论文部分内容阅读
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。
Objective To design and fabricate the transcatheter reverse left atrial appendage occluder and delivery system, and evaluate the feasibility of transcatheter closure of the left atrial appendage with an in vitro blockade experiment, so as to lay the foundation for subsequent animal experiments. Methods Absorbable polydioxanone (PDO) silk, polylactic acid (PLA) nonwovens and polyglycolic acid (PGA) suture braided atrial appendage occluder were used. The compressibility, elastic recovery performance and the number of effective delivery deliveries that can be tolerated by the tail threadings are tested under an in vitro water bath condition. Six healthy hybrid dogs were selected from isolated heart specimens and punctured at the middle 1/3 of the left atrial appendage under direct vision. The external plugging test was performed by using the scaled delivery sheath and occluder. After sealing, the heart was dissected and observed Occluder position and blocking effect. Results The occluder could smoothly receive 14F sheath and deliver and release it. It was released for 15min in the sheath and recovered to 96% of its original shape immediately. The tail thread rivets could effectively deliver (5.20 ± 0.75) times. All 6 dogs were successfully occluded. After the occluder was released, the position was good. A little disk was inserted into the inner ear of the heart. The opening of the left atrial appendage was overextensioned without affecting the pulmonary venous return and the function of the left atrial valve. Conclusion The design of absorbable transthoracic left atrial appendage occluder is reasonable and matches with the anatomy of left atrial appendage in experimental dogs. The blocking effect is exact. Animal experiments can be conducted to further evaluate the feasibility of transthoracic occlusion of left atrial appendage with absorbable left atrial appendage occluder Feasibility, safety and effectiveness.