Unloaded Heart Perfusion via Aortic Flow for Longer Preservation
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Solution Overview
Problem
The existing systems for extracorporeal heart perfusion, particularly for hearts from donation after circulatory death (DCD) donors, are inadequate as they rely on ventricle loading to pump perfusate, leading to high myocardial oxygen consumption and unsuitable for prolonged organ preservation.
Innovation Solution
A method and system that perfuse the heart in an unloaded state by flowing perfusate through the aorta into the coronary arteries and allowing exit via the inferior and superior vena cava, with a centrifugal pump and oxygenator configuration, reducing ventricle loading and enabling perfusate drainage without complex venting arrangements.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If the heart is perfused in a loaded state relying on ventricle loading to pump perfusate, then the heart can maintain normal pumping function, but myocardial oxygen consumption increases and preservation time is limited
Solution Approach 1:
The patent inverts the traditional perfusion approach by reversing the flow direction through the heart. Instead of flowing perfusate through the normal physiological path (right atrium → right ventricle → pulmonary artery), the system flows perfusate in reverse through the coronary arteries → myocardium → coronary sinus → right atrium. This inversion allows the heart to be perfused in an unloaded state without requiring ventricular contraction, thereby reducing myocardial oxygen consumption while maintaining tissue viability.
Solution Approach 2:
The patent changes the physiological parameters of heart perfusion by maintaining the heart in an unloaded state with reduced metabolic demand. By altering the flow path and using a centrifugal pump to drive perfusate through the coronary circulation rather than relying on ventricular loading, the system achieves extended preservation times (up to 120 hours) compared to traditional methods by reducing the energy consumption of the myocardium.
2Duration of action of stationary object
If the heart is perfused in an unloaded state with reduced metabolic demand, then preservation time is extended and tissue recovery is improved, but the heart cannot maintain normal pumping function
Solution Approach 1:
The patent inverts the traditional perfusion approach by reversing the flow direction through the heart. Instead of flowing perfusate through the normal physiological path (right atrium → right ventricle → pulmonary artery), the system flows perfusate in reverse through the coronary arteries → myocardium → coronary sinus → right atrium. This inversion allows the heart to be perfused in an unloaded state without requiring ventricular contraction, thereby reducing myocardial oxygen consumption while maintaining tissue viability.
Solution Approach 2:
The patent extracts the pumping function from the heart during preservation by using an external centrifugal pump to drive perfusate through the coronary circulation. This separation allows the heart to be maintained in a low-metabolic state without the energy expenditure of active pumping, while the external pump provides the necessary flow to sustain tissue viability and enable extended preservation times.
3Reliability
If complex venting arrangements are used to drain perfusate from the heart, then complete perfusate drainage is achieved, but device complexity increases
Solution Approach 1:
The patent inverts the traditional perfusion approach by reversing the flow direction through the heart. Instead of flowing perfusate through the normal physiological path (right atrium → right ventricle → pulmonary artery), the system flows perfusate in reverse through the coronary arteries → myocardium → coronary sinus → right atrium. This inversion allows the heart to be perfused in an unloaded state without requiring ventricular contraction, thereby reducing myocardial oxygen consumption while maintaining tissue viability.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
This approach reduces myocardial oxygen consumption, allows for improved heart tissue recovery, and extends the preservation time of the heart by maintaining it in a low metabolic state.
Implementation Method 1
A pump interface is provided and arranged to transfer a pumping force from a pump to pump venous perfusate within a first fluid flow path via an oxygenator to thereby provide a subsequent flow of oxygenated perfusate to the heart
Implementation Method 2
pump venous perfusate within a first fluid flow path via an oxygenator to thereby provide subsequent flow of oxygenated perfusate
Data Source
AI summary
An organ perfusion system (100) for extracorporeal perfusion of a heart (1) includes an organ chamber (15) having an aortic connector (17), and a first fluid flow path (19) comprising a pump interface (23) and an oxygenator (25), the aortic connector being fluidly connected to the first fluid flow path. The system is adapted for use in a method, wherein oxygenated perfusate is flowed into the heart via the aorta and desoxygenated perfusate is allowed to exit the heart via the inferior vena cava and/or the superior vena cava to thereby perfuse the heart in a substantially unloaded state. Such method may allow for improved recovery of the heart tissue during perfusion. The organ perfusion system may further comprise a perfusate reservoir (27) and/or a chassis, wherein the organ chamber is pivotable with respect to the chassis for holding the heart in a tilted position or to allow rotation of the organ chamber in a horizontal plane.