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三单元 An artificial heart containing miniaturized space technology will soon beat inside a person, having now been approved for human trials in France. With heart disease killing over 100 million people in developed countries alone and the demand for transplants far exceeding donations, creating a totally artificial heart has been the holy grail of cardiovascular medicine for half a century.一种包含微型空间技术的人造心脏将很快在人体内跳动,目前已获准在法国进行人体试验。仅在发达国家,心脏病就夺去了1亿人的生命,人们对移植的需求远远超过了捐赠,因此,半个世纪以来,建立一个完全人造的心脏一直是心血管医学的圣杯。 Brainchild of the visionary cardiac surgeon, Professor Alain Carpentier, the prosthetic is the result of 15 years of collaboration with aerospace giant Astrium, the space subsidiary of EADS. In 2008, with support from the French Government and investors, Prof. Carpentier founded the EADS spin-off company, Carmat, to complete the work. Combining the unique expertise of Prof. Carpentier, known worldwide for inventing todays most used heart valves, with Astriums experience in building satellites, Carmat produced their first completely artificial heart earlier this year. It turned out that space had the ingredients that Carmat needed. Working closely with satellite engineers, the company applied Astriums expertise in building spacecraft to guarantee the necessary precision and durability for an artificial human organ like a heart.这具远见卓识的心脏外科医生阿兰卡彭迪尔教授的构想,是该公司与航空业巨头阿斯特瑞姆公司合作15年的成果,阿斯特瑞姆公司是EADS的空间子公司。2008年,在法国政府和投资者的支持下,卡彭提尔教授创立了欧洲航空防务和航天公司(EADS)分拆公司Carmat,以完成这项工作。卡玛提尔教授以发明当今最常用的心脏瓣膜而闻名于世,加上阿斯特里姆在制造卫星方面的经验,卡玛特在今年早些时候生产出了他们的第一个完全人造心脏。结果证明,太空中含有卡玛特所需要的成分。该公司与卫星工程师密切合作,利用阿斯特瑞姆公司在制造航天器方面的专长,以保证人造人体器官如心脏所需的精度和耐久性。 Fashioned in part from biology tissue and in part from miniature satellite equipment, the device combines the latest advances in medicine, biology, electronics and materials science to imitate a real heart. The team had to build a device that could withstand the tough conditions of the bodys circulatory system and pump 35 million times per year for at least five years without fail. They needed the ultimate in reliability, and the answer came from design methodologies, testing strategies and know-how for the electronics on satellites. “Space and the inside of your body have a lot in common,” says Matthieu Dollon, Head of Business Development in Astriums French Elancourt Equipment team, who are working closely with Carmat on the heart. “They both present harsh and inaccessible environments .” Telecom satellites are built to last 15 years on their own in space, 36,000 km above Earth. The heart might be closer than a satellite but it is just as inaccessible. “Failure in space is not an option. Nor is onsite maintenance. If a part breaks down, we cannot simply go and fix it. Its the same inside the body.”该装置部分由生物组织制成,部分由微型卫星设备制成,结合了医学、生物学、电子学和材料科学方面的最新进展,模拟出一颗真正的心脏。该团队必须制造一种设备,能够承受身体循环系统的恶劣环境,并且至少五年内每年要泵3500万次而不发生故障。他们需要最终的可靠性,答案来自于卫星电子设备的设计方法、测试策略和诀窍。“空间和你的身体内部有许多共同之处,”马蒂厄多伦说,他是阿斯特瑞姆法国艾兰考特设备团队的业务发展主管,他在心脏方面与卡玛特进行了密切合作。“他们都面临着恶劣和难以接近的环境。”电信卫星是在距离地球36000公里的太空中自建15年的。心脏可能比卫星近,但也同样难以接近。“太空中的失败不是一个选择。现场维护也是如此。如果一个零件坏了,我们就不能简单地去修理它。体内也是一样的。” Equally, space engineers tolerate no interruptions or bugs in their electronics. Team member Dung Vo-Quoc, who designed some of the vital electronics for the heart, points out: “If your satellite stops working during the final penalty of the football world cup, its disappointing. But if a heart stops beating for five seconds, its fatal. We try hard to make sure that every single part will function as planned for the duration of the device.”Its this need for long-term dependability that makes the quality threshold for space electronics higher than any other field. Every component has to be tested meticulously to make sure it will stand the test of time, even in the harshest conditions. Nothing is left to chance. Every one of the 900 tiny components in the Carmat heart must function perfectly. Just as they would for satellites, the team used advanced modeling and digital simulation technologies and developed latest-generation test benches to perform thorough analysis. For Carmats Technical Director, Marc Grimme, it was a revelation, “I hadnt realized quite how demanding the testing is for spacecraft. I knew the military had high standards, but in space the bar is even higher.”同样,太空工程师不容许他们的电子设备出现中断或故障。团队成员董沃国(Dung Vo-Quoc)为心脏设计了一些重要的电子产品,他指出:“如果你的卫星在世界杯的点球大战中停止工作,那就太令人失望了。但是如果心脏停止跳动5秒钟,那就是致命的。我们努力确保每一个零件在设备运行期间都能按计划运行。” 正是这种对长期可靠性的需求,使得空间电子的质量门槛高于任何其他领域。每个组件都必须经过仔细测试,以确保即使在最艰苦的条件下也能经受住时间的考验。没有什么是靠运气的。卡玛特心脏里900个微小部件中的每一个都必须完美地工作。正如他们对卫星一样,该团队使用先进的建模和数字仿真技术,开发了最新一代的测试台来进行彻底的分析。对卡玛特的技术总监马克格林来说,这是一个启示。“我还没有意识到太空船的测试是多么的苛刻。我知道军方有很高的标准,但在太空中酒吧甚至更高。” That rigor has paid off. The French Health Authority has deemed the prosthetic reliable enough to authorize the first human implants in three approved hospitals in Paris. Doctors can now start selecting the first four patients to trial it inside their bodies. “The countdown has started to the next phase,” says Marc Grimme. “Its a bit like arriving at base camp on Mount Everest and getting the authorization to head out to the next level. Its very exciting and very emotional.”这种严谨得到了回报。法国卫生署认为这种义肢足够可靠,可以授权在巴黎的三所经批准的医院进行首例人体移植手术。医生现在可以开始选择前四名患者在他们的体内进行试验。“倒计时已经开始进入下一个阶段,”马克格林说。“这有点像到达珠穆朗玛峰上的大本营,并获得前往下一级别的授权。这很令人兴奋,也很感性。” One of the challenges was to create a heart that would beat like the real thing and speed up or slow down depending on its owners exertion levels. Space had the answer here, too. Based on technologies developed for European space projects, the tiny electronics in the prosthetic heart are the equivalent of those on the bus of a telecommunications satellite.“Like the heart, a satellite needs to respond on its own to whats happening around it,” explains Matthieu Dollon. “It has a brain, the onboard computer, which gleans information from sensors about where it is in space and its environment, such as its position or temperature. It then commands the satellite to perform functions like pointing an antenna to Earth or rotating its solar wings towards the Sun.”其中的一个挑战是创造一颗像真的心脏一样跳动,并根据主人的努力程度来加快或放慢心跳速度。空间也给出了答案。根据为欧洲空间项目开发的技术,假心脏中的微型电子装置相当于电信卫星上的电子装置。马蒂厄道伦解释说:“就像心脏一样,卫星需要对周围发生的事情做出自己的反应。”“它有大脑,板载计算机,它从传感器上收集关于它在太空中的位置和环境的信息,例如位置或温度。然后,它命令卫星执行诸如指向地球的天线或将其太阳翼旋转向太阳等功能。” The heart contains the same technology, only 100 times smaller. High-tech sensors detect a patients exertion levels and transmit the information to a miniature computer. This commands the brushless motors to pump the heart faster or slower, allowing it to feed more or less oxygen to the body and control blood pressure depending on the persons level of activity.心脏包含着同样的技术,只是小了100倍。高科技传感器检测患者的运动水平,并将信息传送到微型计算机上。这指令无刷电机泵送心脏快或慢,让它提供或多或少的氧气给身体,并根据人的活动水平控制血压。 Another hurdle was to build a heart that the body might better accept. Previous artificial hearts have presented complications, with synthetic materials triggering blood clots that can travel to the brain and cause strokes. The Carmat prosthetic overcomes this by using animal pericardium, the membrane surrounding the heart, which has been chemically treated to reduce the hosts immune response. The device has two chambers separated by a membrane with the biological tissue on the side in contact with the patients blood and polyurethane on the other. The miniaturized pumping system of motors and hydraulic fluids changes the membranes shape. It also uses biological material for the artificial valves created by Prof. Carpentier.另一个障碍是建立一个心脏,身体最好接受。以前的人工心脏出现了并发症,合成材料触发的血凝块可以传播到大脑并引起中风。通过使用动物的心包膜,心脏周围的膜,经过化学处理以减少宿主的免疫反应,卡马假体克服了这一点。该装置有两个腔室,其中一个与患者血液接触的生物组织和另一个与聚氨酯接触的生物组织相隔离。电动机和液压油的小型泵系统改变了膜的形状。它还使用生物材料为卡彭提尔教授创建的人工瓣膜。 “The fusion of space technology with medical and biological sciences to create a potentially lifesaving organ is not only a feat of human engineering,” says Tech2Markets Claude-Emmanuel Serre. “Its also a great example of how advanced space technology and expertise can benefit our lives here on Earth in a concrete way.”Tech2Market is the French partner in ESAs Technology Transfer Network set up by the Agencys Technology Transfer Program

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