可吸收经胸逆向左心耳封堵器的研制及体外动物实验

发布时间：2018-10-17 13:18

【摘要】：目的设计和制作可吸收经胸逆向左心耳封堵器及输送系统,并用体外封堵实验评价其经胸逆向封堵左心耳的可行性,为后续动物实验奠定基础。方法使用可吸收材料聚对二氧环己酮(PDO)丝材、聚乳酸(PLA)无纺布及聚乙醇酸(PGA)缝线编织左心耳封堵器。在体外水浴条件下测试可吸收左心耳封堵器的压缩性能、弹性恢复性能及尾部螺纹铆可承受的有效输送释放次数。选取6只健康杂种犬离体心脏标本,直视下在左心耳外上中1/3处穿刺,使用带刻度的输送鞘及封堵器完成体外封堵实验,封堵完毕后解剖心脏,观察封堵器位置和封堵效果。结果封堵器可顺利收入14F鞘管并完成输送和释放,在鞘管中保留15min后释放,即刻恢复到原状96%的程度,尾部螺纹铆能承受(5.20±0.75)次的有效输送。6只犬心脏标本全部封堵成功,封堵器释放以后,位置良好,内盘面进入心耳口内少许,左心耳开口呈过度撑开状态,不影响肺静脉血液回流和左房室瓣功能。结论可吸收经胸逆向左心耳封堵器设计合理,与实验犬左心耳解剖形态匹配,封堵效果确切,可以进行动物实验以进一步评价采用可吸收左心耳封堵器经胸逆向封堵左心耳的可行性、安全性和有效性。
[Abstract]:Objective to design and make absorbable transthoracic reverse left atrial appendage occluder and transport system, and evaluate the feasibility of transthoracic reverse occlusion of left atrial appendage with external occlusion experiment, and lay a foundation for subsequent animal experiments. Methods the absorbable poly (p dioxanone) (PDO) wire, polylactic acid (PLA) nonwoven fabric and poly (ethanolide) (PGA) suture were used to weave the left atrial ear occluder. The compression performance of absorbable left atrial appendage occluder, the elastic recovery performance and the effective delivery and release times of tail thread riveting were tested under the condition of external water bath. The isolated hearts of 6 healthy mongrel dogs were selected and punctured in the middle of the left atrial appendage at the middle of one third of the left atrial appendage under direct vision. The external occlusion experiments were carried out by using a calibrated transport sheath and occluder. After occlusion, the heart was dissected, and the occluder location and the occlusion effect were observed. Results the occluder could successfully transport and release the 14F sheath tube. After retaining 15min in the sheath tube, the occluder could be released to 96% of the original state immediately, and the tail thread riveting could withstand (5.20 卤0.75) effective transportation.All the heart specimens of 6 dogs were successfully occluded. After the occluder was released, the position of the occluder was good, the internal disc surface entered into the auricle of the heart a little, and the opening of the left atrial appendage was overstretched, which did not affect the blood flow of pulmonary vein and the function of left atrioventricular valve. Conclusion the absorbable transthoracic converse left atrial appendage occluder is reasonably designed and matched with the anatomic morphology of the left atrial appendage in experimental dogs. Animal experiments can be carried out to further evaluate the feasibility, safety and effectiveness of using absorbable left atrial appendage occluder for transthoracic reverse occlusion of left atrial ear.
【作者单位】：解放军422医院心血管内科;第二军医大学长海医院心血管内科;第二军医大学长海医院胸心外科;上海锦葵医疗器械有限公司研发部;
【基金】：国家自然科学基金(81175150) 上海市自然科学基金(13ZR1409500) 第二军医大学2014年度博士创新基金(201402)~~
【分类号】：R541.75

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