The Apico Aortic Blood Pump (AABP) is a centrifugal continuous flow left ventricular assist device (LVAD) with ceramic bearings. The device is in the initial development phase and is being designed to be attached directly to the left ventricular apex by introducing an inlet cannula. This paper reports results from in vitro experiments. In order to evaluate implantation procedures and device dimensioning, in vitro experiments included an anatomic positioning study for the analysis of surgical implantation procedure and device dimensions and positioning that was performed using the body of a pig. The results revealed no damage caused by the device, and the surgical implantation procedure was considered feasible. Hydrodynamic performance curves were obtained to verify the applicability of the device as an LVAD, showing adequate performance. Mechanical blood trauma was analyzed through 6-h hemolysis tests, with total pressure head of 100 mm Hg and flow of 5 L/min. Mean normalized index of hemolysis was 0.009 g/100 L (±0.002 g/100 L). Studies using a hybrid cardiovascular simulator were conducted for three types of circulatory conditions: normal healthy conditions, concentric hypertrophic heart failure (CHHF), and CHHF with AABP assistance. Analysis of cardiovascular parameters under those three conditions demonstrated that when the AABP was assisting the system, parameters under CHHF conditions went back to normal healthy values, indicating the AABP's effectiveness as CHHF therapy. Our preliminary results indicate that it is feasible to use the AABP as a LVAD. The next steps include long-term in vivo experiments.

An implantable centrifugal blood pump was developed for long-term ventricular assistance in cardiac patients. In vitro tests were performed, as wear evaluation, performance tests and hemolysis tests in human blood. Numerical computational simulations were performed during design process in order to predict its best geometry. Wear evaluations helped to select the best materials for double pivot bearing system proposed to achieve longer durability. Performance tests pointed the best impeller geometry. The implantable centrifugal blood pump was compared with other blood pumps founded in literature. The proposed implantable centrifugal blood pump showed the best performance. But, its results showed a strong descendant curve in high flow. Other prototype was manufactured with a different inlet port angle to overcome this problem. The normalized index of hemolysis (NIH) measured 0.0054 mg/100L that can be considered excellent since it is close to the minimum found in literature (between 0.004 g/ 100L e 0.02 g/ 100L). The authors' expectation is that this pump will become a promising Technological Innovation for Sustainability.

Modelo de estudo: Estudo de prevalência. Objetivo do estudo: Avaliar o perfil epidemiológico dos casos de hipospádia atendidos no Hospital São Francisco na Providência de Deus da Universidade São Francisco (HUSF), Bragança Paulista/SP nos últimos 10 anos (2007-2017), relacionando os tipos de hipospádia com as malformações associadas e idade à primeira cirurgia corretiva. Metodologia: Foi realizado um levantamento de casos de hipospádia atendidos entre 2007 e 2017 no HUSF, com pacientes oriundos das cidades da Região Bragantina do estado de São Paulo. Os tipos de hipospádia foram relacionados com as malformações associadas. Foram pesquisados nos prontuários: tipo de hipospádia, idade à primeira cirurgia, laudo de exame ultrassonográfico, etnia, local de nascimento e malformação associada. Os dados foram analisados estatisticamente utilizando os testes Qui-quadrado, teste F e de Kruskal-Wallis. Resultados: Em 1401 atendimentos pediátricos no período avaliado, foram encontrados 45 casos de hipospádia com prevalência igual a 0,7/1000 nascidos vivos. Do total de casos, 29 foram classificados como do tipo distal, seis casos de hipospádia média e 10 casos do tipo proximal [F-test (2,8)=5,552; P=0,003; χ2=9,3117; P=0,009]. Nos casos de hipospádia distal, foram detectadas 16 malformações associadas e, nos tipos média e proximal, foram observadas sete malformações associadas em cada uma (KW=3,322, P=0,19). O maior número de casos foi abordado cirurgicamente no intervalo entre os três e quatro anos de idade. Conclusão: A hipospádia distal foi a mais prevalente, com idade à primeira cirurgia em desacordo com o intervalo proposto para a correção da hipospádia.

Objective The objective of this paper is to present the results from Spiral Pump clinical trial after design modifications performed at its previous project. This pump applies axial end centrifugal hydraulic effects for blood pumping during cardiopulmonary bypass for patients under cardiac surgery. Methods This study was performed in 52 patients (51% males), between 20 to 80 (67±14.4) years old weighing 53 to 102 (71.7±12.6) kg, mostly under myocardial revascularization surgery (34.6%) and valvular surgery (32.8%). Besides the routine evaluation of the data observed in these cases, we monitored pump rotational speed, blood flow, cardiopulmonary bypass duration, urine free hemoglobin for blood cell trauma analysis (+ to 4+), lactate desidrogenase (UI/L), fibrinogen level (mg/dL) and platelet count (nº/mm3). Results Besides maintaining appropriate blood pressure and metabolic parameters it was also observed that the Free Hemoglobin levels remained normal, with a slight increase after 90 minutes of cardiopulmonary bypass. The Lactate Dehydrogenase showed an increase, with medians varying between 550-770 IU/L, whereas the decrease in Fibrinogen showed medians of 130-100 mg/dl. The number of platelets showed a slight decrease with the medians ranging from 240,000 to 200,000/mm3. No difficulty was observed during perfusion terminations, nor were there any immediate deaths, and all patients except one, were discharged in good condition. CONCLUSION The Spiral Pump, as blood propeller during cardiopulmonary bypass, demonstrated to be reliable and safe, comprising in a good option as original and national product for this kind of application.

No abstract