JPH03202069A - Balloon pumping device - Google Patents

Abstract

PURPOSE:To constitute the device so that an MRI contrast-medium goes into a balloon by pumping and a position and a shape of the balloon can be recognized by supplying the MRI contrast-medium to a liquid space extending from a pumping means to the balloon by a supply means. CONSTITUTION:A liquid supply control means actuates pumping means AGA, ADU, and thereafter, at the time of pressurization of at least once, a second opening/closing valve 58 is maintained in an open state and a first opening/ closing valve 59 is closed, therefore, in this case, a previous operating fluid which remains behind in the pumping means AGA, ADU and a balloon 60 is discharged through a second opening/closing valve 58. Also, thereafter, a fluid supply control means opens/closed a first opening/closing valve 59 so that fluid pressure in a pressure reduction period of the pumping means AGA, ADU of a fluid space 90 becomes set pressure, therefore, by the discharge, a shortage portion of an operating fluid in the fluid space 90, and an operating fluid of a fluid source connected newly are supplied to the fluid space 90 through a first opening/closing valve 59, therefore, the replacement of the operating fluid in the balloon 60 is realized quickly.

Description

[Detailed Description of the Invention] [Object of the Invention] (Industrial Application Field) The present invention relates to a device for pumping and driving a balloon inserted into a living body, and particularly relates to a pumping device for performing MRI imaging of the balloon. .

(Prior Art) Balloon pumping devices are known, for example, in US Pat. No. 4.32
No. 1,109, No. 4,362,150 and No. 4,4
No. 22,477, Mei. M et al. No. 22,477.

In one use of the balloon, the balloon 60 is inserted into the aorta and pushed into the immediate vicinity of the heart, as shown in Figure 8a. In synchronization with the heartbeat, during the expansion phase of the heart, the 8th b.
By inflating the balloon 60 as shown in the figure and deflating the balloon 60 during the systole, the balloon 60 assists the heart in sucking and sending blood, thereby reducing the burden on the heart.

When the balloon 60 is in the proper position shown in FIGS. 8a to 8c, it exhibits the above-mentioned effect, but if the balloon 60 is deviated from the proper position, the above-mentioned effect is not fully exerted. Otherwise, the front end of the balloon 60 may easily swing and cause relatively strong stimulation or damage to the inner wall of the aorta. Therefore, conventionally, the balloon 60 is integrally connected to the balloon 60.
The tube for supplying/inhaling air from outside the body into the inside of the body is marked with a scale. When inserting the balloon 60 into a living body, the operator knows the insertion length from the scale on the tube at the insertion port of the living body and estimates the position of the balloon 60.

(Problem to be Solved by the Invention) However, there are individual differences in the body shape of living organisms, and whether or not the balloon 60 is actually inserted in the appropriate position can be determined by pumping the balloon 60 after insertion. It is determined whether or not physiological functions such as blood circulation have improved based on other biological examination information, and if they have improved, it is estimated that the balloon 60 is in an appropriate position and is operating as desired.

However, even if the physiological function improves to a certain extent, the position of the balloon 60 is not necessarily in the correct and appropriate position.
Moreover, the operation is not necessarily correct or appropriate. For example, if the balloon 60 is slightly misaligned and its leading end is oscillating, the leading end may hit or rub against the inner wall of the blood vessel, potentially damaging the blood vessel during long-term pumping. One possible method is to visually check the position and operating shape of the balloon 60 using X-ray fluoroscopy, but since it is not preferable to irradiate the living body with X-rays, MRI (Magnetic Resonance
It is preferable to visualize the balloon position and shape by anceImaging, however, since conventional balloons and their working fluids do not substantially produce MR phenomena, recognition of the position and shape by MRI is difficult.

An object of the present invention is to provide a balloon pumping device that can recognize the balloon position and shape using MRI. 60)
; Pumping means (AGA, ADO) that has a closed space communicating with the balloon (60) and pressurizes/depressurizes the closed space;
; an MRI contrast agent source (PTA); and a fluid space (90) from the closed space to the balloon (60).

Supply means (75, 73, 59) for supplying an MRI contrast agent (CF4) of an MRI contrast agent source (PTA) are provided.

Note that symbols in parentheses indicate corresponding elements in the embodiments shown in the drawings and described later.

(Function) According to this, the supply means (75, 73, 59)
From the pumping means (AGA, ADIJ) to the balloon (
The fluid space (90) up to 60) can be supplied with an MRI contrast agent (CF4) of an MRI contrast agent source (PTA). An MRI contrast agent (CFa) is placed in the fluid space (90).
), pumping means (AGA, ADO)
The MRI contrast agent (CFa) enters the balloon (60) by pumping.

Balloon (
60) can be visually recognized.

It is preferable that the balloon (60) has an extremely thin film thickness, inflates/deflates smoothly, and provides minimal resistance to blood flow. ) is preferably a gas. Therefore, He has conventionally been used.

By the way, if solid powder that causes an MR phenomenon is included in the working gas for balloon pumping, the solid powder will accumulate unevenly within the balloon, making it difficult to take MRI images of the entire position and shape of the balloon, and the shape of the balloon will be disturbed. Because it's easy,
Preferably, the MRI contrast agent is also purely gaseous. Some gases that cause the MR phenomenon include elements such as H, N, and F, but N2 is highly flammable and poses a risk of explosion. Although N2 and CF are preferred as working fluids for MHI contrast agents and balloon pumping because they are relatively easy to handle and pose virtually no risks, they are relatively heavy gases. Therefore, it is preferable to supply a gas for MRI contrast, such as CF, N2, etc., to the balloon during MRI imaging, and to supply a light gas, such as He, to the balloon while MRI imaging is not being performed.

Therefore, the balloon pumping device according to the first aspect of the present invention,
Balloon (60); has a closed space communicating with the balloon (60), and pumping means (for pressurizing/depressurizing the closed space);
AGA, ADO); Balloon (60) from the closed space
The fluid space (90) up to the fluid source (HTA, PT
A connector (73) for connecting to the balloon (90); the opening/closing valve (59) inserted between the fluid space (90) from the closed space to the balloon (90) and the connector (73);
; a second on-off valve (5g) interposed between the fluid space (90) from the closed space to the balloon (60) and the fluid discharge path (GEQ) ; in response to the start instruction, pumping means; (AGA.

After starting the pumping means (ADU), the second on-off valve (58) is kept open and the first on-off valve (59) is closed.
, ADU), the fluid pressure during the depressurization period of the pumping means (AGA, ADD) in the fluid space (90) from the closed space to the balloon (60) reaches the set pressure (Pnt ); and an MRI contrast agent source (PTA) connected to the connector (73);
;

According to this, a commonly used fluid source (HTA) containing a light gas such as He and an MRI contrast agent source (PTA) containing an MRI contrast gas such as CF or N2 are selectively connected to the connector (73). Since it can be connected and supplied to the balloon (60), when performing MRI imaging, the connector (
An MRI contrast agent source (PTA) is connected to the connector (73), and a commonly used fluid source (HTA) is connected to the connector (73) when MRI imaging is not performed.

Therefore, when switching the connection of the fluid source to the connector (73) from a conventional one (HTA) to one for MRI contrast imaging (PTA) or vice versa, the pumping is stopped before the switching, and after the switching Pumping is restarted. When the start of pumping is instructed, the fluid supply control means (100) starts the pumping means (AGA).

ADLI), and after that, when pressurizing at least once, the second on-off valve (58) is kept open and the first on-off valve (59) is kept open.
is closed, so at this time the pumping means (AGA, A
DU) and the previous working fluid remaining in the balloon (60) are discharged through the second on-off valve (58). Moreover,
The fluid supply control means (100) then controls the fluid space (
Since the first on-off valve (59) is opened and closed so that the fluid pressure during the pressure reduction period of the pumping means (AGA, ADD) becomes the set pressure (Pnt, ), the discharge causes the fluid space (90) to be When the working fluid is insufficient, the working fluid from the newly connected fluid source flows into the fluid space (9) through the first on-off valve.
0). In this way, immediately after the start of pumping, the working fluid remaining in the fluid space (90) etc. before switching the connection of the fluid source is discharged, and the working fluid of the newly connected fluid source is transferred to the fluid space (90). 90), the working fluid can be quickly replaced in the balloon (60).The balloon pumping device according to the second aspect of the present invention includes a balloon (60); a closed space that communicates with the balloon (60); and a pumping means (AGA) that pressurizes/depressurizes the closed space.
, ADU); A connector (73) for connecting the fluid space (90) from the closed space to the balloon (60) to a fluid source (HTA, PTA); A connector (73) for connecting the fluid space (90) from the closed space to the balloon (60); first on-off valve (59) inserted between the fluid space (90) and the connector (73): the fluid space (from the closed space to the balloon (60));
90) and the second fluid outlet (GEO)
On-off valve (58); In response to a stop instruction, the first on-off valve (58)
59) is a pumping means (AGA) which is maintained closed and the second on-off valve (58) is opened.

After at least one pressurization of the ADU, the pumping means (AGA, ADO) is stopped and the second on-off valve (58) is kept closed between the start of depressurization and the beginning of pressurization. means (100); and an MRI contrast agent source (PTA) connected to the connector (73).

According to this, similar to the first aspect, a commonly used fluid source (HTA) containing a light gas such as He and an MRI contrast agent source (HTA) containing an MRI contrast gas such as CF4 or N2 are used.
PTA) can be selectively connected to connector (73) and supplied to balloon (60). However, the connector (73)
Connect the fluid source to the conventional one ()ITA) to the MR
When switching to PTA or vice versa, the pumping is stopped before switching, and the pumping is restarted after switching. When the pumping is instructed to stop, the fluid discharge control means (100 ), when the pumping means (AGA, ADU) is pressurized at least once, the first on-off valve (59) is kept closed and the second on-off valve (58) is opened, so that the fluid space (90) The balloon (60) and the working fluid of the pumping means (AGA) connected thereto are discharged through the second on-off valve (58). Therefore, when the connection of the fluid source to the connector (73) is subsequently switched and the pumping means (AGA, ADU) is restarted, the working fluid of the newly connected fluid source is supplied to the fluid space (90), so that the balloon The replacement of the working fluid in (60) is achieved quickly.

In order to improve the workability of switching the fluid source, the balloon pumping device according to the third aspect of the present invention includes a balloon (60):
Pumping means (AGA) has a closed space communicating with the balloon (60) and pressurizes/depressurizes the closed space.

ADO): First gas source (HTA) containing a gas with a small molecular weight (He); MRI contrast gas (CF4)
) containing a second gas source (PTA); a first gas source (PTA) in the fluid space (90) from the closed space to the balloon (60);
selective connection means (598, 59F) for selectively connecting one of the gas source (HTA) and the second gas source (PTA); fluid space (9) from the closed space to the balloon (60);
Exhaust valve (5g) inserted between 0) and the fluid discharge path (GEO); Switches the selection connection means (59H, 59F) in response to a gas switching instruction, and pumps before or after this switching. interposed between the fluid space (90) from said closed space to the balloon (60) and the gas source (HTA, PTA) during at least one pressurization of the means (AGA, ADU). The air supply valves (59H, 59F) are kept closed and the exhaust valve (58) is opened, and after this at least one pressurization and the switching, the fluid space from the closed space to the balloon (60) is closed. (90) Pumping means (AGA,
a switching control means (100) for opening and closing the air supply valve (the one selected for air supply out of 59H and 59F) so that the fluid pressure during the pressure reduction period of ADO becomes the set pressure (Pnt); Be prepared.

According to this, when the operator instructs to switch the gas,
In response to this, the switching control means (ioo) first switches the selection connection means (59H, 59F) and at least one pressurization of the pumping means (AGA, ADU) before or after this switching. , a balloon (60
) up to the fluid space (90) and the gas source (l(TA.).

The air supply valves (59H, 59F) inserted between the PTA) are kept closed and the exhaust valve (58) is opened, so the fluid space (
90) and pumping means (AGA) communicating therewith.
And the gas of the balloon (60) before switching is discharged from the exhaust valve (5).
8). and switching control means (100
) after at least one pressurization and switching, the air supply valve (59H and 59F (whichever is selected for air supply), the gas from the newly connected gas source will automatically flow into the fluid space (90) and the pumping means (AGA) and balloon communicating therewith. Enter (60).

In this way, the working gas of the balloon (60) is automatically switched in response to a gas switching instruction, so that the working fluid can be supplied to the balloon (60) from the commonly used one (He of ITA) for MRI imaging. The operator's effort when switching to the desired one (CF4 of PTA) and vice versa is greatly reduced.

Other objects and features of the present invention will become apparent from the following description of embodiments with reference to the drawings.

(Embodiment) FIG. 1 shows an embodiment of the present invention. A balloon 60 inserted into the aorta of a living body is connected to a pipe 90, and the pipe 90 is connected to the output pressure space 82 of the isolator AGA.
It is connected to the. The inner space of the isolator AGA is divided into an input pressure space 81 and an output pressure space 82 by a diaphragm 81.
The output pressure space 82 is separated from the accumulator 50.
It is connected to the output boat of an electromagnetic on-off valve 52 for positive pressure output and an electromagnetic on-off valve 55 for negative pressure output.

Input ports of the electromagnetic on-off valves 52 and 55 communicate with positive pressure spaces ACI and AC2, respectively.

An air compressor 173 supplies positive pressure (high pressure air) to the positive pressure space ACI through the electromagnetic on-off valve 51, and an air compressor 172 supplies negative pressure (air suction pressure) through the electromagnetic on-off valve 54 to the negative pressure space AC2. supply

Pressure sensors PS1 and PS2 are housed in the positive pressure space Act and the negative pressure space AC2, respectively, and these detect the pressures in the positive pressure space ACI and the negative pressure space AC2, respectively. The pressures detected by the pressure sensors PS1 and PS2 are read by a microcomputer (hereinafter referred to as CPU) 100 (Fig. 3), which will be described later. The on-off valve 51 is turned on (between the flow paths) and turned off (between the flow paths) when it is equal to or higher than the target value, thereby maintaining the pressure in the positive pressure space Act at a substantially constant value (positive pressure target value). When the absolute value of the negative pressure detected by the pressure sensor PS2 is less than the negative pressure target value (absolute value), the CPU 100 turns on the electromagnetic on-off valve 54 (between channels), and when it is equal to or higher than the target value, turns it off (between channels). As, negative pressure space A
The pressure of C2 is maintained at a substantially constant value (negative pressure target value). Through such pressure control, the pressure in the positive pressure space ACI is maintained at a constant positive pressure value, and the pressure in the negative pressure space AC2 is maintained at a constant negative pressure value.

As described later, the CPU 100 (Fig. 3)
The isolator Positive pressure and negative pressure are alternately applied to the input pressure chamber 82 of the AGA in synchronization with the heartbeat, and this positive pressure and negative pressure are applied to the output pressure chamber 8 of the isolator AGA via the diaphragm 81.
2, which is added to the inner space of the balloon 60 through the pipe 90. As a result, the balloon 60 contracts during systole and expands during diastole in synchronization with the beating of the heart.

An electromagnetic on-off valve 59 and a check valve 72 are serially connected between the pipe 90 and the connector 73.
A check valve 70 and an electromagnetic on/off valve 58 are serially connected between the exhaust gas passage GEO and the exhaust path GEO which is open to the atmosphere.

An MRI contrast gas cylinder PTA containing a light gas cylinder HTA or CF containing He is connected to the connector 73 manually by an operator.

FIG. 1 shows a state in which a light gas cylinder HTA is connected.

Pressure sensor PS3 detects pressure P2 in output pressure chamber 83 of isolator AGA. The CPU 100 (FIG. 3), which will be described later, reads the detected pressure P2 of the sensor PS3 and determines that the absolute value of the detected pressure P2 (negative pressure) is When the negative pressure reaches the set value Pnt (absolute value) or more, the electromagnetic on-off valve 59 is opened to replenish the pipe 90 with gas from the cylinder HTA to maintain the negative pressure applied to the balloon 60 at the set negative pressure Pnt (absolute value). During the diastolic phase of the heart (diastolic phase of the balloon 60: positive pressure period), the detected pressure P
2 becomes equal to or higher than the positive pressure set value ppt, the electromagnetic on-off valve 58 is opened to release the gas in the pipe 90 to the discharge path GEO, and the positive pressure applied to the balloon 60 is maintained at the positive pressure set value Ppt.

The structure of the balloon 60 is shown in FIG. A gas flow path is open in the center of the Y-shaped base 21 that is always outside the living body, and it branches into a Y shape, and one branch path 20 is connected to a pipe 90 via a tube 71. There is. Seeds 24 are airtightly and rotatably attached to the other branch. One end of a tube (catheter) 22 having a length scale on its outer surface is connected to the main body of the gas flow path.

One end of a balloon-shaped flexible thin film (balloon in a narrow sense) 25 is fixed to the other end of the tube 22 . The other end of the thin film 25 is fixed to a bullet 26. An elastic wire 23 passes through the thin film 25 and the tube 22,
One end thereof is fixed to the seed 24 and the other end to the bullet 26. Figure 2 is.

When a negative pressure is applied to the 0-branch passage 20, which indicates a state in which positive pressure is applied to the branch passage 20 and the thin film 25 is expanded, the gas inside the thin membrane 25 is sucked out, and the thin film 25 contracts toward the wire 23.

Before inserting the thin membrane 25 into the living body, the seeds 24 are attached to the wire 2 because the balloon 60 needs to have a thin outer shape to facilitate insertion of the balloon 60 into the aorta and delivery to a predetermined position.
3 in the forward direction, thereby rotating the wire 23 and the bullet 16, twisting the thin film 25, and twisting the wire 25.
In this state, as shown in FIGS. 8a and 8C, the balloon 60 is inserted into the living body and placed in a predetermined position, and then the seeds 24 are rotated in the opposite direction. The wire is returned and rotated to untwist the thin film 25 and restore the thin film 25 to its expandable state. When positive pressure is applied to the branch passage 20 in this restored state, the thin film 25 expands as shown in FIGS. 2 and 8b. Thereafter, by applying a negative pressure to the first branch 20, the thin film 25 contracts as shown in FIG. 8C, and by applying a positive pressure, it expands as shown in FIG. 8B.

FIG. 3 shows the configuration of the electrical equipment section connected to the mechanism shown in FIG. 1. The main body of the electrical equipment section is the CPU 100, and the CPU
tJloo, pressure sensor 105° detection electrode 110. Electrocardiograph 120. Signal processing circuit 150, A/D converter 1
60. Oscillator 170° buffer 180. driver 185
, 190°buzzer 195. Operation board 200. An operation board control unit 300 and a display control unit 400 are provided.

The electrocardiograph 120 outputs an electrocardiogram signal Vecg based on an electrical signal obtained from the detection electrode 110 attached to a predetermined position of the living body. This electrocardiogram signal is waveform-shaped by the signal processing circuit 130 and then sent to the A/D converter 160.
is converted into a digital signal and applied to the CPU 100. The CPU 100 detects R waves from the electrocardiogram signal.

Measure the repetition period Trr of the R wave.

Sphygmomanometer 140 generates a blood pressure signal based on the electrical signal obtained from pressure sensor 105. In this example, a pressure sensor 105 for detecting blood pressure is embedded in the tip of the bullet 26 (not shown), and by inserting the balloon 60 into the aorta of a living body, the pressure sensor 105 detects the blood pressure in the aorta. There is.

The electrical signal according to the blood pressure output by the pressure sensor 105 is
The bullet 26 is guided through a lead loosely wound around the wire 23 and a lead wire embedded within the peripheral wall of the tube 22 to a blood pressure monitor 140 located outside the living body. The blood pressure signal output by the blood pressure monitor 140 is applied to the A/D converter 160 via the signal processing circuit 150, converted into a digital signal, and provided to the CPU 100.

Although not shown, the operation board 200 is equipped with many key switches and many indicators. The key switch includes a start key for instructing to start driving the balloon pump and a stop key for instructing to stop driving. The electromagnetic on-off valves 51, 52, 54, 55 shown in FIG.
58 and 59 are connected to a driver 185, and the driver 185 is connected to an output port of the CPU 100.

The CPU 100 shown in FIG. 3 controls the opening and closing of the electromagnetic valve 51 according to the pressure detected by the pressure sensor PSl, and
Maintain the pressure (positive pressure) in c1 at the target value. Further, the solenoid valve 54 is controlled to open and close according to the pressure detected by the pressure sensor PS2, and the pressure (negative pressure) in the pressure accumulator Ac2 is maintained at the target value. Furthermore, the solenoid valves 58 and 59 are controlled to open and close according to the pressure P2 detected by the pressure sensor PS3, and the isolator A
The positive pressure and negative pressure of the output pressure chamber 83 of the GA are determined within a certain range.

Electromagnetic on-off valves 52 and 55 that switch between positive and negative pressure of the driving air pressure in order to switch between inflation and deflation of the balloon pump 60
Figure 5 shows the timing of opening and closing. In Figure 5,
p E P (pr6-EjectionPeriod
) represents the repetition frequency (R-R interval) of the R wave that appears on the electrocardiogram and the time from when the R wave appears on the electrocardiogram until the heart of the living body starts contracting, and P E P + E
T (ET: Ejection Time) is
The R-R interval represents the time from when an R wave appears on an electrocardiogram until the heart of a living body begins to expand. The ideal time to start inflating the balloon 60 is when left ventricular ejection is completed (D N :
This is immediately after the Dicrotic Notch), and the time period of PEP+ET has elapsed since the R wave appeared.

Further, the timing at which the balloon 60 starts deflating is the point at which left ventricular contraction starts after the appearance of the R wave, and the internal pressure increases to become equal to or higher than the aortic diastolic pressure, that is, the point at which left ventricular drive to the aorta starts (
ED: End-Diastole) is ideal.

When driving the pumping of the balloon 60, the CPU 100 detects the ED timing and the DN timing from the aortic pressure, as shown in FIG.

Between ED and DN, the electromagnetic opening/closing valve 52 is turned off and 55 is turned on to deflate the balloon 60, and between DN and ED, the electromagnetic opening valve 52 is turned on and 55 is turned off to inflate the balloon 60.

FIG. 4a and FIG. 4b show the "pumping control" subroutine PM of the electrical processing operations of C: PUloo.
Indicates C. Note that this "pumping control JPMC" has a relatively short cycle (several hundredths of Trr or several tenths of Trr).
This is a subroutine that is executed repeatedly.

(A) Settings when starting pumping "When proceeding to the pumping control JPMC, the CPU 100 checks whether balloon pumping is already in progress (ONF = 1) or not (ONF = 0) (Step 1:
(Hereinafter, the word "step" will be omitted in parentheses). If it has not entered yet, wait for the arrival of the start input (2). When the start input arrives, the electric motors of the decompressor 172 and compressor 173 are energized (driven) (3). )
, turn on the electromagnetic on-off valves 51 and 55 (between the flow paths) 4),
Write l to register ONF (5: Set information indicating that balloon pumping has started).

Furthermore, register SAF is set to indicate that it is in the start-up period.
Write 1 to (6) and register N for counting the number of pulsations.
Write the intestine in R (7).

(B Pumping excitation process (B-0) The CPU 100 next processes the pressure sensor Psi
When the detected pressure is higher than the set positive pressure, the electromagnetic on-off valve 51 is turned off (closed the flow path), and when it is less than the set pressure, it is turned on (between the flow paths), and the detected pressure of the pressure sensor PS2 is read. When the absolute value is equal to or greater than the absolute value of the set negative pressure, the electromagnetic on-off valve 54 is turned off, and when it is less than the set value, it is turned on (8
).

Next, the CPU 100 reads the pressure of the aorta (output of blood pressure=130) and determines whether it is the ED or DN timing (see FIG. 5) (9).

(B-1) If it is the ED timing, write 1 to the register EDF to indicate that it is the contraction period (11)
, writes the balloon negative pressure limit value Pnt to the balloon target pressure register TPR (12), turns off the electromagnetic on-off valve 52 and turns on 55 to apply negative pressure to the isolator AGA, and turns off the electromagnetic on-off valve 58. Do (13). In addition,
During the contraction period (ED-DN), the electromagnetic on-off valve 58 is continuously kept off (13).

During the deflation period, in order to prevent excessive negative pressure from being applied to the balloon 60, the detection pressure P2 of the pressure sensor PS3 is read and a check is made to see if its absolute value exceeds the absolute value of the negative pressure limit value Pnt of the register TRR. Please check 14.15), and if so, turn on the solenoid on-off valve 59 (between flow paths).
), the gas from the cylinder HTA is supplied to the pipe 90, and otherwise it is turned off (the flow path is closed) (17).

When the content of the register SAF is 1 (startup period), following the above, the CPU 100 updates the content of the register NR for counting the number of pulsations to a number smaller by 1.
19), it is checked whether the contents of the register NR have become 0 (20), and if it has not become 0 or less, the process returns to the main routine. When it becomes 0, the register SAF is cleared (21): O is written indicating that the startup period has elapsed), the pumping lamp of the operation board 200 is turned on (22), and the process returns to the main routine. Returning to the main routine, the "pumping control" subroutine PM is executed again at a predetermined timing.
Proceed to step C (step 1).

(B-2) If it is DN timing, write 0 to register EDF to indicate that it is an expansion period (26);
Write the balloon positive pressure limit value Ppt in the balloon target pressure register TPH (27), turn on the electromagnetic on-off valve 52,
55 is turned off to apply positive pressure to the isolator AGA, and at the same time, the electromagnetic on-off valve 59 is turned off (28). Note that during the expansion period (DN-ED), the electromagnetic on-off valve 59 is continuously kept off (28).

During the expansion period of the startup period, the electromagnetic on-off valve 58 is turned on in order to discharge the gas in the pipe 90 to the exhaust path GEO through the electromagnetic on-off valve 58 (30, 35). Then, it returns to the main routine, and when it returns to the main routine, the "pumping control" subroutine PMC (
Proceed to step 1).

The above-described control operation of the CPU 100 at startup causes m cycles of contraction/
During the expansion, during the expansion (positive pressure) period, the gas in the pipe 90 is exhausted through the exhaust passage GEO, and during the contraction (negative pressure) period, the absolute value of the negative pressure (P2) in the pipe 90 is less than the absolute value of TRR = Pnt. The electromagnetic on-off valve 59 is opened so that the gas in the cylinder HTA is supplied to the pipe 90. That is,
The gas previously remaining in the pipe 90 is discharged, and the gas from the cylinder HTA is newly injected into the pipe 90.

This gas exchange operation continues for m deflation/inflation cycles after the start of pumping of the balloon 60.

(C-0) Clear register SAF in (B-1) above (
After setting the content to 0: Startup completed), CPLI 100 is
In the "pumping control" subroutine PMC, the steps proceed from step 1 to 23-24-8, and in subroutine 8,
The accumulator 50 described at the beginning of section (B-0) above
Pressure control is executed, and in subroutine 9 ED, DN
Make a timing judgment.

(C-1) If it is the ED timing, write 1 to the register EDF to indicate that it is the contraction period (11);
Write the balloon negative pressure limit value Pnt in the balloon target pressure register TPR (12), turn off the electromagnetic on-off valve 52,
55 is turned on to apply negative pressure to the isolator AGA, and the electromagnetic on-off valve 58 is turned off (13). Note that during the contraction period (ED-DN), the electromagnetic on-off valve 58 is continuously kept off (13).

During the contraction period (ED - ON), in order to prevent excessive negative pressure from being applied to the balloon 6o, the detected pressure P2 of the pressure sensor PS3 is read and its absolute value is greater than or equal to the absolute value of the negative pressure limit value Pnt of the register TRR. Please check if it is 1
4.15), if so, turn on the electromagnetic on-off valve 59 (between flow paths) and supply gas from the cylinder HTA to the pipe 90 with 16), otherwise turn it off (close flow path) (17) )
. Then, return to the main routine. (C-2) If it is the DN timing, O is written in the register EDF to indicate that it is the inflation period (26), and the balloon positive pressure limit value Ppt is written in the balloon target pressure register TPR. Write (2
7) Turn on the electromagnetic on-off valve 52 and turn off the electromagnetic on-off valve 55 to apply positive pressure to the isolator AGA, and turn on the electromagnetic on-off valve 59.
Turn off (28). In addition, the expansion period (DN-ED
), the electromagnetic on-off valve 59 is continuously kept off (28
).

During the inflation period (DN-ED), in order to prevent excessive positive pressure from being applied to the balloon 60, the pressure P2 detected by the pressure sensor PS3 is read and checked to see if it exceeds the positive pressure limit value Ppt of the register TRR. If so, turn on the electromagnetic on-off valve 58 (between channels).
), the gas in the pipe 90 is exhausted to the exhaust path GEO, and otherwise it is turned off (between the flow paths) (34).

Then return to the main routine.

This operation is steady and stable, and in synchronization with the heartbeat, a negative pressure of Pnt is applied to the balloon 60 during the systole, and a positive pressure of Ppt is applied during the diastole, so that the balloon 60 moves in synchronization with the heartbeat. Beating in sync.

The expansion of the balloon 60 as shown in FIG. 8b pushes blood from the aorta to the heart and assists the heart in sucking blood, and the contraction of the balloon 60 as shown in FIG. assists in blood transfusion.

(D Pumping When there is a stop input at 7 o'clock, the CPU 100 stops energizing the electric motors of the decompressor 172 and compressor 17336), turns off the electromagnetic on-off valves 51 and 55 (between the flow paths)37), and ends. Write 1 to the register SOF to indicate that it is in the period (38), write n to the register NR for counting the number of pulsations (39), and operate the operation board 20.
0 pumping lamp is turned off (40).

(D Processing at the end of pumping (D-0) Next, the CPU 100 reads the aortic pressure (blood pressure: output of 130) and determines whether it is the ED or DN timing (see Figure 5) (9 ).

(D-1) If it is HD timing, write 1 to register EDF to indicate that it is the contraction period (11);
Write the balloon negative pressure limit value Pnt in the balloon target pressure register TPR (12), turn off the electromagnetic on-off valve 52,
55 is turned on to apply negative pressure to the isolator AGA, and the electromagnetic on-off valve 58 is turned off (13). Note that during the contraction period (HD-ON), the electromagnetic on-off valve 58 is continuously kept off (13).

In the deflation period (HD-DN) at the end of pumping, the electromagnetic on-off valve 59 is turned off (14-17) in order to stop refilling the balloon 60 with gas.
Since the content of OF is 1 (end period), the CPU 100
updates the contents of the register NR for counting the number of pulsations to a smaller number (41.42), and the contents of the register NR becomes 0.
It is checked whether the value has become 0 or less (43), and if it is not less than 0, the process returns to the main routine. When it becomes 0, clear the register SOF (44: write O indicating the elapse of the end period), turn off the electromagnetic on-off valve 58.59, and turn off the solenoid valve 52.5.
5 is also turned off to stop pumping and clear the register ONF (45: writes O indicating that it is stopped). Then return to the main routine.

(D-2) If it is DN timing, write 0 to register EDF to indicate that it is an expansion period (26)
, writes the balloon positive pressure limit value Ppt to the balloon target pressure register TPR (27), turns on the electromagnetic on-off valve 52 and turns off 55 to apply positive pressure to the isolator AGA, and turns off the electromagnetic on-off valve 59. (28). Note that during the expansion period (DN-ED), the electromagnetic on-off valve 59 is continuously kept off (28).

In the expansion period (DN-ED) of the end period, the electromagnetic on-off valve 58 is turned on in order to discharge the gas in the pipe 90 to the exhaust path GEO through the electromagnetic on-off valve 58 (32, 35). And then we go back to the main routine, and when we go back to the main routine,
Further, at a predetermined timing, the process proceeds to the "pumping control" subroutine PMC.

Through the process at the end of pumping explained above, during the n cycles of contraction/expansion after the stop input, the gas in the pipe 90 is exhausted through the exhaust path GEO during the expansion (positive pressure) period, and the gas is contracted (negative pressure). During this period, the electromagnetic on-off valve 59 is continuously kept off.

That is, since the gas in the balloon 60 is exhausted and no gas is supplied during the expansion (negative pressure) period, the balloon 60 becomes a negative pressure and the pumping stops in a deflated state. This gas removal operation starts from the balloon 6 after the stop input is received.
Continues for 0 n deflation/inflation cycles. n is 1 or more.

Since the pumping is stopped at the end of the contraction of the balloon 60, when the pumping is stopped, the balloon 60
is under negative pressure and is contracting. This is advantageous when the parapet 24 is rotated in the normal direction to make the balloon 60 string-like and have a small diameter when the balloon 60 is removed from the aorta.

By the way, the working gas of the balloon 60 is
When switching from e to CF4 of cylinder FTA, or vice versa, the operator first presses the stop key on the operation board 200. In response to this, CP
U100 executes the above-mentioned process (D) at the end of pumping, and pumping of balloon 60 is stopped. Then, the operator connects the cylinder HTA (PTA) from connector 73.
and connect another cylinder PTA (HT
A) and press the start key on the operation board 200. In response to this, the CPU 100 first executes the above-mentioned (A) setting at the time of pumping startup, then executes the process at the time of pumping startup (B), and then executes the post-startup process (C). .

Therefore, when exchanging the working gas of the balloon 60 (replacing the cylinder), gas He (CF4) is first removed from the balloon 60 in the process at the end of pumping in (D) above, and then at the time of starting pumping in (B) above. During the process, the gas from the balloon 60 was further removed and the newly connected cylinder PTA
(HTA) gas CF4 (He) is supplied to the balloon 60.
be provided.

Note that when exchanging gas, it is sufficient to remove the gas from the balloon 60 using only one of the above (D) and (B).

At the first start when the balloon 60 is inserted into a living body and connected to the pipe 90, it is necessary to replace the air in the pipe 90 and the balloon 60 with the working gas He (CFi). Gas exchange is required during start-up processing. Furthermore, when stopping the pumping and removing the balloon 60 from the living body, the balloon 60 can be removed from the pipe 90.
becomes atmospheric pressure, but it is preferable to actively remove the gas from the balloon 60 to deflate it. In this case, the above (D)
Since the gas discharge process at the end of pumping is effective, the operator should wait until pumping has stopped before starting work on the parapet 2.
4 in the normal direction, the balloon 60 is pulled out into a thin string shape and removed from the living body, and the balloon 60 is removed from the pipe 90.

Next, one procedure for monitoring the position and operating shape of the balloon 60 using MRI while operating the balloon 60 inserted into the living body with He supplied from the cylinder HTA as shown in FIG. Explain.

(1) While the balloon 60 remains driven, the patient and the driving device are moved to the MRI examination room.

(2) Press the stop key on the operation board 200 to stop pumping the balloon 60, remove the cylinder HTA from the connector 73, and connect the cylinder PTA to the connector 73. At this time, the length of the gas drive line 71 between the living body and the drive device is extended as necessary.

(3) As shown in Figure 6, transfer the living body to the MRI machine,
Move the balloon drive devices GDU and ADU to a location where they will not be affected by the MRI device, and press the start key on the operation board 200.

(4) Prepare the MRI device for imaging.

(5) Synchronize the imaging timing of the MHI device with the electrocardiogram.

(6) Balloon 60 is normally approximately 300 m5 after the R wave occurs.
Assuming that there is an expansion operation from ec (P E P + ET) to the next R wave, imaging is performed by triggering a certain period of time (300 msec later) after detecting the R wave of the electrocardiogram. Note that imaging is performed as many times as necessary for contrast imaging with the MRI apparatus.

(7) The insertion position and shape of the balloon 60 within the blood vessel are read from the cross-sectional image obtained by the MRI device.

(8) If it is necessary to correct the insertion position of the balloon 60,
Do this, and then repeat steps (5) to (7).

(9) When the MRI examination is completed, the living body is returned to the portable bed equipped with a balloon pumping device, and the operation board 200
Press the stop key to stop pumping, remove cylinder FTA from connector 73, and connect cylinder H to connector 73.
Connect the TA and press the start key on the operation board 200.

In addition, FIG. 4 shows the balloon pump 60 using an MRI device.
This figure schematically shows how the measurement is performed when detecting the insertion position of B.

With the above procedure, the fluid that drives the balloon 6o is heated to H.
By replacing e with CF4 and imaging with an MRI device, the position and shape of the balloon 6o in the living body can be visualized,
Since the suitability of these conditions can be determined visually, the balloon 60 can be positioned at an optimal position and the correctness or failure of the operation of the balloon 60 can be inspected.

Next, another embodiment of the present invention, a second embodiment, will be described. In the second embodiment, fluid exchange can be performed automatically. That is, as shown in FIG. 7a, the light gas supply connector 73 is connected to a cylinder HTA containing He.
is always connected, and another cylinder PT containing CF4 is connected to the connector 76 for supplying MRI contrast gas.
A is always connected. The connector 73 connects to the pipe 90 via a light gas electromagnetic on-off valve 59H and a check valve 72H.
The connector 76 is connected to a pipe 90 via an MRI contrast gas electromagnetic on-off valve 59F and a check valve 72F. With this configuration, when the light gas electromagnetic on-off valve 59H is turned on, He is supplied to the pipe 90, and when the MRI contrast gas electromagnetic on-off valve 59F is turned on, CF4 is supplied to the pipe 90. The mechanism section of the second embodiment is similar to the detailed implementation described above in that one of the gases is automatically supplied to the pipe 90 by selectively turning on the electromagnetic on-off valves 59H and 59F. Unlike the first embodiment, the other mechanisms are the same as those of the first embodiment.

Although the configuration of the electrical equipment section of the second embodiment is the same as that of the first embodiment shown in FIG. 3, there are slight changes in the control operation of the CPU 100 in the second embodiment. Flowcharts of the modification section are shown in FIGS. 7b, 7c, and 7d.

As shown in FIG. 7b, the CPU 1OO of the second embodiment is
Between step 2, which detects the start input, and step 3, which sets the startup when there is a start input, the process "Gas supply setting J G5Cl" is executed, and as shown in Figure 7C, the pumping is started. After that, before the stop input arrives, the process of "Gas switching setting" G5C2 is
It is executed between step 24 and subroutines 8 and 9 in the embodiment, and further, as shown in FIG. The process of subroutine 45 "Gas switching" is executed. Other processing is similar to that of the first embodiment.

First, referring to FIG. 7b, in the second embodiment, when there is a (E) start input, the CPU 100 controls the operation board 200.
If the gas specification is M, refer to the gas specification information entered in
If it is RI contrast gas (cylinder PTA), the electromagnetic on-off valve 59
50), set the gas supply solenoid valve (assigned to 59 in the first embodiment) to 59F (51), and enter information PTA indicating the MRI gas (gas supply cylinder PTA) in the register GAR. Write (52). When the gas specification is light gas (cylinder HTA) or when gas specification information has not yet been input on the operation board 200,
In order to
(48), and writes information HTA indicating light gas (gas cylinder HTA) to register GAR (48).
9).

Reference is now made to Figure 7c. The outline of the subsequent startup processing and the steady operation processing after the startup processing is the same as in the first embodiment, but in the second embodiment, (F) during these control operations,
Refers to the gas specification information and checks whether the gas specification information has changed from the previous specification (53). When the gas specification changes, the newly specified gas specification information is updated and written to the register GAR. (54), writes information “1” indicating gas change to register GEF (55), register SOF
Pumping stop information "1" is written in the register NR, and n is written in the number register NR (56).

Write 1 to register GEF like this and register SOF
When l is written to CPU1. of the second embodiment. OO is (F
) When the termination process (41-42-43) is executed and the termination process is terminated (NR≦0 and 44 is executed), the seventh
Set the supply of the newly specified gas with "Gas switching J (45)" in Figure d (59-63), write information "1" indicating pumping start to register SAH, and write m to number register NR. Enter (44).

Then, the CPU 100 of the second embodiment executes (G) startup processing (18 to 22) as in the first embodiment.

When it is finished (H) steady operation processing (8-17 & 8-10-25-35
).

(I) When there is a stop input, the termination process (23-36 to 40-9 to 18-41 to 44-5
8-65).

Note that in (F), the decompressor 172 and the compressor 173 do not stop, and the solenoid valves 52 and 55 continue to be turned on alternately in synchronization with the heartbeat. The operator uses the operation board 200 to select a gas (CF4 in the cylinder FTA) that is different from the working gas being pumped (for example, He in the cylinder HTA).
When inputting the information specifying the
), except that:
When the content of the number of times register NR becomes 0, the electromagnetic on-off valves 58 and 59 are not closed simultaneously, and then the supply gas is switched and the above-mentioned process (B) at the time of pumping startup is executed, Next, the above-described post-startup process (C) is executed.

Therefore, in the second embodiment, the operator
When exchanging gas during the pumping operation of 0, it is only necessary to input information specifying the gas to be newly supplied to the balloon 60 into the operation board 200. In this case, the working gas in the balloon 60 is automatically exchanged without substantially interrupting the pumping of the balloon 60.

In this second embodiment as well, as in the first embodiment, when the operator presses the stop key, the end process is executed and pumping is stopped. Therefore, for example, during an MRI contrast examination, the relay tube 71 can be replaced with a longer one. When necessary, the operator first presses the stop key to stop pumping, then replaces the relay tube 71 with a longer one, then inputs information specifying the required gas on the operation board 200, and then presses the start key. Bayoshi).

In this second embodiment, the operator can use the pumping device in the same manner as in the first embodiment, and also can operate the operation board 200 without changing the connection of the cylinder.
The gas in the balloon 60 can be exchanged only by key-in operation.

〔Effect of the invention〕

As described above, according to the present invention, the supply means (75, 73°5
9), MR is added to the fluid space (90) from the pumping means (AGA, ADO) to the balloon (60).
The MRI contrast agent (CF4) can be supplied by a contrast agent source (PTA). When the MRI contrast agent (CFa) is supplied to the fluid space (90), the pumping means (AGA,
MRI contrast agent (CFa) by pumping ADO)
enters the balloon (60), and the position and shape of the balloon (60) can be visually confirmed by MRI imaging of the living body using an MRI apparatus.

[Brief explanation of drawings]

FIG. 1 is a block diagram showing the mechanism of a first embodiment of the present invention. FIG. 2 is an enlarged longitudinal sectional view of the balloon 60 shown in FIG. 1. FIG. 3 is a block diagram showing the configuration of the electrical equipment section of the first embodiment of the present invention. 4a and 4b are flowcharts showing the control operation of the microcomputer 100 shown in FIG. 3. FIG. FIG. 5 shows the electrocardiogram and aortic pressure of a living body equipped with the balloon 60 shown in FIG. 1, and the electromagnetic on-off valve 52 shown in FIG.
55 is a time chart showing the opening/closing relationship of 55. FIG. 6 is an overview diagram showing an MRI examination of a living body equipped with the balloon 60 shown in FIG. 1. FIG. 7a is a block diagram showing a mechanical part of a second embodiment of the present invention that is different from that of the first embodiment. FIGS. 7b, 7c, and 7d are flowcharts showing control operation portions of the microcomputer 100 according to the second embodiment of the present invention, which are different from those in the first embodiment. FIG. 8a is a plan view showing the balloon position in the living body when the balloon 60 shown in FIG. 1 is inserted into the living body. FIG. 8b is an enlarged plan view showing the appearance of the balloon 60 inserted into the living body as shown in FIG. 8a during the inflation period. FIG. 8c is an enlarged plan view showing the appearance of the balloon 60 inserted into the living body as shown in FIG. 8a during systole. 20: Branch path 21: Substrate 22: Tube 23: Wire 24: Seed
25: Thin film 26: Bullet
50: Accumulator 51.52, 54, 5
5,58,59.59) 1.59F: Solenoid on-off valve 60
: Balloon (Balloon) 70, 72, 72H
, 72F: Check valve 71: Tube
73, 74, 75, 76: Connector AGA near isolator (75, 73, 59: Supply means)
81: Diaphragm 82: Input pressure space 8
3: Output pressure space 90: Pipe (fluid space) 172: Compressor 173: Compressor HTA: Helium gas cylinder GEO: Exhaust path FTA: Freon gas cylinder (MHI contrast agent source) P
si~PS3: Pressure sensor ACI: Positive pressure space AC2: Negative pressure space ADU: Air pressure control mechanism (AG
A, ADD: Pumping means) Voice 4b figure East figure 78 figure J7b figure

Claims (4)

[Claims] (1) Balloon; having a closed space communicating with the balloon; pumping means for pressurizing/depressurizing the closed space; an MRI contrast agent source; and a fluid space from the closed space to the balloon;
A balloon pumping device comprising: supply means for supplying an MRI contrast agent of the MRI contrast agent source. (2) Balloon; Pumping means that has a closed space communicating with the balloon and pressurizes/depressurizes the closed space; A connector for connecting a fluid space from the closed space to the balloon to a fluid source; a first on-off valve inserted between a fluid space from the closed space to the balloon and the connector; a first on-off valve inserted between the fluid space from the closed space to the balloon and a fluid discharge path; second on-off valve; after at least one pressurization of the pumping means, the second on-off valve is maintained open and the first on-off valve is closed after activating the pumping means in response to a start instruction; the first so that the fluid pressure during the decompression period of the pumping means in the fluid space from the closed space to the balloon becomes a set pressure;
A balloon pumping device comprising: a fluid supply control means for opening/closing an on-off valve; and an MRI contrast agent source connected to the connector. (3) Balloon; Pumping means that has a closed space communicating with the balloon and pressurizes/depressurizes the closed space; A connector for connecting a fluid space from the closed space to the balloon to a fluid source; a first on-off valve inserted between a fluid space from the closed space to the balloon and the connector; a first on-off valve inserted between the fluid space from the closed space to the balloon and a fluid discharge path; Second on-off valve: In response to a stop instruction, the first on-off valve is kept closed and the second on-off valve is opened, after at least one pressurization of the pumping means, from the start of depressurization to the initial stage of pressurization. a fluid discharge control means for stopping the pumping means and keeping the second on-off valve closed during the period of time; and an MRI contrast agent source connected to the connector. (4) Balloon; Pumping means that has a closed space that communicates with the balloon and pressurizes/depressurizes the closed space; A first gas source that contains a gas with a small molecular weight; A second gas source that contains an MRI contrast gas; selective connection means for selectively connecting one of a first gas source and a second gas source to a fluid space from the closed space to the balloon; a fluid space and a fluid discharge path from the closed space to the balloon; an exhaust valve interposed between the switching means for switching said selective connection means in response to a gas switching instruction; and for at least one pressurization of said pumping means before or after said switching; An air supply valve interposed between a fluid space and a gas source from the space to the balloon is maintained closed and an exhaust valve is opened, and after this at least one pressurization and the switching, the air supply valve is maintained closed and the exhaust valve is opened. A balloon pumping device comprising: switching control means for opening/closing the air supply valve so that the fluid pressure during the pressure reduction period of the pumping means in the fluid space from the space to the balloon becomes a set pressure;