Artificial Blood Circulation in Surgery
Development, Technical Decisions and Tests of Systems of an Auxiliary and Complete Heart-Lung Bypass Ensuring Maximum Physiological Effect of a Circulation
Tech Area / Field
- MED-DID/Diagnostics & Devices/Medicine
3 Approved without Funding
Tbilisi Medical Academy / Department of Topographical and Operative Surgery, Georgia, Tbilisi
The basic purpose of the submitted project - development and creation of new generation of technical systems and methods for maintenance of Artificial and Supporting Circulation (AC and SC), substituting the function of heart and lung during cardiosurgical operations on the open, stopped heart, and in critical situations situations possibly resulting in a heart failure. These systems should provide the maximal approximation of their basic target characteristics to the hemodynamical characteristics of replaced organs /heart and lung / .
The submitted project enables the group of "arms-bound" scientists and experts to revert their capacities and qualification for researches not dealing with armament, but benefiting peaceful purposes for the good of humankind.
The attraction of these experts into the given work will allow to accomplish the design development, creation of experienced models of medical and technical systems used in cardiac surgery and resuscitation, to carry out their automated stand and experimental tests on animals and to prepare for clinical application. Moreover, the submitted project will allow the weapon scientists to be integrated in the international scientific community.
Today majority of devices for cardiopulmonary detour used in the clinic is equipped with pumps of a roller type. These machines are capable to transmit blood on an artificial contour in an aorta, framing framing non-pulsating or intermittent blood flow in an arterial channel laminar. Such flow only approximately suggests the natural, physiological cardiac emission. and controlled on a principle of monitoring of volume of a pumped over blood. Even though the extensive theoretical dispute among the scientists regarding the optimum (for the organism) character of the artificial pump has been settled in favor of the pulsating flaw, this fact has not yet met the due reflection in technical improvement of the primary forcing pump.
The idea of creating the system substituting the functions of heart and lung that would differ from the standard devices used for this purpose was conceived as a result of long-term development and experimental researches of AV, Total Artificial Heart (TAH), various contrapulsators for SC, and oxygenators of various kinds by The Department of Topographical Anatomy and Operative Surgery Tbilisi Medical Academy.
Since 1981, our department has developed several, essentially distinguished systems for AC and SC. As a result of these development we created the trial model of systems, which uses the device developed by us as the basic forcing pump; the basic circuit was created of this device's configuration in a complex with venous and cardiotomy reservoirs, oxygenator, arterial filter, system of pumps and control system of the executive devices. The systems have passed preliminary stand approbation, were used in experiments on animals, and have shown high correlation of the basic hemodynamical parameters with parameters of the natural heart.
However, the completion and clinical introduction of the given project requires the continuation of researches for the decision on series of questions of the technical, methodical, surgical and biological character that have arisen during the preliminary experiences.
The prospective basic stages of works should include:
- design development of the model of framed system for a heart-lung bypass.
- development of certain units of this system working on the principle of a feedback with the use of the most informative parameters of a homeostasis;
- development and creation of controls assembly, ensuring the cardiosynchronization of the basic pump, switching of the system of its management with a control system of other auxiliary pumps with the optimization of volume of filling and distribution of blood in reservoirs of accumulation and artificial oxygenation;
- creation of experienced model of new system for a heart-lung bypass with pulsatile flow and realization of its stand researches;
- research of experimental bio-model most suitable by anatomic and hemodynamic parameters (for realization of chronic experiences) and having most approximate parameters to those of a human;
- study of processes of interaction in a biotechnical complex of an organism - device and research of methods of optimization of this interaction with the use of the developed system for a heart-lung bypass;
- development and creation of the technical and methodical documentation concerning the given project for realization of its clinical introduction.
The role of the collaborators in the given project will consist of estimating the new ideological approaches concerning the judgement of the most informative parameters and criteria determining the contact of an organism with an artificial contour; in participation in joint seminars, experimental researches on biological objects and keeping the summary reports.
The results of experiments will allow to create a new type of system for AC, with the characteristics most closely approximated to those of a natural cardiopulmonary complex; excluding the perfusion and post-perfusion complications; not requiring realization of expensive monitoring of the homeostasis and its pharmacological correction. This will allow the increase in general efficiency of cardiosurgical operations on an open heart, prolonging the safe period of similar perfusions, expanding the indications of its application both at a complete heart-lung bypass, and at an auxiliary extra-pulmonary oxygenation (AEPO), and will considerably lower the cost of these manipulations.
The International Science and Technology Center (ISTC) is an intergovernmental organization connecting scientists from Kazakhstan, Armenia, Tajikistan, Kyrgyzstan, and Georgia with their peers and research organizations in the EU, Japan, Republic of Korea, Norway and the United States.
ISTC facilitates international science projects and assists the global scientific and business community to source and engage with CIS and Georgian institutes that develop or possess an excellence of scientific know-how.