turning now to the drawings , there is shown in fig1 a body implantable centrifugal pump 16 including a housing formed by joinder of an impeller casing 18 and a rotor casing 20 , both casings being annular and constructed of a non - electrically conductive , biocompatible material such as polycarbonate or polysulfone . a titanium stator casing 22 surrounds the bottom portion of rotor casing 20 , for securing an annular stator to the outside of the rotor casing . alternatively , the stator and rotor casing bottom can be encapsulated in a plastic , e . g . a biocompatible epoxy . an inlet catheter or tube 24 having a plurality of inlet openings 26 receives blood or other bodily fluids into an impeller chamber defined by impeller casing 18 . bodily fluid is expelled from the chamber through an outlet tube 28 and a catheter or tube 30 connected to the outlet tube . catheter 24 extends from the pump to the heart where the inlet with openings 26 extends into the left ventrical of the heart . catheter 30 extends from the pump to the aorta at which point the blood returns to circulation . catheters 24 and 30 are secured by dacron grafts , cuffs or other appropriate means . a body implantable infusion pump 32 supplies a saline solution through a length of flexible tubing 34 to a rotor chamber formed in rotor casing 20 . infusion pump 32 preferably is a roller pump or a syringe pump powered by an internal battery to discharge saline at a predetermined , constant rate , for example by a continuous or stepped advance of a plunger in a manner well known and thus not further described herein . implanted infusion pumps of either the constant flow type available from infusaid or the electronic variable flow type available from medtronic or minimed , can be used . as seen in fig2 the saline solution is provided through a passageway 36 to a rotor chamber 38 formed by rotor casing 20 . a stainless steel rotor 40 is contained to rotate within the pump housing about a vertical axis , and is generally cylindrical having an inverted t - shaped profile . rotor 40 includes a cylindrical shank 42 and a shell 44 below the shank and somewhat larger in diameter . a disc - shaped cover 46 is secured to the shell for retaining an annular , four - pole neodymium iron ( ndfe ) permanent magnet 48 . the magnet is sealed within the enclosure by welding cover 46 , to separate the chemically reactive ndfe magnet from the saline solution , preventing corrosion of the magnet and contamination of the saline solution . magnet 48 also is cemented in place within the shell prior to welding of the end cap to prevent free rotation of the magnet within the shell . impeller casing 18 includes an inlet throat 50 received into tube 24 , and forms an impeller chamber 52 in which an impeller 54 is rotatably mounted . more particularly , the impeller includes a plurality of impeller blades fixed to a vertical cylindrical impeller shaft 56 , which in turn is fixed to shank 42 either by a threaded connection or an adhesive , whereby shaft 56 and impeller 54 are integral with rotor 40 . the impeller , shaft and rotor further are concentric on a common axis of rotation which in fig2 is vertical . shaft 56 preferably is constructed of a low temperature isotropic graphite , or alternatively polished , stainless steel . impeller 54 is constructed of polycarbonate or polysulfone . the radial position of the rotor shaft impeller assembly in the pump housing is determined by an annular rotor guide 58 surrounding shank 42 . rotor guide 58 is fixed relative to rotor casing 20 , and preferably is constructed of polycarbonate or polysulfone , with an interior diameter slightly larger than the shank diameter . the axial position of the rotor is limited by a thrust bearing 60 molded into rotor casing 20 . impeller chamber 52 and rotor chamber 38 are separated from one another by a flexible annular seal member 62 , preferably constructed of a graphite filled elastomer , e . g . neoprene rubber , with an embedded metal annular plate 63 for increased strength and stability . the upper surface of the seal facing the impeller chamber is provided with a non - thrombogenic polyurethane layer 64 to prevent formation of blood clots along the surface during operation of the pump . seal member 62 includes a ring seal 55 and an annular lip seal 66 immediately surrounding shaft 56 . for maximum seal effectiveness at the lip seal and shaft interface , lip seal 66 and shaft 56 must be concentric . accordingly , to facilitate a concentric positioning of the lip seal about the shaft , seal 66 and rotor guide 58 are concentrically aligned on a fixture ( not shown ) and fixed to one another with an adhesive . then , impeller shaft 56 is directed through lip seal 66 and mounted in shank 42 , with the shank surrounded by rotor guide 58 , all prior to assembly of these members into the impeller and rotor casings . consequently , as the rotor guide controls the radial location of shank 56 , the guide likewise controls shaft 56 and maintains the shaft concentric within the lip seal . rotor guide 58 and seal member 62 are fixed within the pump housing by virtue of a threaded engagement of the rotor casing and impeller casing as indicated at 68 . a flexible ring seal 70 prevents flow of fluids into and out of the housing at the junction of the casings . a stator 67 , including an annular iron core 69 and copper wire windings 71 about the core , surrounds the lower portion of rotor casing 20 and is maintained about the casing by stator casing 22 . electrical energy selectively supplied to windings 71 generates and alters the magnetic field in a known manner to rotate magnet 48 , and thus the rotor , impeller and shaft , at a predetermined speed , e . g . in the range of about 4 , 000 to 7 , 000 rpm . hall sensors 73 on the stator are used to sense the angular position of magnet 48 with respect to the stator , to control the electrical current applied to the stator coils . operation of pump 32 involves two fluid paths . the first concerns passage of blood through inlet throat 50 into the impeller chamber , where it is expelled from the chamber through an exit conduit 72 by rotation of impeller 54 . the second fluid path involves the constant flow of the saline solution into rotor chamber 38 through passageway 36 . in filling the rotor chamber , the saline solution provides a fluid lubricant between the movable rotor and shaft , and the fixed rotor casing , rotor guide and seal member . in particular , the saline solution provides hydrodynamic bearings between the stationary and rotating parts , e . g . face seals or bearings between cover 46 and thrust bearing 60 , an annular face seal between rotor guide 58 and shell 44 , and journal bearings between the rotor guide and shank 42 , and between the shell and rotor casing 20 . finally , the saline solution forms an annular journal bearing between impeller shaft 56 and lip seal 66 . while a saline solution is frequently preferred , other fluid lubricants compatible with bodily fluids may be used in lieu of a saline solution . to prevent passage of blood from impeller chamber 52 into rotor chamber 38 , the saline solution is caused to perfuse past lip seal 66 into the impeller chamber at a constant perfusion rate . further , as the passage into the impeller chamber is the sole path for saline out of rotor chamber 38 , the perfusion rate is equal to the rate at which the lubricant is supplied to the rotor chamber by infusion pump 32 . this simplifies construction of the centrifugal pump housing in eliminating the need to provide a separate exit passage for the lubricant fluid . moreover , it provides for positive , direct control of the saline solution seal perfusion rate through control of the infusion pump . as seen in fig3 the configuration of seal member 62 is particularly well suited to facilitate passage of fluid lubricant upwardly into the impeller chamber , while substantially preventing passage of blood downwardly into the rotor chamber . near lip seal 66 , seal member 62 includes a narrowed annular neck 74 which allows for a slight misalignment of impeller shaft 56 with respect to the seal member , and encourages the elastic flexure or deformation of the seal necessary for lubricant perfusion . lip seal 66 includes a relatively small , annular and vertical interfacing surface 76 with a diameter slightly smaller than the outer diameter of shaft 56 . consequently , in the absence of saline solution flow , the interface surface contacts impeller shaft 56 to form an annular interface between lip seal 66 and the shaft . a tapered surface 78 next to the interface surface is inclined away from shaft 56 , in the direction towards rotor chamber 38 or downwardly as viewed in fig3 at an acute angle preferably less than 45 °. by contrast , an upper surface 80 , on the opposite side of surface 76 and facing into impeller chamber 52 , is substantially normal to the impeller shaft . as a result , fluid pressure exerted by saline solution between lip seal 66 and shaft 56 includes a substantial transverse component ( horizontal as viewed in fig3 ) which tends to separate the lip seal from the shaft and permit flow of the lubricant past the lip seal . by contrast , fluid pressure due to blood in the impeller chamber , acting upon upper surface 80 , tends to close the seal . moreover , the combination of forces due to blood upon the upper surface and neck 74 , tend to maintain the lip seal closed or in surface engagement with the shaft in the absence of saline perfusion . this substantially prevents entry of blood or other bodily fluid into the rotor chamber , even in the event of temporary loss of positive saline fluid pressure . lip seal 66 &# 34 ; normally &# 34 ; is in surface engagement with impeller shaft 56 , in the sense that such surface engagement exists in the absence of lubricant perfusion . however , under pump operating conditions , a steady perfusion of saline solution provides a thin film surrounding the shaft and maintaining the lip seal in a close but spaced apart relation to the shaft . the seal clearance can be calculated from the following equation for flow in an annular gap : ## equ1 ## where q = cc / sec . when solved for the dimension and fluids used , and for a nominal pressure of 8 . 7 psi and a flow rate of one cc / day , the radial clearance is 2 . 26 um . this is on the order of the size of the red blood cells that must be excluded from the seal . any interruption in saline flow would permit lip seal 66 to engage the shaft once again in response to restoring forces in the lip seal . the flexibility of seal member 62 thus provides for an annular gap between shaft 56 and lip seal 66 which can vary in size responsive to lubricant fluid pressure , or can close altogether in the absence of such pressure . this feature provides an effective seal against entry of blood into the rotor chamber in the event the perfusion of saline is interrupted . it also reduces manufacturing cost in avoiding the strict tolerances for such passages when formed by rigid walls . moreover , the flexible seal facilitates adjustment of the lubricant flow rate over a wider range , limited only by the maximum advisable perfusion of saline into the blood stream , but otherwise variable for measured delivery of medication , e . g . heparin or another anticoagulant . fig4 illustrates the use of centrifugal pump 16 as part of a system for assisting a left ventricle 82 of the heart . pump 16 is implanted in the chest cavity , preferably near the heart apex , with inlet tube 24 inserted directly into the left ventricle to receive blood entering that ventricle . outlet tubing 30 is inserted into the abdominal aorta above the renal arteries . infusion pump 32 is outside the body as shown , or alternatively can be implanted below centrifugal pump 16 , where it may be refilled with lubricant solution or medication , percutaneously with a syringe . a control unit 84 , outside of the body , provides the necessary electrical energy over a line 86 to the stator for driving the pump . as an alternative to the arrangement shown , implantable infusion pump 32 can be replaced by a syringe or roller pump mounted within the control unit , in which case line 86 provides a conduit for the fluid lubricant as well . prior to operating centrifugal pump 16 , infusion pump 32 is operated to supply saline solution through tubing 34 into rotor chamber 38 , in an amount sufficient to fill the rotor chamber and perfuse across the interface between the impeller shaft and lip seal . thus , the lip seal and shaft are adequately lubricated prior to operating pump 16 , to eliminate wear and overheating of the lip seal , shaft and proximate blood or other bodily fluid . perfusion continues at a steady rate controlled by infusion pump 32 during operation of centrifugal pump 16 , and thus the fluid expelled into the abdominal aorta is a combination of bodily fluid and the saline solution . infusion pump 32 , as previously mentioned , supplies the lubricant at a constant rate rather than at a constant pressure . thus , pressure of the saline solution builds to a break pressure necessary to separate the initially contiguous shaft and lip seal , with a rapid initial saline flow reducing pressure until steady - state values for flow rate and pressure are achieved . saline delivery is not pressure dependent and can be delivered at a selectively increased or decreased rate for supplying a particular medication . at the same time , pressure in the rotary chamber , particularly near the lip seal , can be monitored as a means for monitoring the lubricant fluid flow . thus , in accordance with the present invention a steady perfusion of saline across an interface between a rotating shaft and a flexible lip seal , effectively lubricates the shaft and seal while preventing passage of blood across the seal .
a centrifugal pump for left ventricle assist includes a pump housing forming an impeller chamber with inlet and outlet passages and enclosing an impeller rotatable to move blood through the impeller chamber , and a rotor chamber enclosing a rotor integral with the impeller and rotatable to drive the impeller . an elastically deformable seal member separates the rotor and impeller chambers , and includes an annular lip seal surrounding a shaft which joins the impeller and rotor . a saline solution is supplied at a constant fluid flow rate to the rotor chamber through an inlet passage , and leaves the rotor chamber by perfusing into the impeller chamber along the interface between the shaft and lip seal . the saline solution thus provides hydrodynamic bearings between the rotating shaft and rotor , and the fixed pump housing and lip seal , and further prevents blood in the impeller chamber from entering the rotor chamber . the lip seal is configured to encourage flow of saline solution along the lip seal / impeller shaft interface , while resisting the flow of blood along the interface .