JP2002102333A - Auxiliary artificial heart - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a small auxiliary artificial heart attachable and detachable with respective members. SOLUTION: The auxiliary artificial heart has an attachable and detachable main body of auxiliary artificial heart composed of a blood pump (1) and inflow and outflow conduits (2) and (3) for blood respectively connected to this blood pump. The blood pump (1) is composed of a substrate (7) of blood pump, a joint lid (9) and a diaphragm (10) located between them and the substrate (7) of blood pump, the diaphragm (10) and the joint lid (9) having a push seat (12) are attachably and detachably integrated by fitting so that the blood or gas can not be leaked from the fitting portion. Besides, the inside of the substrate (7) of blood pump is made into blood chamber (6) by the diaphragm 10 and has an inlet (13) and an outlet (14) for the blood. These inlet (13) and outlet (14) are respectively attachably and detachably fitted with the inflow conduit (2) and the outflow conduit (3).

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an assisted artificial heart used as an assisted circulatory device for severe heart disease requiring a heart transplant or the like, in particular, left heart failure.

[0002]

2. Description of the Related Art In some countries where heart transplantation is possible, there are some countries unlike Japan in which donors due to brain death do not readily appear. For this reason, severe heart disease patients who require a heart transplant have more and more opportunities to wear a ventricular assist device over a long period of time until the heart transplant.

[0003] Assist devices are generally pneumatically driven,
There are two types, the electromagnetically driven type and the two types, both of which require the implantation of the main body of the artificial heart in the body of a small patient, such as a child, especially when the main body of the artificial heart is large. It is difficult. In general, the body of the ventricular prosthesis is external to the body and is therefore susceptible to infection and death. Most of such assisted artificial hearts that have been conventionally clinically used worldwide are pneumatically assisted assisted artificial hearts, which will be described below.

[0004] The body of a pneumatically assisted ventricular assist device consists of first forming a gypsum mold from a mold, and then injecting polyurethane into the gypsum mold and having an inflow conduit and an outflow conduit leading to the blood chamber. Create an outer frame for. Further, a diaphragm is provided so as to divide the inside of the blood pump into a blood chamber and a driving chamber.
Then, polyurethane is further poured into and adhered to the portion where the diaphragm is adhered to seal the blood chamber and the drive chamber. Artificial check valves are adapted to fit into the inflow and outflow conduits. As described above, the main body of the conventional assistive artificial heart is integrally formed. Also,
One end of a drive line for injecting air into the drive chamber is connected to the main body of the assist artificial heart, and a drive device for injecting compressed air is connected to the other end of the drive line.

[0005] This assisted artificial heart is generally used for treating left heart failure in Japan, compared with other countries in the United States and Europe, which are often used as a bridge until heart transplantation.

[0006] As a method of treating left heart failure using this ventricular assist device, blood removal from the left atrium is mainly used, but when the left ventricle is used to obtain a sufficient amount of blood removal. There is also. When sending blood, unless there is a particular problem
An artificial blood vessel is sewn to the aorta, the artificial blood vessel is led out of the body, and the artificial blood vessel is connected to a blood pump outside the body to circulate blood.

[0007]

However, such an assisted artificial heart has the following problems.

First, since the members constituting the main body of the assist artificial heart are integrally formed, the members cannot be replaced or washed, and even if a thrombus is formed inside the blood chamber, it is removed. It is difficult.

In addition, since the body of the artificial heart is large,
It is difficult to implant it in the body, which tends to cause infections. In particular, it is difficult to implant this body in children and small-sized patients.

SUMMARY OF THE INVENTION The present invention has been made to solve such problems, and an object of the present invention is to solve these problems, and at the same time, to reduce the size of each member, which is less likely to cause thrombosis and infection. It is an object of the present invention to provide a removable artificial heart.

[0011]

According to the present invention, there is provided a base having a dome-shaped blood chamber for temporarily storing blood, and a gas for driving the assisting artificial heart. An artificial heart having a blood pump composed of a dome-shaped mating lid having a drive chamber injected through a member and a diaphragm placed between the base and the mating lid, Providing a first flange portion having a fitting body around an end of the base, and providing the first flange around an end of the mat lid.
A second flange portion having a fitting body is provided so as to be detachably fitted to the flange portion of the first cover, and further, a ring-shaped push seat serving as a spring body is provided around the end of the fitting lid, And the fitting body of the second flange portion is detachably fitted, the periphery of the end of the diaphragm is brought into close contact with the periphery of the end of the base by the push seat, and the blood chamber is hermetically sealed. Is divided into the blood chamber and the driving chamber.

With such an artificial heart, the members constituting the blood pump, which is the center of the main body of the artificial heart, are detachably formed, so that each member can be easily replaced or washed. It is possible, and furthermore, the moldability is improved, and it is possible to make it smaller than the conventional assisted artificial heart.

Further, in order to solve the above-mentioned problems, according to the present invention, there are provided check valves for preventing backflow of blood, an inflow conduit for guiding blood to the blood chamber, and a temporary storage in the blood chamber. An artificial heart having an outflow conduit for outflowing blood, wherein each of the inflow conduit and the outflow conduit has at least one fitting portion on a tube wall at one end, and the base includes And an inlet and an outlet for blood communicating with the blood chamber, respectively, and are fitted to walls of end portions of the inlet and the outlet so as to be fitted to the fitting portion. A mating portion is provided, and a fitting portion between the inflow conduit and the inflow port is detachably fitted, and
The fitting part between the outflow conduit and the outflow port was detachably fitted.

By using such an assisted artificial heart, the connection between the blood pump and the blood inflow conduit and outflow conduit can be made detachable, and these members can be easily exchanged and cleaned. In addition, the moldability is improved, and the size can be reduced.

Further, in order to solve the above problems, the base and the lid of the blood pump of the assistive artificial heart according to the present invention are formed of an acrylic resin.

By using such an artificial heart, the material can be easily processed and various shapes can be easily formed. Further, since the transparency of the material is high, the body of the artificial heart can be used. It is possible to grasp the internal state of the vehicle at an early stage.

Further, in order to solve the above-mentioned problems, the diaphragm according to the present invention is formed of a flexible polymer material having durability and antithrombotic properties.

By using such an assisted artificial heart, even if the diaphragm repeatedly contracts and expands to pump blood, the diaphragm has durability and antithrombotic properties, and thus prevents the occurrence of thrombus. Blood can be supplied stably.

Further, in order to solve the above problems, the main body of the assisting artificial heart of the assisting artificial heart according to the present invention can be implanted in a body.

The use of such an assisted artificial heart makes it possible to suppress infectious diseases, and furthermore, it is possible to easily move a patient.

Further, in order to solve the above-mentioned problem, an intra-aortic balloon pump is used for the driving device of the assist artificial heart according to the present invention.

By using such an assisted artificial heart, it is not necessary to prepare a new drive device, and it is possible to reduce the cost.

Further, in order to solve the above-mentioned problems, helium gas or air is used as the gas of the assisted artificial heart according to the present invention.

By using such an assisted artificial heart, the responsiveness of the blood pump is improved, and it is possible to sufficiently cope with an increase in the heart rate.

[0025]

Embodiments of the present invention will be described below with reference to the drawings.

First, the configuration of the assistive artificial heart according to the present embodiment will be described with reference to FIGS. FIG.
FIG. 2 is a top view of the body of the artificial heart, and FIG.
It is sectional drawing of the side surface of a main body when it cut | disconnects at -A. FIG. 3 is a front view of the main body showing a partial cross section when cut in a direction different from that of FIG. This assisting artificial heart is a gas pressure type and a diaphragm type, a main body of the assisting artificial heart, and a gas driving device for driving the assisting artificial heart,
And a drive line for driving the body of the assisting artificial heart through the gas ejected from the drive device.

The main body of the artificial heart is a blood pump 1
And an inflow conduit 2 and an outflow conduit 3 for blood. The inflow conduit 2 and the outflow conduit 3 are respectively provided with artificial check valves 4 and 5 for preventing backflow of blood. The inflow conduit 2 closes the check valve 4 immediately after opening the check valve 4 and introducing blood into the blood pump 1,
Next, the outflow conduit 3 closes the check valve 5 immediately after the check valve 5 is opened to cause blood to flow from the blood pump 1. The inflow conduit 2 and the outflow conduit 3 shown in FIGS. 2 and 3 are formed of silicone rubber, each having a fitting portion (fitting projection) on the lower inner wall, and a fitting portion (fitting hole) on the outer wall. )have.

As shown in FIG. 2, the blood pump 1 comprises a base body 6, a dome-shaped mating lid 7 provided with holes, and a diaphragm 8. A blood chamber 9 for temporarily storing blood is provided inside the base 6, and the blood chamber 9 has a dome shape. In addition, the lid 7
Is a driving chamber 10 into which gas for driving the blood pump 1 flows.

Further, a first flange portion is provided around the end of the base 6, and a thread groove (not shown) is cut in this flange portion as a fitting body. Further, a second flange portion is provided around the end portion of the fitting lid 7 so as to be in close contact with the first flange portion, and a screw (not shown) serving as a fitting body is provided in this flange portion. Is installed. The base 6 and the matching lid 7 are detachably fitted by inserting the screw of the matching lid 7 into the screw groove of the base 6. Further, inside the second flange around the end of the lid 7,
A push seat 11 which is annular and is a spring body is provided.

Here, it is also possible to fit the base 6 and the mating lid 7 using the screw groove provided in the base 6 as a screw and the screw provided in the mating lid 7 as a screw groove. further,
These fittings need not be the above-mentioned screws as long as the base 6 and the mating lid 7 can be brought into close contact with each other.

The diaphragm 8 is sandwiched between the base 6 and the mating lid 7, and is fitted around the base 6 and the mating lid 7 to form a ring-shaped member provided around the end of the mating lid. Of the blood chamber 9 is prevented from leaking. Further, the push seat 11 is a spring body, and the adhesion between the base 6 and the diaphragm 8 is improved.

Further, the base 6 and the lid 7 are sealed by the O-ring 12, so that the gas in the drive chamber 10 does not leak from the portion where the base 6 and the lid 7 are fitted.

Further, as shown in FIGS. 2 and 3, the base 6 has an inflow port 13 and an outflow port 14 for blood connected to the blood chamber 9, and the outer diameters of the upper portions of the inflow ports 13 and It has the same diameter as the inner diameter below conduit 2 and outlet conduit 3. Furthermore, the inlet 13 and the outlet 1
The outer wall above 4 has a fitting portion (fitting hole).
The fitting protrusion of the inflow conduit 2 and the fitting hole of the inflow port 13 are fitted to each other, and the inflow conduit 2 and the inflow port 13 are detachably connected. The fitting projection of the outflow conduit 3 and the fitting hole of the outflow port 14 are fitted together, and the outflow conduit 3 and the outflow port 14 are detachably connected. Further, titanium bands 15 and 16 having fitting projections are detachably fitted into fitting holes of the inflow conduit 2 and the outflow conduit 3, and the inflow port 13 and the outflow port 14 are firmly fixed, Blood is prevented from leaking from the portion connecting the inflow conduit 2 and the inflow port 13 and from the portion connecting the outflow conduit 3 and the outflow port 14.

Here, the inflow port 13 and the outflow port 1
It is also possible to make the fitting holes provided in 4 a fitting projection and the fitting projections provided in the inflow conduit 2 and the outflow conduit 3 as fitting holes.

The fitting lid 7 has a hole through which gas inside the drive chamber 10 and gas outside the blood pump 1 communicate. The hole is made of titanium having a joint connected to the drive line 17. And a gap between the member 18 and the hole of the drive chamber 10 is sealed and detachably fixed, so that the inside of the drive chamber 10 and the outside of the blood pump 1 are connected. ing.

Acrylic resin is used for the base 6 and the lid 7, and an antithrombotic polyurethane is applied to the inner wall of the blood chamber 9 to prevent thrombus. The acrylic resin is soft and very easy to mold. In particular, the fitting lid 7 is obtained by cutting a cylindrical lump into an appropriate size and cutting it out by machining. In addition, this material has a very high transparency, so that the state inside the main body of the assist artificial heart can be easily grasped.

For the diaphragm 8, it is preferable to use cowskin or pigskin having higher durability than the conventionally used synthetic polymer materials such as silicone rubber or polyurethane. When this cow skin or pig skin is used after being deproteinized, proteins in the blood are adsorbed to the skin, and the antithrombotic properties are improved. This diaphragm is an example, and it is of course possible to use a synthetic polymer material such as silicone rubber or polyurethane that has been conventionally used, and furthermore, it has characteristics useful as a diaphragm, such as durability and antithrombotic properties. If so, other materials can be used.

In the main body of the assisting artificial heart according to the present embodiment, since the respective members are detachable, the moldability is improved as compared with the conventional assisting artificial heart in which the respective members are integrally formed, and the assisting artificial heart is improved. Each member of the body of the heart is downsized. For this reason, this artificial heart can pump blood into the aorta more smoothly than the conventional artificial heart, and can suppress the formation of thrombus more than the conventional artificial heart. Further, replacement and cleaning of each member can be easily performed. Therefore, it is possible to suppress the formation of blood clots and infectious diseases more than the conventional artificial heart. The shape of the main body of the assistive artificial heart according to the present embodiment is thinner than the thickness of the body of the conventional assistive heart, and the base 6 is processed to be flatter than the conventional assistive heart. It is possible to implant the body of this assisted heart into the body even in a small patient. It is preferable that the main body of the assisting heart be implanted in the body and used. Therefore, it is possible to suppress the occurrence of infectious diseases, and it is possible to easily move the patient.

Next, the structure when the drive line 17 and the drive device are mounted on the main body of the assisting artificial heart having the above structure will be described.

First, one end of a drive line 17 made of silicone rubber is connected to a joint of a cylindrical member 18 fixed to the lid 7 so that gas does not leak, and an O-ring 19 is fitted and sealed. It is fixed. Further, the other end of the drive line 17 is connected to a drive device (not shown). This drive device is a device that repeatedly injects a compressed gas into the drive chamber 10 through a drive line 17 at a constant cycle, contracts and expands the diaphragm 8, and drives the blood pump 1 in a pulsating manner. . This drive utilizes intra-aortic balloon pumping.

Intra-aortic balloon pumping, which is already in clinical use, is a device in which a balloon catheter is inserted into the aorta and contracted and expanded by a driving device for the intra-aortic balloon pumping. Occasionally, the balloon is deflated, the balloon is inflated during cardiac inflation, the afterload of the heart is removed, and coronary blood flow is increased during cardiac inflation.

When this intra-aortic balloon pumping is used as a driving device for an assisted artificial heart, the above-mentioned driving program is changed so that the balloon is inflated at the time of cardiac deflation and used to be deflated at the time of cardiac inflation. Pumping can serve to assist the heart.

Since the intra-aortic balloon pumping is generally driven by using helium gas, it is possible to easily use helium gas also for an assisted artificial heart. Helium gas has a sufficiently low density as compared with air, and the drive line can be made narrower than a pneumatic drive line.

Further, the helium gas is, as described above,
Since the density is lower than that of air, the moving speed of gas can be increased. For this reason, the responsiveness of the blood pump 1 is improved, and the diaphragm 8 can easily follow the heart rate even when the heart rate is increased.

Since this ventricular assist device is small, and the amount of one stroke of blood is smaller than that of the conventional assist device, for example, 40 ml / time, the heart rate is increased to increase the amount of blood pumped. It is designed to supplement. This stroke volume is 4 balloons
An example value obtained by setting 0 ml,
When the volume of the balloon and the body of the artificial heart is changed, the stroke volume per stroke can be changed accordingly.

Next, the operation of the artificial heart will be described.

The method of connecting the assisting artificial heart to the living body has been described in the prior art, and will be briefly described here. The inflow conduit 2 of the ventricular assist device is connected to the left ventricle or left atrium, and the outflow conduit 3 is connected to the aorta, and the body of the assist device is driven by intra-aortic balloon pumping.

First, the check valves 4 and 5 are closed. The check valve 4 is opened from the left ventricle or the left atrium, flows into the blood chamber 9 through the inflow conduit 2 and the inflow port 13 and is stored, and the check valve 4 is closed. Next, the helium gas ejected by the intra-aortic balloon pumping is injected into the drive chamber 10 via the drive line 17. The volume of the blood chamber is changed by contracting the diaphragm 8 by the injected helium gas, and the blood stored in the blood chamber 9 is discharged into the aorta through the outlet 14 and the outflow conduit 3 with the check valve 5 opened. Provide assistance for

Here, helium gas is used as a gas for driving the assisting artificial heart, but compressed air or another gas may be used by changing the thickness of the drive line 17 and the cylindrical member 18. It is.

Although the embodiments have been specifically described with reference to the drawings, the present invention is not limited to the above-described embodiments, and all aspects of the present invention may be implemented without departing from the scope of the invention. Including implementation.

[0051]

As described above, according to the present invention,
Since the main body of the assistive artificial heart has detachable members, each member can be easily cleaned or replaced, and even if a thrombus has formed therein, it can be easily removed.

Further, according to the present invention, since the main body of the assisting artificial heart has detachable members, it can be easily formed, is reduced in size, and can pump blood smoothly. Is possible. For this reason, it is possible to suppress the occurrence of thrombus and to implant this body even in small patients such as children, so that it is possible to suppress infectious diseases and endure long-term use. .

Further, according to the present invention, the blood pump can be easily formed by using the acrylic resin and the transparency is high, so that the internal state can be easily grasped. .

Further, according to the present invention, it is possible to use an intra-aortic balloon pump, which has been conventionally used in clinical practice, as a driving device, and a special driving device for driving the assist artificial heart is required. This can lead to significant cost reduction.

[Brief description of the drawings]

FIG. 1 is a top view of a ventricular assist device according to an embodiment of the present invention.

FIG. 2 is a side cross-sectional view taken along line AA of FIG. 1 according to the embodiment of the present invention.

FIG. 3 is a front view showing a cross section of a part of the assisting heart according to the embodiment of the present invention.

[Explanation of symbols]

1 blood pump, 2 inflow conduit, 3 outflow conduit, 4, 5
... check valve, 6 ... base, 7 ... matching lid, 8 ... diaphragm,
9 blood chamber, 10 drive chamber, 11 push seat, 12
... O-ring, 13 ... inlet, 14 ... outlet, 15,1
6 band, 17 drive line, 18 cylindrical member,
19 ... O-ring

Claims (7)

[Claims] 1. A base having a dome-shaped blood chamber for temporarily storing blood, and a dome-shaped mating lid having a drive chamber into which gas for driving the artificial heart is injected through a cylindrical member. An artificial heart having a blood pump composed of a diaphragm interposed between the base and the mating lid, wherein the blood pump has a fitting body around an end of the base. A fitting body provided with a flange portion, and detachably fitted to the first flange portion around an end of the mating lid,
A second flange portion is provided so as to be in close contact with the first flange, and further, a ring-shaped push seat serving as a spring body is provided around an end of the fitting lid, and the first and second flange portions are provided. The fitting body is detachably fitted, and the periphery of the end of the diaphragm is brought into close contact with the periphery of the end of the base by the push seat, thereby sealing the blood chamber.
An auxiliary artificial heart, wherein the inside of the blood pump is divided into the blood chamber and the driving chamber. 2. An assisting artificial device having a check valve for preventing backflow of blood and having an inflow conduit for guiding blood to the blood chamber and an outflow conduit for discharging blood temporarily stored in the blood chamber. A heart, wherein each of the inflow conduit and the outflow conduit is provided with at least one fitting portion on a tube wall at one end, and the base is provided with a blood flow communicating with the blood chamber. An inlet and an outlet are provided, and a fitting portion is further provided on an end wall of the inlet and the outlet so as to be fitted with the fitting portion. The fitting part with the inflow port is detachably fitted, and the fitting part between the outflow conduit and the outflow port is detachably fitted and connected. Item 2. The artificial heart according to Item 1. 3. The assisting artificial heart according to claim 1, wherein the base and the lid are made of an acrylic resin. 4. The assistive artificial heart according to claim 1, wherein the diaphragm is formed of a flexible polymer material having durability and antithrombotic properties. 5. The artificial heart according to claim 1, wherein the body of the assisting heart, which connects the blood pump to the inflow conduit and the outflow conduit, can be implanted in a body. Assisted artificial heart. 6. The assistive artificial heart according to claim 1, wherein an intra-aortic balloon pump is used as the driving device. 7. The assist device according to claim 1, wherein the gas is helium gas or air.