JPH10174713A - Heart assisting device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a heart assisting device capable of making the more meticulous assistance approximate to the movement of the heart than the conventional devices. SOLUTION: This heart assisting device 1 has a balloon 11 for the right atrium, a balloon 12 for the right ventricle, a balloon 13 for the left atrium and a balloon 14 for the left ventricle which are respectively dilatable and contractable, first to fourth tubes 16 to 19 which are discretely disposed in correspondence respectively to these four balloons 11 to 14 and function as feed and discharge paths for gaseous helium to the respective balloons 11 to 14 and a cup-shaped holder 20 which is adhered with the four balloons 11 to 14 on its inner peripheral surface. In such a case, the set of the balloon 11 for the right atrium and the balloon 13 for the left atrium and the set of the balloon 12 for the right ventricle and the balloon 14 for the left ventricle are alternately dilated and contracted to compress both of the atrium and the ventricle from the outer side, by which the pulsation of the heart is assisted.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a heart assisting device for assisting the pulsation of a heart by compressing the heart from outside.

[0002]

2. Description of the Related Art Conventionally, assisting the heart function has been performed by compressing the heart from the outside, and several heart assisting devices used for this purpose have already been proposed in academic societies and the like. . This type of heart assist device
For example, it comprises a balloon that expands when a fluid is supplied to the inside and contracts when the fluid is discharged, and a tube that forms a supply and discharge path for the fluid supplied to the balloon. By expanding the balloon, pressure was applied from the outside of the ventricle, and the load on the heart when the ventricle was contracted could be reduced.

[0003]

However, since the above-mentioned conventional heart assist device can only assist the contraction of the ventricle, it has not been possible to provide a precise assist closer to the movement of the heart.

[0004] For this reason, for example, the heart function is significantly reduced,
Even if the blood in the atrium cannot be sufficiently pumped into the ventricle, it is impossible to provide appropriate assistance with a conventional heart assist device, and in some cases, blood may stay in the atrium. As a result, there is a fear that a problem such as formation of a thrombus may be caused.

SUMMARY OF THE INVENTION The present invention has been made to solve the above-mentioned problem, and an object of the present invention is to provide a heart assisting device capable of performing minute assistance closer to the movement of the heart than conventional products. .

[0006]

SUMMARY OF THE INVENTION In order to achieve the above-mentioned object, a heart assisting device according to the present invention is arranged outside the atrium and expands when fluid is supplied to the inside. On the other hand, it contracts when the fluid inside is discharged, and by compressing the atrium from the outside at the time of expansion, it is arranged at the outside of the ventricle with an atrial balloon capable of assisting atrial contraction,
A ventricular balloon capable of assisting the contraction of the ventricle by expanding when a fluid is supplied to the inside, contracting when the internal fluid is discharged, and compressing the ventricle from the outside at the time of expansion, and the atrial balloon. And a plurality of tubes that are individually provided corresponding to each of the ventricular balloons, each have a lumen communicating with the inside of each balloon, and the lumen serves as a fluid supply / discharge path for each balloon. It is characterized by having.

[0007] According to the heart assist device configured as described above, in addition to the ventricular balloon driven in the same manner as the conventional product,
Since it also has an atrial balloon that can compress the atrium,
While the atrial balloon is deflated and the ventricular balloon is expanded at the same time, the atrial balloon is expanded and the ventricular balloon is deflated to provide more precise assistance closer to the heart movement than conventional products. Therefore, for example, even when heart function is impaired, blood in the atrium can be sufficiently pumped into the ventricle to increase the amount of blood pumped from the ventricle to the artery. It can be prevented beforehand.

The balloon is made of, for example, polyurethane, latex, silicone rubber, natural rubber, polyvinyl chloride, polyamide, polyamide elastomer, ethylene vinyl acetate copolymer, polyethylene, polyimide, polyethylene terephthalate, fluororesin, or the like. However, the material is not particularly limited as long as it is a resin material that can expand and contract flexibly. The tube may be formed of the same resin material as that of the balloon, and may be any other material as long as it can flexibly bend while maintaining the lumen.

As the fluid, a gas or a liquid can be considered, but a gas having a small flow resistance is desirable in terms of excellent responsiveness, and a helium gas used for IABP or the like may be used. . However,
Unlike IABP, there is no fear of gas leaking into blood vessels, so that gases other than helium gas, such as air, can be widely used.

To drive this heart assist device,
A drive device for supplying and discharging fluid in synchronization with the heart beat may be connected to the proximal end side of the tube. In this case, since the driving device supplies and discharges the fluid in synchronization with the heartbeat, the balloon of the heart assist device can be driven favorably, and the desired assist circulation can be performed. It should be noted that such a driving device may be configured exactly as the driving device used in the IABP, and a dedicated connector or the like for connecting to the driving device is provided on the proximal end side of the tube. You may have.

Further, regarding the method of arranging the balloon,
Any arrangement method may be adopted as long as the heart can be arranged so as to be able to be compressed from the outside. More specifically, for example, a method of simply arranging the balloon around the heart and expanding the balloon to a size large enough to compress the heart may be used. In order to effectively compress the heart using a relatively small balloon, a cup-shaped holder that covers the outer periphery of the heart is arranged, and the balloon is expanded between the inner surface of the holder and the outer peripheral surface of the heart. It is also good. When such a holder is provided, in addition to a cup-shaped one having a relatively high rigidity, a bag having a relatively low rigidity is used unless the volume is equally increased with the expansion of the balloon. The heart may be wrapped in a heart shaped holder. Furthermore, if a balloon is inserted between the pericardium and the myocardium on the surface of the heart, the pericardium functions in the same manner as the holder, and thus the heart can be compressed.

By the way, the atrial balloon and the ventricular balloon may both surround the entire circumference of the heart. However, since there is a coronary artery on the side of the heart, the balloon does not compress the coronary artery. It is desirable to position the balloon at a location. To this end, as in the heart assist device according to claim 2, one or both of the atrial balloon and the ventricular balloon compresses the left heart balloon or the right heart side for compressing the left heart side. It is good to be constituted by either one or both of the right heart balloons for performing the operation.

In such a heart assist device, each balloon compresses one of the left atrium, the right atrium, the left ventricle, and the right ventricle, but mainly exists near an intermediate wall between the left heart and the right heart. This prevents the problem that the coronary artery is not compressed and the blood supplied to the myocardium is reduced.

The atrial balloon and the ventricular balloon are considered to be formed by both the left heart balloon and the right heart balloon, so that the auxiliary effect is considered to be correspondingly high. In some cases, only the left heart support or the right heart support may be sufficient, so that either or both of the atrial balloon and the ventricular balloon may be constituted by either the left heart balloon or the right heart balloon. Absent. In addition, it is only necessary that both the atrial balloon and the ventricular balloon are both composed of a left heart balloon and a right heart balloon, but, for example, only the ventricular balloon surrounds the entire circumference of the heart. Even if only one of the atrial balloon or the ventricular balloon is divided into the left heart balloon and the right heart balloon, it is not divided into the left heart balloon and the right heart balloon at all. It is harder to compress the coronary artery than the one.

Still further, in the case where one or both of the atrial balloon and the ventricular balloon are constituted by one or both of the left heart balloon and the right heart balloon as described above, the following claims may be made. 3, the left heart balloon and the right heart balloon do not communicate with each other, and the tubes correspond to the left heart balloon and the right heart balloon, respectively. It may be provided separately.

According to the heart assisting device configured as described above, only one of the left heart balloon and the right heart balloon can be driven. Therefore, for example, when the patient is in a bad condition, the two hearts are assisted. When the patient's condition recovers, the left heart and the right heart can be independently executed or stopped, such as switching to the left heart only.

In addition to the configuration described in claim 3, for example, a left heart balloon and a right heart balloon communicate with each other, a left heart balloon or a right heart balloon only has one, or the like. It is conceivable that it is still possible to avoid compression of the coronary arteries. Therefore, when there is no plan to change the compression part in the middle, it is not always necessary to configure as described in claim 3, especially if the left heart balloon and the right heart balloon communicate with each other,
By sharing a tube for supplying and discharging fluid,
There is also an advantage that the device can be made compact,
These may be appropriately used depending on the case, for example.

[0018]

Next, an example of an embodiment of the present invention will be described with reference to the drawings. As shown in FIG. 1, the heart assist device 1 expands when helium gas is supplied to each of the insides 11 a to 14 a, and contracts when the helium gas in the insides 11 a to 14 a is exhausted. , Right ventricular balloon 12, left atrial balloon 13,
And the left ventricular balloon 14, which are provided individually corresponding to each of these four balloons 11 to 14, each having a lumen 16 a to 19 a communicating with the interior 11 a to 14 a of each balloon 11 to 14, Its lumen 16a-1
9a includes first to fourth tubes 16 to 19 serving as supply and discharge paths of helium gas to and from each of the balloons 11 to 14, and a cup-shaped holder 20 to which the four balloons 11 to 14 are adhered to the inner peripheral surface. ing.

Of these, the right atrial balloon 11 is made of polyurethane, and the mounting position inside the holder 20 is set to a position adjacent to the outside of the right atrium when the heart is accommodated in the holder 20, and When the atrial balloon 11 is inflated, the shape and dimensions are such that the right atrium can be compressed from the outside. The right ventricle balloon 12, the left atrial balloon 13, and the left ventricle balloon 14 are also made of polyurethane, and the mounting position, shape, and dimensions inside each holder 20 are the right ventricle, the left atrium, and the left ventricle. The configuration is the same as that of the right atrial balloon 11 except that it corresponds to

The first to fourth tubes 16 to 19 are
Each is made of polyurethane, one end is connected to each of the balloons 11 to 14, the portion led out of the holder 20 is bundled by an outer tube 22, and the other end is a heart beat. It is connected to a driving device (not shown) capable of supplying and discharging helium gas according to the movement. It should be noted that this type of driving device is exactly the same as a driving device used in IABP and the like, and a detailed description thereof will be omitted.

Further, the holder 20 is made of acrylic resin and has such a size that a space for accommodating the heart can be secured inside the balloon 11 to 14 with the balloons 11 to 14 adhered thereto. In addition, in FIG. 1, although the shape and arrangement | positioning position of each balloon 11-14 are not exactly represented for the sake of showing the existence of four balloons 11-14 explicitly, the said four balloons 11-14 The outer shape and the arrangement position are optimized according to the parts to be compressed. Especially,
Since blood vessels such as pulmonary veins are near the left atrium,
The position where the left atrial balloon 13 can be arranged is more limited than the other balloons 11, 12, and 14, and the actual left atrial balloon 13 can compress the left atrium locally from the front side of the heart. Placed in a state. The holder 20 is also adjusted to a size and a shape that can be introduced into the holder 20 without excessively compressing the pulmonary vein, the inferior vena cava, and the like.

The heart assist device 1 configured as described above is
Thoracotomy is performed and attached to the patient's heart. At the time of mounting, a driving device capable of supplying and discharging helium gas is connected to the first to fourth tubes 16 to 19, and the inside of each balloon 11 to 14 is connected via the first to fourth tubes 16 to 19.
By decompressing 1a to 14a, all of the balloons 11 to 14 are deflated. Then, the mounting position of the heart assisting device 1 is adjusted so that the desired portion can be compressed by each of the balloons 11 to 14.

When the mounting is completed, the balloons 11 to 14 are driven in accordance with the pulsation of the heart by operating the driving device to supply and discharge helium gas. When the driving of the balloons 11 to 14 is started, during the diastole of the ventricle, the right ventricular balloon 12 and the left ventricular balloon 14 are contracted as shown in FIG. Therefore, blood is smoothly sucked into the right ventricle RV and the left ventricle LV. At the same time, since the right atrial balloon 11 and the left atrial balloon 13 expand to compress the right atrium RA and the left atrium LA from the outside, the blood in the right atrium RA and the left atrium LA is released from the right ventricle RV.
And into the left ventricle LV, and the right ventricle RV and the left ventricle LV will be filled with more blood, and the work of the right atrium RA and the left atrium LA at this time will provide assistance. It is reduced more than not.

On the other hand, during the systole of the heart, as shown in FIG. 2B, the right ventricle balloon 12 and the left ventricle balloon 1
4 expands to compress the right ventricle RV and the left ventricle LV from the outside, so that the blood in the right ventricle RV and the left ventricle LV is delivered to the artery side, and at this time, the right ventricle RV and the left ventricle L
V's work is lessened than without assistance. At the same time, the right atrial balloon 11 and the left atrial balloon 13 are deflated and do not inhibit the expansion of the atrium, so that the right ventricle RV and the left ventricle LV enter the right atrium RA and the left atrium LA. Blood to be pumped into is inhaled.

As described above, according to the above-mentioned heart assisting device 1, it is possible to perform more precise assisting closer to the movement of the heart than the conventional product which can compress only the ventricle. Therefore, for example, even when heart function is impaired, blood in the atrium can be sufficiently pumped into the ventricle to increase the amount of blood pumped from the ventricle to the artery. It can be prevented beforehand.

Further, since the heart assist device 1 includes four balloons 11 to 14 which are divided according to the compression site, the right atrium, the right ventricle, the left atrium, and the left ventricle are individually compressed. be able to. Therefore, there is no problem that the coronary artery existing near the middle wall between the left heart and the right heart is not compressed, and the blood supplied to the myocardium decreases.

Further, since the heart assist device 1 has a structure in which each of the balloons 11 to 14 can be expanded and contracted independently, when the patient's condition is poor, both hearts are assisted and the patient's condition is restored. Then, it is possible to independently execute or stop the assistance of the left heart and the right heart, such as switching to the assistance of only the left heart.

Although the embodiment of the present invention has been described above, various constitutional means of the present invention can be considered in addition to the above-described embodiment. For example, the heart assisting apparatus 1 includes both the right atrial balloon 11 and the left atrial balloon 13, but when emphasizing either the right heart assist or the left heart assist, the right atrial balloon 11 is used. Alternatively, only one of the left atrial balloon 13 may be provided. The same applies to the right ventricular balloon 12 and the left ventricular balloon 14.

Although the four balloons 11 to 14 have a structure that can be driven independently of each other in the heart assist device 1, the atrial atrium is provided inside the holder 30 as in the heart assist device 2 shown in FIG. Balloon 31 and ventricular balloon 3
2 is arranged so that gas can be supplied and exhausted through the first tube 33 and the second tube 34 connected to the balloons 31 and 32 so that the atria and ventricles of both hearts can be compressed. Good. With such a heart assisting device 2, the structure can be made compact as the number of tubes is reduced, and the effect of sufficiently assisting both hearts can be obtained. In addition,
In the case of the heart assisting device 2, unlike the heart assisting device 1, it is not possible to switch only to the left heart assist on the way, but this may be appropriately used depending on the condition of the patient.

Further, in the heart assist device 1,
Although a hard cup-shaped holder 20 was used, the holder may be formed of a film or net having a hardness enough to be folded into a cup shape. If the heart can be sufficiently pressed, the holder should be used. Instead, the balloon may be expanded alone.

[Brief description of the drawings]

FIG. 1 is a cross-sectional view showing a schematic configuration of a heart assist device.

FIG. 2 is a sectional view showing a use state of the heart assist device,
(A) shows the state of the ventricle in the diastole, and (b) shows the state of the ventricle in the systole.

FIG. 3 is a cross-sectional view illustrating a schematic configuration of another heart assist device.

[Explanation of symbols]

DESCRIPTION OF SYMBOLS 1 ... Heart assist device, 11 ... Right atrial balloon,
12 balloon for right ventricle, 13 balloon for left atrium, 14 balloon for left ventricle, 16-19 ...
First to fourth tubes, 20 ... holder, 22 ... outer tube.

Claims (3)

[Claims] Claims 1. An atrium contraction is located outside the atrium and expands when fluid is supplied to the interior, contracts when the fluid inside is discharged, and compresses the atrium from outside during expansion. An assistable atrial balloon, which is arranged outside the ventricle and expands when fluid is supplied to the inside, contracts when the fluid inside is discharged, and compresses the ventricle from outside during expansion, thereby making the ventricle A ventricular balloon capable of assisting the contraction of the atrial balloon, the atrial balloon and the ventricular balloon are provided individually corresponding to each of the balloons, and each has a lumen communicating with the inside of each balloon, and the lumen is A heart assist device comprising: a plurality of tubes serving as supply and discharge paths of fluid to each balloon. 2. The heart assist device according to claim 1, wherein one or both of the atrial balloon and the ventricular balloon compresses a left heart balloon or a right heart side for compressing a left heart side. A heart assisting device comprising one or both of a right heart balloon and a right heart balloon. 3. The heart assist device according to claim 2, wherein the left heart balloon and the right heart balloon are not connected to each other, and the tube is the left heart balloon and the right heart balloon. A heart assisting device provided separately for each of the following.