myocardial contraction efficient obviously descends.After chambers of the heart enlargement deformation arrived to a certain degree, myocardial contraction further descended.In the case, if cardiac valve annulus also enlarges thereupon, then valvular regurgitation will occur, valvular regurgitation will quicken the infringement of cardiac structure and function, causes heart contraction, diastolic function to go down rapidly and arrhythmia.The direct result of malignant arrhythmia often is rapid dead.Therefore, strengthening myocardial contraction, recovery cardiac function structure and correction arrhythmia treats very important to heart failure.Severe arrhythmia and cardiac structure unusually normally need the endstage cardiac insufficiency patient's of mechanical assistance treatment characteristics, so power-assisted is difficult to satisfy fully its treatment requirement merely, needs in conjunction with the apparatus and method of correcting arrhythmia, reparation cardiac shape and functional structure.
The treatment of heart failure is the emphasis problem of medical attention always.Heart failure therapy means at present commonly used comprise Drug therapy, mechanical assistance and heart transplantation.Drug therapy is the Primary Care means, and mainly treating mechanism has the myocardial contraction of enhancing and alleviate the heart burden.The common feature that strengthens the myocardial contraction Drug therapy is to need cardiac muscle that medicine is had the certain reaction ability, and medicine also has certain limitation to the enhanced degree of myocardial contraction.The Drug therapy that alleviates the heart burden is a cost to sacrifice the organism metabolism demand, and body homergy demand is the basis that there is and keeps certain quality of life in life, is limited equally so alleviate the heart burden.Simultaneously since pharmaceutically-active non-selective feasible treatment often with some parts or whole body toxic and side effects.Cardiac muscle is badly damaged during heart failure, and cardiac muscle descends to the reactivity of medicine, and the histoorgan blood flow reduces and concurrent dysbolismus makes that the effect of medicine correction heart failure is very limited.The endstage cardiac insufficiency patient also obviously descends to the sensitivity of medicine because of accepting Drug therapy for a long time, uses more heavy dose of medicine to make that also its toxic and side effects is difficult to tolerate for realizing therapeutic effect.Therefore, not good usually for endstage cardiac insufficiency patient medication effect.
The cardiac structure of endstage cardiac insufficiency and functional lesion are normally irreversible, and the risk of surgical repair and Drug therapy is very big, produces little effect.What arise at the historic moment thus is replacement therapy, comprises heart transplantation, heart-assist device and total artificial heart.Heart transplantation is subjected to the restriction of donor to be difficult to satisfy the demand of medical treatment.
Be based upon the heart-assist device on artificial mechanical's device basic and the difference of total artificial heart two aspects are arranged: the one, function top is auxiliary and substitute ventricle work fully; The 2nd, on the heart combination, heart-assist device usually with exist simultaneously from systemic heart, carry out power-assisted with parallel or serial mode, total artificial heart then is with residual atrium to combine fully substitute ventricle work with artificial ventricle in excision on the basis of chamber, body-centered.
Because the subject matter of heart failure is that myocardial contraction goes down, the still complete existence of architecture basics from systemic heart, on the basis of systemic heart defective, carry out the mechanical assistance treatment in reparation and become the method for the treatment heart failure that can select, and become the emphasis of clinical medicine and biomimetic engineering research gradually.The method of the heart failure of mechanical assistance treatment at present is limited to the outer bypass assist circulation of heart with different driving and connected mode improvement more.For example, Fig. 1 outer bypass assist circulation mode of heart of showing a kind of employing membrane pump power of classics is treated the principle schematic of heart failure.With reference to Fig. 1, membrane pump 100 implant into body are inner but be positioned at the outside of heart 101, and the input 102 of membrane pump 100 is connected with atrium intubate 105.A left side or right atrium inside that atrium intubate 105 is inserted heart 101.The outfan of membrane pump 100 is connected with aorta 104 or pulmonary artery through arterial cannulation 103.The drive source that is arranged on the outside of human body is connected with membrane pump 100 by connecting line 106 with the control device (not shown).Drive system triggers for driving device synchronously through external electrode collection electrocardiosignal simultaneously.Like this, membrane pump under the control of control device with heartthrob synchronously or asynchronous behavior, make the atrium intubate 105 of blood through inserting the atrium from a left side or right atrium be pumped in the membrane pump 100, and in membrane pump filling power after arterial cannulation 103 is injected into aorta 104 or pulmonary artery.The parallel outward assist circulation therapeutic modality of the heart of this employing membrane pump recovers to have certain auxiliary treatment effect to the cardiac function of heart failure patient, but its work efficiency is subjected to the influence of drainage effect, especially obviously low in synchronous working state efficient, easily produce thrombosis in the pump housing, valve and the tube chamber, need anticoagulant therapy.Because it is external that the pipeline of connection heart and trunk passes, easy displacement damages heart and trunk causes massive hemorrhage and patient's activity is restricted, and this type of system supplymentary treatment time upper limit generally is no more than three months.
Fig. 2 shows the principle schematic that another kind of traditional outer bypass circuit supplementary mode of employing heart is treated heart failure.With reference to Fig. 2, axial-flow pump 200 implant into body are inner but be positioned at the outside of heart 201, and the input of axial-flow pump 200 is connected with ventricle intubate 202.Ventricle intubate 202 is inserted in the left ventricle of heart 201 from the apex of the heart of heart.The outfan of axial-flow pump 200 links to each other with aorta 204 through artificial blood vessel 203.The drive source that is arranged on human external is connected with axial-flow pump 200 by connecting line 205 with the control device (not shown).Axial-flow pump 200 makes blood draw through ventricle intubate 202 from left ventricle under the control of control device, annotates power after artificial blood vessel 203 injects aortas 204 through axial-flow pump 200.The blood flow form that this auxiliary treatment system produced is non-straight blood flow of beating, and fight pulsatile blood flow that blood produces of human body self heart is superimposed upon on the straight blood flow that auxiliary treatment system produces and forms pulsatile flow.Therefore the working foundation of this auxiliary treatment system is that self heart must have certain blood ability of fighting, to keep the perfusion of fluctuation blood flow.In case cardiac function worsens, the blood ability drop of self fighting is so that ventricular systole power can not overcome the aortic pressure that the axial-flow pump aid system forms, and then ventricle stops to arrange blood, and arteriotony is expressed as the non-pressure of beating fully, and life is difficult to keep.In addition, the big flow of the high rotating speed of axial-flow pump system is bigger to the destructiveness of blood formed element when moving, and is not suitable for psychological need, and is difficult to keep long-time use.
Present used heart-assist device does not all possess the ability that effectively works asynchronously with heartbeat; Do not possess the ability of simulating physical stress preface phase accessory heart in the ventricular chamber fully; Do not possess the ability that ventricle is assisted to repair cardiac shape and repaired perforation of ventricular septum of implanting; More do not possess the ARR ability of correction.
Summary of the invention
For addressing the above problem, the invention provides a kind of implantable ventricle inside, can be fully with heart beat synchronously work, be used for accessory heart and beat acting to treat the heartbeat aid system of heart failure.
Heartbeat aid system of the present invention wherein, comprising:
The ventricular volume adjusting device is used to regulate ventricular volume;
Synchronizer, the pick off of synchronizer is connected to heart, is used to gather the ventricular systole signal;
Control device is used to receive the ventricular systole signal that synchronizer is gathered, and controls described ventricular volume adjusting device reduces ventricle synchronously when ventricular systole volume.
Heartbeat aid system of the present invention, wherein: be provided with automatic defibrillation device and synchronization therapy device in the described synchronizer, the defibrillation electrode of described automatic defibrillation device is connected to heart, and the pacing electrode of described synchronization therapy device is implanted the chambers of the heart.
Heartbeat aid system of the present invention, wherein: described heartbeat aid system also comprises ventricle form holding device, described ventricle form holding device has the netted concave structure that the external shape with the heart left and right ventricles is complementary, and is attached to the outside of left and right ventricles with surgical sutures.
Heartbeat aid system of the present invention, wherein: described ventricular volume adjusting device comprises following structure:
The spill supportive device that adapts with the interior shape of ventricle is fixed in the ventricle, described supportive device inboard is provided with the flexible telescopic mounting of cryptomere, the lower end of described telescopic mounting is provided with the pipeline that is communicated with described telescopic mounting inner chamber, described pipeline is connected to power set after passing described supportive device and ventricle wall, and described power set are connected to described control device.
Heartbeat aid system of the present invention, wherein: the opening of described pipeline in described telescopic mounting is provided with the blockage resisting net.
Heartbeat aid system of the present invention, wherein: described supportive device is the flexible support net.
Heartbeat aid system of the present invention, wherein: described ventricular volume adjusting device comprises following structure:
Discoid pedestal is fixed on the apex of the heart end of ventricle, the center fixation of described pedestal has brshless DC motor, the rotor of described motor center is provided with axially extending bore, described axially extending bore has female thread, drive screw and the engagement of described female thread, membranous periphery combines with the edge sealing of described pedestal, and described membranous medial surface center is provided with driving-disc, the lower surface of described driving-disc and the top of drive screw are fixed together, and the downside of described pedestal is fixed with semielliptical shape drain pan; Described motor is connected to described control device and power supply.
Heartbeat aid system of the present invention, wherein: be connected with the guide rod of some downward extensions on the described driving-disc lower surface, each described guide rod all passes the bullport that is positioned on the described pedestal.
Heartbeat aid system of the present invention, wherein: also be provided with guide rod movement position pick off on the described guide rod, guide rod movement position pick off is connected to described control device, described guide rod movement position pick off is used for sending signal when described guide rod moves to the residing position of described guide rod movement position pick off, with the start-stop boundary of controlling the motion of described guide rod and the location of described guide rod.
The ventricular volume adjusting device volume of heartbeat aid system of the present invention is little, and implantable ventricle inside can be fully and the heart work of beating synchronously, can be used for accessory heart and beat acting to treat heart failure.Heartbeat aid system of the present invention possesses the ability that effectively works asynchronously with heartbeat; Possesses the ability of simulating physical stress preface phase accessory heart in the ventricular chamber fully; Possesses the ability that ventricle is assisted to repair cardiac shape and repaired perforation of ventricular septum of implanting; Possesses the ARR ability of correction.
Description of drawings
The employing pneumatic diaphragm pump that Fig. 1 shows a kind of current classics is the principle schematic that the outer bypass assist circulation mode of the heart of power is treated heart failure;
The outer bypass assist circulation mode of the heart that it is power that Fig. 2 shows another kind of current popular employing axial-flow pump is treated the principle schematic of heart failure;
Fig. 3 is the sketch map of ventricular volume adjusting device under expansion state of first kind of embodiment of heartbeat aid system of the present invention;
Fig. 4 is the sketch map of supporting network;
Fig. 5 is the sketch map of ventricular volume adjusting device under retracted state shown in Figure 3;
Fig. 6 is ventricular volume adjusting device sketch map under diastole (ventricular volume adjusting device retraction) state of first kind of embodiment;
Fig. 7 is the sketch map of ventricular volume adjusting device under heart contraction shape (expansion of ventricular volume adjusting device) attitude of first kind of embodiment;
Fig. 8 is the structural representation of first kind of embodiment of heartbeat aid system, and its cardiac is in relaxing period, and the ventricular volume adjusting device is in retracted state;
Fig. 9 is arranged on the sketch map of the cardiac shape holding device of the outer face of left and right ventricles;
Figure 10 is that the ventricular volume adjusting device of second kind of embodiment is sketch map under the expansion state at paradoxical expansion;
Figure 11 is that the ventricular volume adjusting device of second kind of embodiment is sketch map under the retracted state at diastole;
Figure 12 is the structural representation of second kind of embodiment of heartbeat aid system.
The specific embodiment
Describe embodiments of the invention below in detail, the embodiment that describes below with reference to accompanying drawing is intended to explain the present invention, and can not be interpreted as a kind of restriction of the present invention.
First kind of embodiment:
Referring to Fig. 8, heartbeat aid system of the present invention comprises:
Ventricular volume adjusting device 10, these ventricular volume adjusting device 10 whole ventricle inside of implanting the patient who suffers from heart failure are used to regulate ventricular volume;
Synchronizer 27, the pick off of synchronizer 27 is connected to heart, is used to gather the ventricular systole signal; Be provided with automatic defibrillation device and synchronization therapy device in the synchronizer 27, the outfan of defibrillation device and synchronization therapy device is connected to heart automatically;
Control device 26 is used to receive the ventricular systole signal that synchronizer is gathered, and control ventricular volume adjusting device 10 reduces the volume of ventricle synchronously when ventricular systole.
Control device 26, synchronizer 27 can be adopted existing related techniques.
Fig. 3 is that the ventricular volume adjusting device 10 of first kind of embodiment of the present invention is the sketch map of expansion state at paradoxical expansion, and Fig. 5 is that the telescopic mounting 12 of ventricular volume adjusting device 10 bounces back to the sketch map in the bracing or strutting arrangement 11 under the diastole state.
Ventricular volume adjusting device 10 comprises following structure:
The spill supportive device 11 that adapts with the interior shape of ventricle is fixed in the ventricle, the bracing or strutting arrangement 11 of for example implanting the ventricular volume adjusting device 10 of left ventricle is semiellipsoid, keeps well contacting and fixing in the surgery mode to implant in the ventricle and with the inwall of ventricle apex.Supportive device 11 inboards are provided with the flexible telescopic mounting 12 of cryptomere, telescopic mounting 12 is contained in the bracing or strutting arrangement 11 whole or in part, and have expansion state that can come out from bracing or strutting arrangement 11 expansion and a retracted state that in bracing or strutting arrangement 11, bounces back from expansion state, with heartthrob synchronously, periodic variation ventricle internal volume and pressure.
The lower end of telescopic mounting 12 is provided with the pipeline 20 that is communicated with telescopic mounting 12 inner chambers, and pipeline 20 is connected to power set 25 (Fig. 8) after passing supportive device 11 and ventricle wall, and power set 25 are connected to control device 26.The drive medium of this ventricular volume adjusting device 10 is gas or liquid, and promptly the power drive medium turnover telescopic mounting 12 that provides by power set 25 stretches.The driving force of power set 25 forces drive medium to enter telescopic mounting 12 inside, and it is interior to outer expansion by bracing or strutting arrangement 11 to promote telescopic mounting 12; The negative driving force is with the drive medium sucking-off, and telescopic mounting 12 is bounced back in bracing or strutting arrangement 11 by suction function.Power set 25 can be air pressure or fluid pressure type, and by power conduit air pressure or hydraulic power are transferred to and are arranged on intraventricular ventricular volume adjusting device 10, driving intraventricular ventricular volume adjusting device 10 works asynchronously with heart, acting of compensation heart contraction and promotion ventricular diastole are full, realize improving the purpose of cardiac function.The uninterrupted power source that can keep the power supply of heartbeat aid system is contained in power set inside.
Be provided with blockage resisting net 14 outside the opening 13 that on telescopic mounting 12, is connected, the opening of the pipeline 20 of adherent obstruction drive medium turnover when preventing telescopic mounting 12 retraction with pipeline 20.The material example that is suitable for making blockage resisting net 14 can be selected the biocompatible materials as nitinol (Nitinol), silicone, medical polyurethane and so on.The diameter of opening 13 for example is 10-12mm, and pipeline 20 length can be 18-22mm, so that the ventricular volume adjusting device is when implanting heart, pipeline 20 can pass myocardial wall and be communicated with the power conduit that comes from power set 25.Pipeline 20 can be made by materials such as titanium alloy, medical hard polyaminoester or medical silica-gels.
Ventricular volume adjusting device with the implantation left ventricle is an example, telescopic mounting 12 under the expansion situation is the flexible capsula interna 16 of spheroid, the spheroid that bottom opening arranged of capsula interna 16 for being made by medical macromolecular materials one-shot formings such as multilamellar medical polyurethane and silica gel.In the present embodiment, capsula interna 16 comprises three-decker, i.e. the internal layer 17 that contacts with drive medium as capsula interna, middle level 18 that plays strength support role and the skin 19 that is used to contact blood.But also can select to make capsula interna 16 to have one deck or two-layer even more multi-layered; Material therefor also can be selected of the same race or heterogeneity biological material, and biomaterial is in conjunction with medical macromolecular materials or metal material.In a word, if guarantee capsule 16 have air-tightness, scalability, anti-subduing property, with the physical and chemical stability and the biocompatibility of respective interface.According to the physical dimension of the target chambers of the heart, the long axis length of this capsula interna 16 is designed to 35,40,45,50,55 and 60mm, and the Design of length of minor axis is 30,35,40,45,50 and 55mm.But the present invention is not limited to this, the capsula interna 16 that can have other size according to the shape customization of patient's ventricle.Pipeline 20 formation that can stretch out by the cyst wall one from capsula interna 16 is to be communicated with (hereinafter will describe in detail) with the interface channel of power set.
After the bottom of capsula interna 16 and supporting network 15 closely contacts, by at supporting network 15 and the even coating medical polyurethane film in the bottom of the capsula interna 16 that contacts with it, supporting network 15 is firmly contacted with the bottom of capsula interna 16, and increase capsula interna 16 the bottom intensity and with the biological capacitive of ventricle wall tissue, the thickness of polyurethane film is about 300～500 μ m.
Ventricular volume adjusting device 10 also can be used for strengthening ventricle wall, assists ventricle to be shaped, to prevent mural thrombus and sealing perforation of ventricular septum.
Work as heart shrinkage period referring to Fig. 7, telescopic mounting 12 enters expansion state from bracing or strutting arrangement 11 interior bulgings, reduce the dischargeable capacity of ventricle storing blood and increased intraventricular pressure, more blood is extruded in the tremulous pulse in the ventricle thereby make, improved the pump blood ability of heart complementaryly, increase the blood flow of body circulation and pulmonary circulation, thereby improved patient's circulatory function.Relaxing period telescopic mounting 12 enlarges the ventricular chamber volume and pressure decline to the concave structure retraction of bracing or strutting arrangement 11, promotes relaxing period blood to reflux ameliorate body pulmonary circulation blood stasis.Therefore, ventricular volume adjusting device of the present invention has certain therapeutical effect to heart failure, even has therapeutical effect completely.
Heartbeat aid system of the present invention also comprises ventricle form holding device 28 as shown in Figure 9, this holding device has the netted concave structure that the external shape with the heart left and right ventricles is complementary, for example to be attached to the outside of left and right ventricles by the surgical sutures with biocompatibility.Like this, holding device 28 is coated on the outer face of ventricle, so that ventricle can further enlargement deformation not take place along with the deterioration of heart failure or because of the malleation the during expansion of ventricular volume adjusting device.Particularly, being in extreme at failure heart shrinks under the unable state, this holding device 28 can prevent because ventricle occurrence of large-area paradoxical movement and the excessive expansion when during systole expanding of intraventricular ventricular volume adjusting device 10, thereby further improves the auxiliary efficient of ventricular volume adjusting device 10.In one embodiment, holding device 28 can be netted containment shroud, and is made by the biocompatible materials with certain stress ability identical with the material of making above-mentioned supporting network.The apex of holding device 28 is provided with opening, so that the pipeline of ventricular volume adjusting device 10 passes.
In addition, also can on the ventricular volume adjusting device 10 of implanting heart inside and holding device 28, be provided for detecting the pick off of cardiac function and ventricular volume adjusting device 10 working conditions, for example be used to detect the pick off of electrocardiosignal, be used to detect the pick off of blood oxygen saturation, be used to detect the pick off of chambers of the heart internal pressure, be used to detect the pick off of vein pressure, be used to detect the volumetrical pick off of ventricle, be used to detect the pick off of ventricular volume adjusting device internal pressure and be used to detect ventricular volume adjusting device 10 flexible distances or volumetrical pick off or the like.The signal that these pick offs produce can be transferred to synchronizer 27 and/or control device 26 respectively.Synchronizer 27 is according to the detection signal of these pick offs 36, need to judge whether automatic defibrillation and start synchronization therapy, and producing synchronous contrast signal by preset program simultaneously, control device 26 is worked by preset program control power set 25 according to synchronous contrast signal.
On holding device 28, be provided with the pick off of a plurality of working conditions that are used to detect heart and epicardial surface defibrillation electrode 36 etc.Defibrillation electrode 36 is quivered behind the signal of telecommunication heart is carried out in the body discharge defibrillation automatically according to coming from chamber that automatic defibrillation device senses, to keep the coordination of cardiac electric excitement and mechanical movement, help ventricular volume adjusting device 10 and keep with effectively synchronously from the systemic heart action.When the motion of each chamber of heart occurs obviously when asynchronous, synchronizer starts the synchronization pacing therapy automatically, makes all chambers of the heart chamber synchronized movement, ensures that simultaneously ventricular volume adjusting device 10 works asynchronously with heart.
The display of power set 25, control device 26, synchronizer 27 and demonstration cardiac function and ventricular volume adjusting device 10 duties etc. is arranged on human external, and is referred to as external device (ED) in the present invention.These external device (ED)s be arranged on ventricular volume adjusting device 10 on pick off, be arranged on the pick off on the holding device 28 and the defibrillation electrode 36 that is arranged on the holding device 28 is electrically connected by lead.Preferably, these leads can be arranged on the inside and/or the outside of power conduit 29, can make various leads pass in and out human body with power conduit 29 like this.In addition, these pick offs can be electrically connected with external device (ED) by wireless mode.The auxiliary capacity and the time-histories of beating when regulating the 10 each expansions of ventricular volume adjusting device according to patient's heart rate, blood pressure and metabolic demand by control device 26, and during the diastole, regulate speed, time-histories and the volume of ventricular volume adjusting device 10 retractions according to patient's heart rate, intraventricular pressure and venous pressure by control device 26.
The embodiment that heartbeat aid system of the present invention comprises a ventricular volume adjusting device 10 has been described above.Be implanted in the left ventricle though there is shown ventricular volume adjusting device 10, those skilled in the art will appreciate that also and this ventricular volume adjusting device 10 can be implanted in the right ventricle.Further, also can in left and right ventricles, implant a ventricular volume adjusting device of the present invention respectively simultaneously and realize that biventricular is auxiliary.If implementing biventricular with ventricular volume adjusting device of the present invention beats auxiliary synchronously, when auxiliary volume reaches certain limit, be that the blood volume of fighting that simple ventricular volume adjusting device produces can be kept enough blood pressures, can satisfy circulation needs under the human body physiological state, can think and realize effect and the notion that total artificial heart is equal to.
Second kind of embodiment:
Second kind of embodiment compares with first kind of embodiment, and the part of variation only has the ventricle volume adjusting means, and Figure 10 and 11 is sketch maps of second kind of ventricular volume adjusting device among the embodiment.The ventricular volume adjusting device 50 of second embodiment is an electric device, promptly implants behind the power set miniaturization, and the electric power that provides by the outside stretches.
Referring to Figure 10, ventricular volume adjusting device 50 comprises following structure: discoid pedestal 52 is fixed on the apex of the heart end of ventricle, the center fixation of pedestal 52 has brshless DC motor 54, the rotor at motor 54 centers is provided with axially extending bore, axially extending bore has female thread, drive screw 55 and female thread engagement, the periphery of barrier film 53 combines with the edge sealing of pedestal 52, the medial surface center of barrier film 53 is provided with driving-disc 56, the top of the lower surface of driving-disc 56 and drive screw 55 is fixed together, and the downside of pedestal 52 is fixed with semielliptical shape drain pan 51; Motor 54 is connected to control device 26.Be connected with the guide rod 57 that some for example (2,3 or 4) extend on driving-disc 56 lower surfaces downwards, each guide rod 57 all passes the bullport that is positioned on the pedestal 52.
Also be provided with guide rod movement position pick off 571 on the guide rod 57, guide rod movement position pick off 571 is connected to control device 26, guide rod movement position pick off 571 is used for sending signal when guide rod 57 moves to guide rod movement position pick off 571 residing positions, with the location of the start-stop boundary of control guide rod 57, barrier film 53 motions and guide rod 57, barrier film 53.
The structure of barrier film 53 can be identical with the capsule 16 of first embodiment with material, repeats no more here.Drain pan 51, pedestal 52 and barrier film 53 form and intraventricular blood, cardiac muscle and the isolated hermetically-sealed construction of surrounding tissue.After the otch by the heart apex was placed into the part more than ventricular volume adjusting device 50 pedestals in the ventricle, the outer rim of pedestal 52 was fixed on apex incision cardiac muscle edge by operation stitching.Drain pan 51 and contained within hold and to be positioned at the outer body cavity of heart.Various leads are drawn in external by thoracic wall tunnel and skin section and are connected with battery with control device 26.
Referring to Figure 10, after the ventricular volume adjusting device 50 with second embodiment is implanted in the ventricle, be accompanied by the contraction of heart, motor 54 forward rotation drive drive screw 55 and driving-disc 56 and move up, and upwards launch thereby drive barrier film 53.Because the contraction of heart itself and the expansion of barrier film 53 are dwindled with intraventricular blood pressure chambers of the heart internal volume and are risen, order about blood and enter main (lung) tremulous pulse through the semilunar valve of heart, enter body, pulmonary circulation.At this moment, the drain pan 51 that is positioned at the bottom contacts closely with the ventricle wall of apex, and do not damage the tissue of local ventricle wall, provide immobilizing foundation and action fulcrum between whole ventricular volume adjusting device 50 and the ventricle wall thus, to guarantee barrier film 53 upwards directed movements.Figure 11 shows that diastole spacer film 53 retracted state of retraction downwards.Be accompanied by the diastole of heart, barrier film 53 roughly is being retracted to downwards under the driving of driven unit near the pedestal 52, promotes that blood is back in the ventricle through the atrioventricular valves (A V valves) of heart.
Implant intracavity or subcutaneous behind synchronizer 27 miniaturizations, lead to heart lead respectively through vein to the chambers of the heart or directly together lead to external through the thoracic wall tunnel and the skin section of motor lead to the lead that is incorporated into electrode or pick off on the holding device 28, leads to control system of heart table.The power supply of motor 54 also may be incorporated in the control device.Carry by patient behind rechargeable battery 60 and control device 26 miniaturizations.Control device and power supply also can be placed on inside of human body, charge with wireless mode.
In addition, adopt ventricular volume adjusting device treatment heart failure of the present invention, intraventricular blood just contacts with the barrier film outer surface of ventricular volume adjusting device, and the barrier film of the included ventricular volume adjusting device of the present invention has fabulous biocompatibility, rather than the outer bypass circuit mode of traditional extracorporeal circulation or heart that resembles is treated the heart failure blood will flow through blood pump and pipeline, therefore, ventricular volume adjusting device of the present invention has reduced the destruction to the blood biological property to greatest extent, thereby has kept the activity of blood.
Above embodiment is described preferred implementation of the present invention; be not that scope of the present invention is limited; design under the prerequisite of spirit not breaking away from the present invention; various distortion and improvement that the common engineers and technicians in this area make technical scheme of the present invention all should fall in the definite protection domain of claims of the present invention.
Claims (5)
1. a heartbeat aid system is characterized in that, comprising:
Ventricle internal volume adjusting device (10) is used to regulate ventricular volume;
Synchronizer (27), the pick off of synchronizer (27) is connected to heart, is used to gather the ventricular systole signal;
Control device (26) is used to receive the ventricular systole signal that synchronizer is gathered, and controls described ventricle internal volume adjusting device (10) reduces ventricle synchronously when ventricular systole volume, and described ventricle internal volume adjusting device (10) comprises following structure:
The spill supportive device (11) that adapts with the interior shape of ventricle is fixed in the ventricle, described supportive device (11) inboard is provided with the flexible telescopic mounting (12) of cryptomere, the lower end of described telescopic mounting (12) is provided with the pipeline (20) that is communicated with described telescopic mounting (12) inner chamber, described pipeline (20) is connected to power set (25) after passing described supportive device (11) and ventricle wall, and described power set (25) are connected to described control device (26).
2. heartbeat aid system according to claim 1, it is characterized in that: be provided with automatic defibrillation device and synchronization therapy device in the described synchronizer (27), the defibrillation electrode of described automatic defibrillation device (36) is connected to heart, and the pacing electrode of described synchronization therapy device is implanted the chambers of the heart.
3. heartbeat aid system according to claim 2, it is characterized in that: described heartbeat aid system also comprises ventricle form holding device (28), and described ventricle form holding device (28) has the netted concave structure that the external shape with the heart left and right ventricles is complementary.
4. heartbeat aid system according to claim 3 is characterized in that: the opening of described pipeline (20) in described telescopic mounting (12) is provided with blockage resisting net (14).
5. heartbeat aid system according to claim 4 is characterized in that: described supportive device (11) is a flexible support net (15).
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| CN 200910177974 CN102038979B (en) | 2009-10-23 | 2009-10-23 | Heart impulse assisting system |
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| CN 200910177974 CN102038979B (en) | 2009-10-23 | 2009-10-23 | Heart impulse assisting system |
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| CN2012104085902A Division CN102872486A (en) | 2009-10-23 | 2009-10-23 | Cardiac impulse assist system |
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| CN102499872B (en) * | 2011-10-17 | 2014-06-18 | 南京大学 | Direct heart-assist device based on artificial muscle network |
| US20130245441A1 (en) * | 2012-03-13 | 2013-09-19 | Siemens Medical Solutions Usa, Inc. | Pressure-Volume with Medical Diagnostic Ultrasound Imaging |
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| CN111429787B (en) * | 2020-04-07 | 2022-04-05 | 中南大学 | Artificial blood pump in-vitro simulation circulating system |
| CN111821528A (en) * | 2020-06-16 | 2020-10-27 | 北京工业大学 | Functional artificial left ventricle system |
| CN112263780A (en) * | 2020-10-10 | 2021-01-26 | 山东大学 | Extracardiac ventricular assist device and use method |
| CN116549762B (en) * | 2023-07-10 | 2023-10-31 | 北京悦唯医疗科技有限责任公司 | Left ventricle auxiliary device |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| CN1376078A (en) * | 1999-08-20 | 2002-10-23 | 卡迪奥雷斯特国际有限公司 | A method of treating a living organism to achieve a heart load reduction, and apparatus for carrying out the method |
| CN1838971A (en) * | 2003-06-26 | 2006-09-27 | 先进复生有限责任公司 | Sensor-equipped and algorithm-controlled direct mechanical ventricular assist device |
| CN201519326U (en) * | 2009-10-23 | 2010-07-07 | 杨碧波 | Cardiac pulsation auxiliary system |
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US5139517A (en) * | 1989-11-08 | 1992-08-18 | Corral David F | Orthotopic intraventricular heart pump |
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Patent Citations (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN1376078A (en) * | 1999-08-20 | 2002-10-23 | 卡迪奥雷斯特国际有限公司 | A method of treating a living organism to achieve a heart load reduction, and apparatus for carrying out the method |
| CN1838971A (en) * | 2003-06-26 | 2006-09-27 | 先进复生有限责任公司 | Sensor-equipped and algorithm-controlled direct mechanical ventricular assist device |
| CN201519326U (en) * | 2009-10-23 | 2010-07-07 | 杨碧波 | Cardiac pulsation auxiliary system |
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| CN102038979A (en) | 2011-05-04 |
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