JP2010148800A - Blood supply device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a blood supply device capable of constantly supplying pulsating blood flow.
SOLUTION: A pulsation pump 10 for intermittently delivering blood by pulsation, a liquid reservoir 20 for temporarily storing blood delivered from the pulsation pump 10, and a pulsation pump 10 from the liquid reservoir 20 And a check valve 23 for preventing backflow into the blood supply device for supplying blood from the pulsating pump 10 through the liquid reservoir 20 into the body, and the internal volume of the liquid reservoir 20 changes due to elasticity. A part of the blood introduced during the contraction period of the pulsation pump 10 is stored by expansion of the variable chamber 22, and the variable chamber 22 is elastically contracted during the expansion period of the pulsation pump 10. The stored blood is discharged.
[Selection] Figure 1

Description

  The present invention relates to a blood supply device, and more particularly to a blood supply device that can be suitably used in bypass surgery under heartbeat.

  In recent years, off-pump CABG (coronary artery bypass graft) has been performed in many cases because the burden on patients and the risk of complications are low. For example, a device disclosed in Patent Document 1 is known as a device for bypassing blood in a bypass operation under heartbeat.

The apparatus includes a blood removal means for extracting blood from a predetermined arterial blood vessel, a pump for supplying the extracted blood, a perfusion means for returning the blood discharged from the pump to a predetermined site of the coronary artery, and a pumping operation of the pump. And a pump control device for controlling the motor. The perfusion means includes an insertion catheter that is inserted into the coronary artery and a blood feeding tube that is thicker and more flexible than the insertion catheter, and blood is pumped out in a pulsating flow that is synchronized with the heartbeat.
JP 2001-61956 A

  In the device disclosed in Patent Document 1, the blood flow in the insertion catheter is similar to a physiological pulsating flow due to the elasticity of the blood feeding tube, and blood can be supplied in accordance with the pulsation.

  However, since the blood supply tube does not have a function of storing blood, it is difficult to continue supplying blood to the myocardium from the insertion catheter during pump suction (diastolic phase), and a large load is applied to the myocardium. There was a risk of giving. For these reasons, the surgeon is required to have an early anastomosis, which places a heavy burden on the psychological and work aspects.

  Then, an object of this invention is to provide the blood supply apparatus which can always continue supplying pulsatile blood flow.

  The object of the present invention is to provide a pulsation pump for intermittently delivering blood by pulsation, a liquid reservoir for temporarily storing blood delivered from the pulsation pump, and the pulsation from the liquid reservoir. A blood supply device that supplies a blood from the pulsating pump to the body through the liquid reservoir, and the internal volume of the liquid reservoir changes due to elasticity. A portion of the blood introduced during the contraction period of the pulsation pump is stored by expansion of the variable chamber, and the variable chamber is elastically contracted during the expansion period of the pulsation pump. This is achieved by a blood supply device that discharges the stored blood.

  According to the blood supply device of the present invention, pulsating blood flow can be continuously supplied.

  Hereinafter, actual forms of the present invention will be described with reference to the accompanying drawings. FIG. 1 is a schematic configuration diagram of a blood supply device according to an embodiment of the present invention. The blood supply device 1 shown in FIG. 1 includes a pulsation pump 10 and a liquid reservoir 20, and the pulsation pump 10 and the liquid reservoir 20 are connected by a connecting tube 2. The blood removal tube 3 and the blood supply tube 4 can be detachably connected to the upstream side of the pulsation pump 10 and the downstream side of the liquid reservoir 20 via connectors or the like. The blood extracted through can be supplied from the blood supply tube 4 to the heart (coronary artery).

  The pulsation pump 10 is configured such that an expandable tube 12 made of an elastically deformable material is accommodated in a sealed casing 11. The telescopic tube 12 is preferably a thin-film tube having anti-thrombogenicity as well as pressure resistance and durability, and examples include materials such as urethane resin (thermoplastic polyurethane elastomer), silicon, and polyvinyl chloride (PVC). Can do. A more specific example is a urethane resin tube having an inner diameter of 5 mm, an outer diameter of 5.4 mm, and a Shore D hardness of 50.

  A drive tube 13 that communicates the inside and outside of the casing 11 is connected to the side wall of the casing 11, and helium gas or the like is interposed between the inner wall surface of the casing 11 and the outer surface of the telescopic tube 12 via the drive tube 13. The driving gas can be supplied. The supply of the driving gas can be performed using, for example, an intraaortic balloon pumping device (IABP: intraaortic balloon pumping), and by monitoring the electrocardiogram, the driving gas supplied to the casing 11 in synchronization with the movement of the heart Control pressure. That is, during the diastole of the heart, the inside of the casing 11 is decompressed to expand the telescopic tube 12, and blood is introduced into the telescopic tube 12 from the femoral artery. In the systole of the heart, the inside of the casing 11 is pressurized to contract the expansion tube 12, and the blood in the expansion tube 12 is discharged toward the coronary artery. Thus, blood can be supplied intermittently by pulsation that matches the contraction and expansion of the heart. Check valves 15 and 16 are provided on both sides of the telescopic tube 12 to ensure one-way blood flow from the femoral artery side to the coronary artery side.

  The pulsation pump 10 only needs to generate blood pulsation corresponding to the contraction and expansion of the heart. In addition to the configuration of this embodiment that changes the internal volume of the telescopic tube by adjusting the gas pressure, for example, And roller pumps and diaphragm pumps. Further, a pulsation pump can be configured by a combination of a steady flow pump and an on-off valve, and a pulsating flow can be generated by opening / closing control of the on-off valve to generate a diastole and a systole.

  The liquid reservoir 20 is provided at the tip of the connecting tube 2 connected to the downstream side of the pulsation pump 10, and includes a variable chamber 21 and a protective cover 22 that covers the variable chamber 21.

  The variable chamber 21 is a cylindrical member having elastic elasticity that changes its internal volume due to a pressure difference between inside and outside. The connecting tube 2 and blood feeding tube 4 are composed of commercially available medical tubes made of soft PVC or the like, whereas the variable chamber 21 is made thinner or more flexible. It is preferable to use a member that easily changes its internal volume due to elastic deformation. For example, the variable chamber 21 can be composed of a straight tube having a length of about 5 to 10 cm, dipped in liquid silicone rubber.

    For example, the variable chamber 21 can be configured from a silicone resin tube made of a material having a small Shore D hardness (30 to 70) and a length of 5 cm to 30 cm and a wall thickness of 0.25 mm to 0.75 mm. is there. In order to easily change the internal volume of the variable chamber 21, it is also effective to reduce the diameter of the downstream flow path with respect to the upstream flow path of the variable chamber 21. The channel diameter can be set to 3 mm, and the downstream channel diameter can be set to 1 mm.

    A check valve 23 is provided on the upstream side of the variable chamber 21, so that backflow to the pulsation pump 10 side when the internal volume of the variable chamber 21 contracts can be prevented.

  According to the blood supply device 1 having the above configuration, when blood is supplied to the variable chamber 21 of the liquid reservoir 20 during the contraction period of the pulsation pump 10 by the operation of the pulsation pump 10, the variable chamber 21 is expanded by excess blood while flowing a part of the blood toward the blood sending tube 4 on the downstream side, and stores the blood inside. When the blood supply from the pulsation pump 10 is interrupted during the expansion period of the pulsation pump 10, the variable chamber 21 supplies the stored blood toward the blood supply tube 4 by elastic contraction.

    Thus, the variable chamber 21 functions as a buffer for suppressing a rapid increase in supply pressure during the contraction period of the pulsation pump 10, while supplying a small amount of blood during the expansion period of the pulsation pump 10. To function as an auxiliary pump. Thus, as shown in FIG. 2, the blood supplied into the body from the blood supply tube 4 is cyclic between the systolic phase a1 and the diastolic phase a2 of the pulsating pump 10 while the pumping pressure is always positive. To change. As a result, blood can be constantly supplied while generating a pulsating flow that matches the pulsation of the heart. The pulsation pump 10 has a negative pressure inside the diastole, but the check valve 23 provided on the upstream side of the variable chamber 21 prevents the back flow of blood in the variable chamber 21. In this embodiment, in addition to the check valve 23 of the variable chamber 21, the pulsation pump 10 is also provided with the check valve 15, and the pushing pressure of the variable chamber 21 can be reliably directed downstream in the transport direction. . However, at least one check valve provided between the pulsation pump 10 and the liquid reservoir 20 may be provided, and the position thereof is not particularly limited.

  The internal volume variable amount of the variable chamber 21 may be set in consideration of the amount of blood stored so that the pulsating pump 10 can maintain the blood supply even in the diastole. Specifically, the ratio (A / B) between the maximum volume A of the variable chamber 21 when the pulsating pump 10 is contracted and the volume B of the variable chamber 21 at the normal time when no internal / external pressure difference occurs is 1.2. The above is preferable. That is, if the buffer capacity is at least about 20%, the function as the variable chamber 21 can be reliably obtained. The upper limit of the volume ratio (A / B) is not particularly limited, but is usually about 2 to 3, and practically 4 or less.

  Further, by covering the variable chamber 21 with the protective cover 22, it is possible to prevent the variable chamber 21 from being deformed or damaged, and to reliably exhibit the above functions of the variable chamber 21. The protective cover 22 preferably has a sealed structure, and even if the variable chamber 21 is damaged, blood can be reliably prevented from flowing out. However, the protective cover 22 is not essential for the liquid reservoir 20.

  As mentioned above, although one Embodiment of this invention was explained in full detail, the specific aspect of this invention is not limited to the said embodiment. For example, the variable chamber 21 constituting the liquid reservoir 20 is formed in a straight tube shape so that the cross-sectional area of the flow path is constant along the blood flow direction in the present embodiment, but FIG. As shown in FIG. 4, the central portion c may have a shape bulging outward in a side view so that the cross-sectional area of the flow path is larger than both end portions e and e. In the period, a sufficient amount of blood can be secured in the variable chamber 21 while ensuring the function as a buffer. On the other hand, as shown in FIG. 3 (b), it is possible to make the central portion c indented in the side view so that the channel cross-sectional area is smaller than both end portions e and e. The recessed central portion c is inverted in a convex shape during the contraction period of the pulsating pump 10 and functions as a buffer, and the expanded central portion c attempts to return to the concave shape during the expansion period of the pulsating pump 10. Blood can be reliably supplied by force. Thus, the buffer function or the blood supply function can be further enhanced by configuring the variable chamber 21 so that the cross-sectional area of the flow path changes along the blood flow direction.

  Further, the variable chamber 21 constituting the liquid reservoir 20 may be any one that changes its internal volume due to elasticity. For example, a head chamber defined by a bellows-like container or a piston that slides in a cylinder includes: It can also be configured to expand and contract by air pressure or spring pressure.

  The connecting tube 2 is not essential for the present invention, and the liquid reservoir 20 can be directly connected to the downstream side of the pulsating pump 10.

It is a schematic block diagram of the blood supply apparatus which concerns on one Embodiment of this invention. It is a figure for demonstrating the action | operation of the blood supply apparatus shown in FIG. It is a perspective view which shows the principal part modification of the blood supply apparatus shown in FIG.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Blood supply apparatus 10 Pulsating pump 20 Liquid reservoir part 21 Variable chamber 22 Protective cover 23 Check valve

Claims (3)

A pulsation pump that intermittently pumps blood by pulsation, a liquid reservoir part that temporarily stores blood delivered from the pulsation pump, and a backflow from the liquid reservoir part to the pulsation pump is prevented. A blood supply device comprising a check valve and supplying blood into the body from the pulsating pump through the liquid reservoir,
The liquid reservoir includes a variable chamber whose internal volume changes due to elasticity, and stores a part of blood introduced during the contraction period of the pulsation pump by expansion of the variable chamber, and the pulsation pump A blood supply device for discharging the stored blood by elastically contracting the variable chamber during the expansion phase of the above. The blood supply apparatus according to claim 1, wherein the liquid reservoir further includes a protective cover that houses the variable chamber. The blood supply apparatus according to claim 1, wherein the variable chamber has a cross-sectional area of a flow path that changes along a blood flow direction.

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