JP6710027B2 - Heart simulation device, control method for heart simulation device, and control program for heart simulation device - Google Patents

Description

The present invention relates to a training heart simulation device for a doctor or the like to perform, for example, heart surgery, a control method of the heart simulation device, and a control program of the heart simulation device.

Although a doctor or the like needs to perform a cardiac surgery, for example, coronary artery bypass grafting (CABG), since this operation involves cutting or suturing a coronary artery stretched around the heart, a doctor or the like is required. Requires high surgical skill.
Therefore, a simulated heart for training for actually operating on a human body has been proposed (for example, Patent Document 1).
As such a simulated heart for training, an animal heart or the like is used, and by further reproducing the pulsation, it is attempted to reproduce a state close to that of a human heart.

US 7,798,815 JP, 2006-276258, A

However, these simulated hearts and the like have many differences from the actual human heart, and there is a problem in that doctors and the like are insufficient for training.

Therefore, an object of the present invention is to provide a heart simulation device that more closely resembles an actual human heart, a control method for the heart simulation device, and a control program for the heart simulation device.

In the present invention, the above-mentioned object is to connect the deformable portion arranged in the training heart, the training blood vessel portion directly arranged in the training heart, the deformable portion, and expand the deformable portion. A drive section for contracting, a working fluid storage section for storing a working fluid to be supplied to the training blood vessel section, a pressurization section capable of applying a pressure to the working fluid storage section by a surface, and the drive section And a controller for controlling the pressurizing unit, wherein the driving unit expands and contracts the deformable unit to enable a pulsating motion including expansion and contraction of the training heart. The working fluid accommodating portion is configured to be deformed by the pressure of the pressure portion, and the controller individually controls the operation timings of the drive portion and the pressurizing portion, whereby the training heart contracts. In this case, the working fluid is delivered to the training blood vessel portion in response to the contraction, and the pulsating motion and the delivery of the working fluid are based on actual heart motion information. The heart simulation apparatus is configured such that the delivery of the working fluid is performed at a timing when an R wave appears in an electrocardiogram in an actual heart and then the aortic valve is opened. Achieved by.

According to the above configuration, when the training heart contracts, the working fluid is delivered to the training blood vessel in response to the contraction.
For this reason, the working fluid is delivered to the training blood vessel in response to "contraction" of the heart pulsation, resulting in a heart simulation device that closely resembles the actual heart, and uses an artificial heart-lung machine performed by a doctor or the like. Training of cardiac surgery such as coronary artery bypass bypass surgery (CABG) can be more effectively performed.
Further, according to the above configuration, the working fluid accommodating portion is provided with the pressurizing portion that can apply a pressure to the working fluid accommodating portion by a surface, and the working fluid accommodating portion is pressured by the pressurizing portion. The part is deformed.
Therefore, since the working fluid is pushed out by the deformation of the working fluid storage portion, it is easy to reproduce the operation such as the irregular supply of the working fluid unlike the pump using the motor etc., and the actual arrhythmia or ventricular fibrillation etc. It has a structure that makes it easy to reproduce the movement of the heart that is closer to the movement.

According to the above configuration, the pulsating motion and the delivery of the working fluid are executed based on the actual motion information of the heart, so that the heart simulator device more closely resembles the actual heart, and the coronary bypass surgery performed by a doctor or the like is performed. Training of cardiac surgery such as (CABG) can be performed more effectively .

Preferably, the pulsating motion is not only a normal pulsating motion that is a normal pulsating motion of the heart, but also an arrhythmic pulsating motion in which the pulsating motion is not constant and a ventricular fibrillation pulsation in which the ventricles of the heart quiver. It is characterized in that it also includes a motion.

According to the above configuration, the pulsatile motion includes not only the normal pulsating motion of the heart, but also the arrhythmic pulsating motion in which the pulsating motion is not constant and the ventricular fibrillation pulsating motion in which the ventricles of the heart quiver. When a doctor or the like conducts a heart surgery training, the training can be performed under various situations in which the heart actually occurs, and the training can be performed more effectively.

Preferably, information about a decrease in the working fluid in the working fluid container is acquired from a sensor, and based on a change in the decrease information , the normal pulsation operation, the arrhythmic pulsation operation, or the ventricular fibrillation pulsation operation. It is characterized in that any one of the above is automatically selected and executed.

According to the above configuration, the normal pulsation operation, the arrhythmic pulsation operation, or the ventricular fibrillation pulsation operation is automatically selected and executed based on the state information of the working fluid in the working fluid container. As a result, the situation that actually occurs in heart surgery is automatically reproduced, so that more effective heart surgery training can be performed.

Preferably, the working fluid is delivered to the training blood vessel portion in a delivery pattern in accordance with each pulsation of the normal pulsation operation, the arrhythmic pulsation operation, and the ventricular fibrillation pulsation operation. It is characterized by being changed.

According to the above configuration, the pattern of sending the working fluid to the training blood vessel part is changed according to each pulsation pattern of the normal pulsation motion, the arrhythmic pulsation motion, and the ventricular fibrillation pulsation motion. Therefore, it is possible to precisely reproduce the blood flow dynamics of the coronary artery in the actual heart surgery.

Preferably, prior to have asked moving parts, it has a diaphragm portion which operates synchronously with the drive unit, in operation of the diaphragm portion, is configured to feed the hydraulic fluid to the training vessel portion It is characterized by

According to the above construction, having a drive moving parts, has a diaphragm portion which operates synchronously with the drive unit, in operation of the diaphragm portion, is configured to feed the hydraulic fluid to the training vessel portion There is.
Therefore, in the above-described configuration, the pulsation operation and the delivery of the working fluid are controlled by the common drive unit, so that the working fluid is easily delivered to the training blood vessel portion in response to the contraction.

Preferably, the working fluid is blood or simulated blood.

According to the above configuration, since the working fluid is composed of blood or simulated blood, it becomes a heart simulation device that more closely resembles an actual heart, and more effective training of the heart surgery of coronary artery bypass surgery (CABG) performed by a doctor. Can be done on a regular basis.

In the present invention, the above-mentioned object is to connect the deformable portion arranged in the training heart, the training blood vessel portion directly arranged in the training heart, the deformable portion, and expand the deformable portion. A drive section for contracting, a working fluid storage section for storing a working fluid to be supplied to the training blood vessel section, a pressurization section capable of applying a pressure to the working fluid storage section by a surface, and the drive section And a controller for controlling the pressurizing unit, wherein the drive unit expands and contracts the deformable unit to expand and contract the training heart. The training heart is operated in a dynamic manner, the working fluid storage section is deformed by the pressure of the pressurizing section, and the controller individually controls the operation timings of the drive section and the pressurizing section, whereby the training heart is exercised. When contracting, the working fluid is delivered to the training blood vessel portion in response to the contraction, and the pulsating operation and the delivery of the working fluid are executed based on actual heart movement information. The delivery of the working fluid is performed by a control method of the heart simulation apparatus, which is performed at a timing when an R wave appears in an electrocardiogram in an actual heart and then the aortic valve is opened .

In the present invention, the above-mentioned object is to connect the deformable portion arranged in the training heart, the training blood vessel portion directly arranged in the training heart, the deformable portion, and expand the deformable portion. A drive section for contracting, a working fluid storage section for storing a working fluid to be supplied to the training blood vessel section, a pressurization section capable of applying a pressure to the working fluid storage section by a surface, and the drive section And a controller for controlling the pressurizing unit, in which the driving unit causes the deforming unit to expand and contract, thereby causing a pulsating motion including expansion and contraction of the training heart. And a step of deforming the working fluid containing section by the pressure of the pressurizing section, and the controller individually controlling operation timings of the drive section and the pressurizing section, whereby the training heart is operated. At the time of contraction, the step of supplying the working fluid to the training blood vessel portion in response to the contraction, the pulsating operation and the supply of the working fluid are executed based on actual heart motion information. The heart simulation apparatus , wherein the step of performing the working fluid is performed at a timing when an R wave appears in an electrocardiogram in an actual heart and then the aortic valve is opened. It is achieved by the control program of.

As described above, according to the present invention, there is an advantage that it is possible to provide a heart simulation device that more closely resembles an actual human heart, a control method for the heart simulation device, and a control program for the heart simulation device.

1 is a schematic diagram showing a cardiac simulation device of the present invention, for example, a coronary artery bypass grafting (CABG) simulation system 1 according to an embodiment including a controller. It is a schematic block diagram which shows the main structures of the controller etc. of FIG. It is a schematic block diagram which shows the main structures of a 1st various information storage part. It is a schematic block diagram which shows the main structures of a 2nd various information storage part. It is a schematic flow chart which shows the main examples of operation etc. of this system. 7 is another schematic flowchart showing a main operation example of the system. 7 is another schematic flowchart showing a main operation example of the system. 7 is another schematic flowchart showing a main operation example of the system. FIG. 3 is a schematic explanatory view showing a state of pulsation (expansion and contraction) which is an actual operation of the human heart by an electrocardiogram and the like. It is the schematic which shows the coronary artery bypass surgery (CABG) simulation system which is the 1st modification of the coronary artery bypass surgery (CABG) simulation system shown in FIG. It is the schematic which shows the coronary artery bypass surgery (CABG) simulation system which is the 2nd modification of the coronary artery bypass surgery (CABG) simulation system shown in FIG.

Since the embodiment described below is a preferred specific example of the present invention, various technically preferable limitations are attached, but the scope of the present invention particularly limits the present invention in the following description. Unless otherwise stated, the present invention is not limited to these embodiments.

FIG. 1 is a schematic diagram showing a coronary artery bypass grafting (CABG) simulation system 1 according to an embodiment including a controller 10, which is a heart simulation apparatus of the present invention.

Coronary artery bypass surgery is an open heart surgery in which the doctor first removes a portion of a healthy blood vessel from the leg, chest, arm or abdomen. After that, this blood vessel is transplanted to the occluded part of the coronary artery to create a new path (bypass) in which blood bypasses the occluded artery and flows to the heart.

Further, in recent years, a device called a stabilizer has been developed, and it has become possible to stop the movement only at a sutured portion, so that it is possible to perform an operation while the heart is moving. This technique is called off-pump CABG.

When performing such a coronary artery bypass surgery, particularly an off-pump CABG surgery, a doctor is required to have a high level of skill. Therefore, a CABG simulation system including a simulated heart and simulated blood vessels is used in advance to train the surgery. It is common to do
The CABG simulation system 1 of the present embodiment is an optimal simulation system for training CABG, particularly off-pump CABG technique.

As shown in FIG. 1, the present system 1 has a training heart 2 using, for example, a pig heart.
As shown in FIG. 1, the training heart 2 is provided with training blood vessels, such as a right coronary artery 22 and a left coronary artery 21, on its surface or the like.
Further, a working fluid (for example, simulated blood) is fed into the training blood vessel part. It should be noted that the simulated blood refers to all ideal liquids that include actual blood, physiological saline colored red, etc. and are ideal for reproducing an actual heart as a heart simulation device.

In the present embodiment, the training heart 2 has the bleeding site 23, and in order to treat this, the off-pump CABG training is performed while the training heart 2 is pulsating.
That is, in the present embodiment, the bleeding site 23 is in the coronary artery and is set to cause bleeding when an anastomosis of blood vessels is performed by the off-pump CABG method. Therefore, the doctor or the like is configured to be able to perform the CABG training while the training heart 2 is pulsating and the simulated blood is delivered to the coronary arteries.

Inside the training heart 2, a flexible balloon 24 made of, for example, silicone, which is a deformable portion, is arranged. The balloon 24 is in the shape of a balloon, and swells when water, which will be described later, is stored therein, and conversely contracts when water is discharged.

That is, the training heart 2 is expanded or contracted by the expansion or contraction of the balloon 24, so that the pulsation of the heart is reproduced.

As shown in FIG. 1, the balloon 24 is connected to a drive unit such as the centrifugal pump 4 via a liquid supply tube 51, and is connected to the tank 3 via a liquid supply tube 52.
The tank 3 contains, for example, water 31 that is a liquid, and when the water 31 is supplied into the balloon 24 by the operation of the centrifugal pump 4, the balloon 24 expands and conversely the water 31. The configuration is such that the balloon 24 is deflated when the supply of P is stopped.
That is, since the balloon 24 is made of silicone or the like that is flexible and highly stretchable and has a restoring force, when the supply of the water 31 to the balloon 24 is stopped, the restoring force causes the balloon 24 to contract to its original size. Is becoming

In addition, the operation of the centrifugal pump 4 supplies or suspends the supply of the water 31 into the balloon 24, thereby inflating and deflating the balloon 24, thereby realizing the pulsation of expansion and contraction of the training heart 2. doing.

Further, in the present embodiment, the blood supply tube 53 is connected to the left coronary artery 21 of the training heart 2. As shown in FIG. 1, the blood supply tube 53 is connected to, for example, a bag 61, which is a working fluid storage unit that stores a simulated blood 7 that is a working fluid, and the simulated blood 7 in the bag 61 is a blood supply. It is configured to be supplied to the left coronary artery 21 via the tube 53.

As shown in FIG. 1, the bag 61 is provided with a level sensor 62 so that the water level and the like of the simulated blood 7 in the bag 61 can be measured.
Further, as shown in FIG. 1, a pressurizing portion 63 capable of pressurizing the bag 61 with a surface is arranged outside the bag 61, and the operation of the pressurizing portion 63 causes the simulated blood 7 in the bag 61 to be removed. The blood is supplied to the training heart 2 via the blood supply tube 53.
The bag 61, the pressure unit 63, the level sensor 62, and the like constitute the pressure bag 6 as a whole.

Further, as shown in FIG. 1, the centrifugal pump 4 and the pressurizing bag 6 are connected to the controller 10, and the controller 10 controls them.

By the way, the controller 10 of the CABG simulation system 1 shown in FIG. 1 has a computer, and the computer has a CPU (Central Processing Unit), a RAM (Random Access Memory), a ROM (Read Only Memory), etc., which are not shown. , These are connected via a bus.

FIG. 2 is a schematic block diagram showing the main configuration of the controller 10 and the like shown in FIG.
As shown in FIG. 2, the controller 10 has a "control unit 11", and the control unit 11 has a "communication device 12" for communicating with the centrifugal pump 4 and the pressurizing bag 6 shown in FIG. doing.
In addition, the control unit 11 in FIG. 2 controls the “display 13” that displays various information and the “input device 14” that inputs various information, and also controls the “clock device 15” that generates time information.
Further, the "control unit 11" controls the "first various information storage unit 110" and the "second various information storage unit 120" shown in FIG.
3 and 4 are schematic block diagrams showing the main configurations of the "first various information storage unit 110" and the "second various information storage unit 120", respectively. The contents of these will be described later.

5 to 8 are schematic flowcharts showing main operation examples of the system 1 and the like. In the following, the description will be given along these flow charts, and also the configuration and the like of FIGS. 1 to 4 and the like.
Here, the pulsation of the actual human heart reproduced in the present embodiment will be described.

FIG. 9 is a schematic explanatory diagram showing the state of pulsation (expansion and contraction), which is the actual operation of the human heart, by an electrocardiogram or the like.
The actual heart pushes blood into the arteries, causing the heart to repeatedly expand and contract. Specifically, the heart contracts and pushes blood into the arteries. Such repeated expansion and contraction of the heart is called pulsation.

As shown in FIG. 9, the heart beats by repeating, for example, “one cardiac cycle” (for example, 1100 ms) including “diastole” of 800 ms and “systole” of 300 ms.
First, when entering the "diastole", the heart begins to expand due to the action of the myocardium (mitral valve opening), and the "P wave" (indicating the excitation of the atrium) appears on the electrocardiogram, and 600 ms after the start, the expansion occurs. Stops.

After that, for example, when 200 ms has elapsed, the “diastole” ends (mitral valve closure), and the “systole” starts.
The "systole" begins when the "R wave" (indicating ventricular excitement due to the flow of electricity when the heart contracts) appears on the electrocardiogram. Preparation of supplying blood to the artery is started by the contraction of the heart, and the "aortic valve" is opened, for example, 20 ms after the "R wave", and the pushing of blood into the artery is started.

After that, for example, 220 ms after the “R wave”, a “T wave” (excited ventricle is cooled) appears on the electrocardiogram. When this "T wave" appears, it indicates that the aortic valve is closed and the blood extrusion is completed.
In this way, one heart cycle consisting of "diastole" and "systole" is completed, and the heart cycle is repeated, so that a pulsation is performed.

In the present embodiment, for example, the pulsation of the heart and the transition of the aortic pressure as described above are faithfully reproduced by the system 1 of FIG.

The flowchart of FIG. 5 and the like will be described below.
First, the training heart 2 and the like are arranged as shown in FIG. Then, the system 1 is operated.
Then, in step (hereinafter referred to as “ST”) 1 of FIG. 5, the “first extended operation execution processing unit (program) 111” of FIG. 3 operates, and the centrifugal pump 4 of FIG. 1 is operated under a predetermined condition. To operate. As a result, a predetermined amount of water 31 starts to be supplied from the tank 3 of FIG. 1 to the balloon 24 of the training heart 2.
Further, the operation start time is stored in the “centrifugal pump operation start time information storage unit 112” in FIG.

As a result, the water 31 is injected into the balloon 24, and the balloon 24 starts to expand. This operation start time corresponds to (1) in the diastole in FIG.
Further, regarding the information about the degree of infusion of the predetermined amount of water 31 and the degree of the restoring (contracting) force of the balloon 24 described above, the same expansion or contraction as the actual expansion or contraction of the heart shown in FIG. It has been calculated and adjusted to be reproduced on Heart 2.

Then, it proceeds to ST2. In ST2 as well, the “first extended operation execution processing unit (program) 111” in FIG. 3 operates, refers to the “clock device 15” in FIG. 2, and determines whether 600 ms has elapsed from the “centrifugal pump operation start time 112”. To judge.
When it is determined in ST3 that "600 ms" has elapsed, the process proceeds to ST4. Also in ST4, the “first extended operation execution processing unit (program) 111” operates and the operation of the centrifugal pump 4 is stopped.

That is, the supply of the water 31 from the tank 3 to the balloon 24 is stopped. Then, the "centrifugal pump stop time information" is stored in the "centrifugal pump stop time information storage unit 113" in FIG.
This centrifugal pump stop time information corresponds to the point (2) in the diastole in FIG.

Then, it proceeds to ST5. In ST5, the “first contraction operation execution processing unit (program) 114” of FIG. 3 operates, the “clock device 15” of FIG. 2 is referred to, and the “centrifugal pump of the centrifugal pump stop time information storage unit 113” is referred to. It is determined whether 200 ms has elapsed from the "stop time information".

That is, it is determined whether the diastole of FIG. 9 has ended and the start of systole has arrived. The start time of this systole corresponds to the "R wave" portion in the electrocardiogram of FIG.

If it is determined in ST6 that "200 ms" has elapsed, the process proceeds to ST7. In ST7 as well, the “first contraction operation execution processing unit (program) 114” operates, refers to the “timer 15” in FIG. 2, and sets the time as the “systolic start time” to the “systolic start time storage unit”. 115”. Then, after 20 ms has elapsed, the “pressurization bag 6” of FIG. 1 is instructed to supply blood.

The time point at which the "pressurization bag 6" is instructed to supply blood corresponds to the time point (3) when 20 ms has elapsed from the "R wave" in the electrocardiogram of FIG. That is, it is the time when the aortic pressure increases.
The "systole start time" corresponds to the time point of "R wave" in the electrocardiogram of FIG. 9 (time point (5) 220 ms before the time point (4) at which the pressure bag 6 is instructed to supply blood). ..

Further, in ST7, the simulated blood 7 in the bag 61 of the pressurizing bag 6 is pushed out to the left coronary artery 21 via the blood supply tube 53.
Specifically, the pressurizing portion 63 of the pressurizing bag 6 swells and pressurizes the bag 61 with the surface, so that the working fluid 7 is pushed out.

Then, it proceeds to ST8. In ST8 as well, the “first contraction operation execution processing unit (program) 114” operates, refers to the “clock device 15” in FIG. 2, and refers to the “systolic start time storage unit 115” in FIG. It has been determined whether or not 220 ms have elapsed.

Next, when it is determined in ST8 that 220 ms has elapsed, the process proceeds to ST10. Also in ST10, the “first contraction operation execution processing unit (program) 114” operates to instruct the pressurization bag 6 to stop the supply of the simulated blood 7.

This time point corresponds to the time point of aortic valve closure (4) in FIG.
At the time of the next diastole, the systole ends, the first first beat (one cardiac cycle) after the system 1 is started, and the second beat starts. To be done.
In the present embodiment, from the second pulsation, the pulsation and the simulated blood 7 of the simulated blood 7 are based on the time point of “R wave” which is the start time point of the systole in FIG. 9, that is, the above-mentioned “systolic time start time”. Control supply.
As a result, it becomes possible to easily and accurately manage the timing of the beat and the like.

First, in ST11, is 300 ms elapsed from the "systolic start time" of the "systolic start time storage unit 115" in Fig. 3 when the "second expansion operation execution processing unit (program) 116" in Fig. 3 operates? Determine whether or not.
That is, it is determined whether or not the time point (1) in FIG. 9 at which the systolic period ends and the diastolic period starts after 300 ms has elapsed from the “R wave” in FIG.

When it is determined in ST12 that 300 ms has elapsed, the process proceeds to ST13. Also in ST13, the "second extended operation execution processing unit (program) 116" operates, and the centrifugal pump 4 in Fig. 1 starts operating. As a result, the balloon 24 is inflated, and the training heart 2 in FIG. 1 is in a diastolic period similar to the diastole in FIG. 9.

Then, it proceeds to ST14. Also in ST14, the "second expanded operation execution processing unit (program) 116" operates to determine whether or not 900 ms has elapsed from the "systolic start time" of the "systolic start time storage unit 115" in FIG.
That is, it is determined whether or not the time point indicated by (2) in FIG. 9 has arrived.

When it is determined in ST15 that 900 ms has elapsed, the process proceeds to ST16. In ST16 as well, the "second expansion operation execution processing unit (program) 116" operates, the operation of the centrifugal pump 4 is stopped, and the expansion period ends.

Then, it proceeds to ST17. In ST17, it is determined whether or not the “second systolic motion execution processing unit (program) 117” in FIG. 3 operates and 1100 ms has elapsed from the “systolic start time” in the “systolic start time storage unit 115” in FIG. To judge.
That is, it is determined whether or not the time point of “R wave” in FIG. 9 (start time point of the next systole) has arrived.

When it is determined in ST18 that 1100 ms has elapsed, the process proceeds to ST19. In ST19 as well, the “second systole operation execution processing unit (program) 117” operates, and the time is stored in the “systole start time storage unit 115” in FIG. 3 as a new “systole start time” and rewritten. Then, after a lapse of 20 ms from the new “systole start time”, the pressure bag 6 of FIG. 1 is instructed to supply blood.

Then, it progresses to ST20. Also in ST20, the "second contraction operation execution processing unit (program) 117" operates, and with reference to the "timer 15" of FIG. 1, it is determined whether or not 220 ms has elapsed from the new "systolic start time".
That is, it is determined whether or not the time point of aortic valve closure in (4) of FIG. 9 has arrived.

When it is determined in ST21 that 220 ms has elapsed, the process proceeds to ST22. Also in ST22, the "second contraction operation execution processing unit (program) 117" operates to stop the operation of the pressure bag 6.

As described above, in the present embodiment, the same pulse as that of the actual human heart shown in FIG. 9 and the same timing as the rise of the aortic pressure can be reproduced by the training heart 2 of FIG.
Therefore, by training the coronary artery bypass grafting (CABG) with the training heart 2, it is possible to perform training in a state closer to the human body and enhance the training effect.
The data such as the pulsation and the rise in aortic pressure similar to those of the actual human heart shown in FIG. 9 is an example of “actual heart motion information”.

Further, it is particularly effective for the training of “off-pump CABG” which is operated while the heart is moving, and in the present embodiment, the training can be performed very effectively.
Furthermore, conventionally, in a heart simulation device that performs heart beat, there is nothing that supplies blood to the coronary arteries in synchronization with the systole of the heart (synchronization), so that it does not interfere with the actual heart for the training doctor. There was a problem that the difference was noticeable.
However, in this regard, in the present embodiment, the working fluid is supplied to the coronary arteries during the actual systole of the heart, so that the blood flow dynamics in the coronary arteries that change with the actual pulsation of the heart are precisely reproduced. be able to. Therefore, it is possible to train under the same conditions as the actual heart.

By the way, after ST22 in FIG. 7, the process proceeds to ST23. In ST23, it is determined whether or not there is data of "arrhythmia" in the "pressurized bag state information storage unit 121".
In the present embodiment, in addition to the control of the pulsation of the training heart 2 and the like, the controller 10 uses the level sensor 62 of the pressurizing bag 6 and the time measuring device 15 to reduce the simulated blood 7 in the pressurizing bag 6. (Example of "state information of working fluid") is generated.

Specifically, the “pressurized bag working fluid lowering related data generation processing unit (program) 122” in FIG. 4 operates and the numerical values of the “timer 15” and the “level sensor 62” of the “pressurized bag 6” are indicated. Based on the above, the data regarding the decrease of the simulated blood 7 is determined.
For example, when the water level falls within 5 ml within 60 seconds, it is an arrhythmic pulsation motion. For example, when the water level falls within 5 ml within 30 seconds, it indicates a ventricular fibrillation pulsation motion. , "Ventricular fibrillation" data is stored in the "pressurized bag state information storage unit 121" of FIG.

Here, "arrhythmia" refers to a state in which the beat rate and rhythm are not constant, and "ventricular fibrillation" refers to a state in which the ventricles of the heart quiver and cannot send blood to the whole body.

In ST23, it is determined whether or not the above-mentioned "arrhythmia" data is stored in the "pressurized bag state information storage unit 121".

In ST23, when the data of “arrhythmia” is stored in the “pressurized bag state information storage unit 121”, the process proceeds to ST24. In ST24, the “arrhythmia operation execution processing unit (program) 123” in FIG. 4 operates, and the operation specific to the arrhythmia is executed a predetermined number of times.

Specifically, for example, the operation of the centrifugal pump 4 is started after 1400 ms has passed from the “systolic start time” in FIG. 3, and then the normal pulsation operation described above is executed.
By operating in this way, it is possible to reproduce an “arrhythmia” in which the pulsation sometimes drops.

This "arrhythmia" pulsation is automatically generated when the simulated blood 7 in the bag 61 decreases and the predetermined condition is met, for example, when the anastomosis of blood vessels takes too long, or when the anastomosis is not performed properly. Specifically, since it occurs in the training heart 2 of FIG. 1, it is possible for a doctor who performs training to perform training under conditions that are closer to the actual conditions of heart surgery, and to enhance the training effect.
In addition, in the present embodiment, the cause of the heart to cause arrhythmic pulsation is due to a decrease in the blood volume in the bag 61 due to blood outflow from the coronary arteries.

Further, in this embodiment, the simulated blood 7 is supplied from the inside of the bag 61 according to the systole of the heart. As a result, it is possible to reproduce not only the actual pulsation of the heart but also the rise in aortic pressure.
With these configurations, the dynamics (changes) of blood outflow (protrusion) from the coronary arteries before and after the heart actually falls into arrhythmic beats can be precisely reproduced.
Therefore, the doctor who performs the training can more practically perform the heart surgery training when the training heart 2 falls into the arrhythmic beat.

Then, it proceeds to ST25. In ST25, it is determined whether or not the above-mentioned “ventricular fibrillation” data is stored in the “pressurized bag state information storage unit 121”.

In ST25, when the data of “ventricular fibrillation” is stored in the “pressurized bag state information storage unit 121”, the process proceeds to ST26. In ST26, the “ventricular fibrillation motion execution processing unit (program) 124” in FIG. 4 operates, and the motion peculiar to ventricular fibrillation is executed a predetermined number of times.

Specifically, for example, 100 ms after the start of the operation of the centrifugal pump 4, the operation is stopped. Then, when 100 ms has elapsed, the supply of blood from the pressure bag 6 is started. After that, the supply is stopped when 100 ms has elapsed. Thus, the centrifugal pump 4 and the pressurizing bag 6 are operated for 100 ms each, and a 100 ms interval between each operation allows the heart to oscillate in small steps, thereby performing a “ventricular fibrillation” operation. In this step, these operations are repeated a predetermined number of times.

The pulsation of "ventricular fibrillation" also occurs when the simulated blood 7 in the bag 61 decreases and meets a predetermined condition, for example, when the anastomosis of blood vessels takes too much time or when the anastomosis is not performed properly. Since it automatically occurs in the training heart 2 of FIG. 1, it is possible for a doctor who performs training to perform training under conditions closer to the situation of actual heart surgery, and to enhance the training effect.
Further, even in the pulsation of ventricular fibrillation, the dynamics (change) of blood outflow (protrusion) from the coronary artery before and after the heart actually falls into the pulsation of ventricular fibrillation can be precisely reproduced. Therefore, the doctor who performs the training can more practically perform the heart surgery training when the training heart 2 falls into the pulsation of ventricular fibrillation.

In the present embodiment, the working fluid 7 in the bag 61 is not provided in the centrifugal pump 4 but is provided with the pressurizing unit 63, and the pressurizing unit 63 pressurizes the bag 61 in a planar manner, thereby simulating blood in the bag 61. 7 is supplied to the training heart 2 via the blood supply tube 53.
Therefore, unlike a pump or the like that uses a motor or the like, it is easy to reproduce operations such as irregular supply of the simulated blood 7, and it is easy to reproduce movements of the heart that are closer to actual movements such as arrhythmia and ventricular fibrillation. ing.

Next, if the instruction to stop the operation of the system 1 is not input in ST27, the process returns to ST11 and the pulsating operation of the same heart is repeated.

(First modification)
FIG. 10 is a schematic diagram showing a coronary artery bypass grafting (CABG) simulation system 200 which is a first modification of the coronary artery bypass grafting (CABG) simulation system 1 shown in FIG. 1.
Since many of the configurations of the present modification are common to the above-described embodiment, common configurations are denoted by the same reference numerals and the like, and differences will be mainly described below.

In this modified example, the pressurizing unit 63 of the pressurizing bag 6 of the above-described embodiment is not included in the configuration, and the simulated blood 7 is only stored in the bag 61.
The simulated blood 7 in the bag 61 is supplied to the training heart 2 by the centrifugal pump 140 shown in FIG.
Therefore, the supply amount of the working fluid 7 to the training heart 2 and the like can be controlled by the pump.

(Second modified example)
FIG. 11 is a schematic diagram showing a coronary artery bypass grafting (CABG) simulation system 300 which is a second modification of the coronary artery bypass grafting (CABG) simulation system 1 shown in FIG.
Since many of the configurations of the present modification are common to the above-described embodiment, common configurations are denoted by the same reference numerals and the like, and differences will be mainly described below.

In this modified example, the pressurizing unit 63 of the pressurizing bag 6 of the above-described embodiment is not included in the configuration, and the simulated blood 7 is only stored in the bag 61.
The simulated blood 7 in the bag 61 is supplied to the training heart 2 by the diaphragm pump 240, which is the diaphragm portion shown in FIG.

Specifically, the diaphragm pump 240 has a diaphragm 241 that can move in the vertical direction in the drawing inside.
Therefore, in FIG. 11, when the centrifugal pump 4 operates and the water 31 in the tank 3 is supplied to the balloon 24, the water 31 in the tank 3 flows from the tank 3 toward the balloon 24, and at that time, the diaphragm pump 240. Air in the space below the inner diaphragm 241 is pulled toward the liquid feeding tube 52 side, the space below the diaphragm 241 becomes negative pressure, and the diaphragm 241 moves to the lower side (broken line part in FIG. 11). ..
Then, the space above the diaphragm 241 becomes negative pressure, and the simulated blood 7 in the bag 61 is drawn into the diaphragm pump 240.

Next, when the centrifugal pump 4 of FIG. 11 stops operating and the flow of the water 31 in the tank 3 stops, the negative pressure below the diaphragm 241 of the diaphragm pump 240 is released and the diaphragm 241 rises.
At this time, the simulated blood 7 drawn into the diaphragm 241 is supplied to the left coronary artery 21 via the blood supply tube 53.

That is, in the above-described embodiment, the centrifugal pump 4 that supplies the inflation water 31 for the balloon 24 and the pressurization bag 6 that supplies the working fluid 7 to the left coronary artery 21 are provided, and the controller 10 is individually provided. The operation timing was controlled.

However, in this modification, the diaphragm type pump 240 operates in synchronization with the operation of the centrifugal pump 4 that supplies the inflation water 31 of the balloon 24, so that the centrifugal pump 4 and the centrifugal pump 4 operate as in the above-described embodiment. There is an advantage that it is not necessary to control each diaphragm type pump 240 separately.

That is, when supplying the water 31, the simulated blood 7 is not supplied, and when the water 31 is not supplied, the operation of supplying the simulated blood 7 can be controlled only by the operation of the centrifugal pump 4.
Further, in this modified example, it is not necessary to separately provide a dedicated motor-driven pump or the like for feeding the simulated blood 7 in the bag 61 to the training heart 2, which is also efficient in terms of cost.

By the way, the present invention is not limited to the above-described embodiments and the like.

1... Coronary artery bypass surgery (CABG (Coronary Artery Bypass Grafting)) simulation system, 2... Training heart, 3... Tank, 4... Centrifugal pump, 6... Pressurization bag, 7. ..Simulated blood, 10... Controller, 11... Control unit, 12... Communication device, 13... Display, 14... Input device, 15... Timing device, 21... Left Coronary artery, 22... right coronary artery, 23... bleeding site, 24... balloon, 31... water, 51, 52... liquid delivery tube, 53... blood delivery tube, 61... Bag, 62... Level sensor, 63... Pressurizing section, 110... First various information storage section, 111... First extended operation execution processing section (program), 112... Centrifuge Pump operation start time information storage unit, 113... Centrifugal pump stop time information storage unit, 114... First contraction operation execution processing unit (program), 115... Systole start time storage unit, 116... Second expansion operation execution processing unit (program) 117... Second contraction operation execution processing unit (program), 120... Second various information storage unit, 121... Pressurized bag state information Storage unit, 122... Pressurized bag simulated blood drop related data generation processing unit (program), 123... Arrhythmia operation execution processing unit (program), 124... Ventricular fibrillation operation execution processing unit (program)

Claims (8)

A deformable section placed on the training heart,
A training blood vessel placed directly on the training heart;
A driving unit that is connected to the deforming unit and expands and contracts the deforming unit;
A working fluid containing portion for containing a working fluid supplied to the training blood vessel portion;
A pressurizing portion capable of applying pressure to the working fluid storage portion by a surface;
A controller that controls the drive unit and the pressure unit,
The drive unit is capable of pulsating motion consisting of expansion and contraction of the training heart by expanding and contracting the deformable unit,
Due to the pressure of the pressurizing portion, the working fluid storage portion is deformed,
The controller individually controls the operation timings of the drive unit and the pressurizing unit, so that when the training heart contracts, the working fluid is supplied to the training blood vessel unit in response to the contraction. It is configured to send liquid ,
The pulsating motion and the delivery of the working fluid are executed based on the actual motion information of the heart,
The heart simulation apparatus is characterized in that the sending of the working fluid is executed at a timing when an R wave appears on an electrocardiogram in an actual heart and then the aortic valve is opened . The pulsating motion includes not only a normal pulsating motion that is a normal pulsating motion of the heart, but also an arrhythmic pulsating motion in which the pulsating motion is not constant and a ventricular fibrillation pulsating motion in which the ventricles of the heart quiver. The heart simulation apparatus according to claim 1, wherein: Acquiring the drop information of the working fluid in the working fluid container from a sensor, and based on the change of the drop information, any one of the normal pulsation operation, the arrhythmic pulsation operation, or the ventricular fibrillation pulsation operation. 3. The heart simulation apparatus according to claim 2, wherein the heart simulation apparatus is configured to automatically select and execute . The delivery of the working fluid to the training blood vessel part changes the delivery pattern in accordance with each beat of the normal pulsation operation, the arrhythmia pulsation operation, or the ventricular fibrillation pulsation operation. is it possible that the heart simulation apparatus according to claim 2 or claim 3, characterized in. Has a diaphragm portion which operates synchronously with the drive unit, this operation of the diaphragm portion, claims 1 to, characterized in that it is configured for feeding the working fluid into the training vessel portion Item 5. The heart simulation device according to any one of items 4 . The working fluid, cardiac simulation apparatus according to any one of claims 1 to 5, characterized in Rukoto such from blood or simulated blood. A deformable section arranged on the training heart, a training blood vessel section directly arranged on the training heart, a drive section connected to the deforming section for expanding and contracting the deformable section, and the training blood vessel section A working fluid containing portion for containing a working fluid to be supplied to, a pressurizing portion capable of applying a pressure to the working fluid containing portion on a surface, and a controller for controlling the drive portion and the pressurizing portion, A method for controlling a heart simulation device comprising:
The drive section expands and contracts the deformable section to cause a pulsating motion of expansion and contraction of the training heart,
The working fluid containing portion is deformed by the pressure of the pressurizing portion,
The controller individually controls the operation timings of the drive unit and the pressurizing unit, so that when the training heart contracts, the working fluid is supplied to the training blood vessel unit in response to the contraction. Send the liquid,
The pulsating motion and the delivery of the working fluid are executed based on the actual motion information of the heart,
The feeding of the working fluid, R wave appears in the ECG in real heart, then, at the timing when the aortic valve is opened, the control method of the heart simulator you characterized in that it is executed. A deformable section arranged on the training heart, a training blood vessel section directly arranged on the training heart, a drive section connected to the deforming section for expanding and contracting the deformable section, and the training blood vessel section A working fluid containing portion for containing a working fluid to be supplied to, a pressurizing portion capable of applying a pressure to the working fluid containing portion on a surface, and a controller for controlling the drive portion and the pressurizing portion, In the heart simulation device equipped with
A step in which the driving section expands and contracts the deformable section to cause a pulsating motion of expansion and contraction of the training heart;
The step of deforming the working fluid container by the pressure of the pressurizing section,
The controller individually controls the operation timings of the drive unit and the pressurizing unit, so that when the training heart contracts, the working fluid is supplied to the training blood vessel unit in response to the contraction. A step of sending a liquid,
The pulsatile motion and the delivery of the working fluid are performed based on actual heart motion information,
Feeding of the working fluid, R wave appears in the ECG in real heart, then, at the timing when the aortic valve is opened, the control program of the cardiac simulation apparatus according to claim Rukoto to execute the steps, to be performed ..

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