An innovative, sensorless, pulsatile, continuous-flow total artificial heart: Device design and initial in vitro study

Fukamachi, Kiyotaka; Horvath, David J.; Massiello, Alex; Fumoto, Hideyuki; Horai, Tetsuya; Rao, Subramanyeshwar; Golding, Leonard A.R.

doi:10.1016/j.healun.2009.05.034

Cited by 86 publications

(68 citation statements)

References 33 publications

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“…10,16,17,27 Flow modulation of ventricular assist devices are affected by the timing of flow modulation to the native myocardial contraction. Early VAD modulation strategies focused on asynchronous modulation of LVAD flow as it was simpler to implement.…”

Section: Introductionmentioning

confidence: 99%

Flow Modulation Algorithms for Continuous Flow Left Ventricular Assist Devices to Increase Vascular Pulsatility: A Computer Simulation Study

Ising

Warren

Sobieski

et al. 2011

Cardiovasc Eng Tech

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Continuous flow (CF) left ventricular assist devices (LVAD) support diminishes vascular pressure pulsatility. Despite its recent clinical success CF LVAD support has been associated with a higher incidence of gastrointestinal bleeding, aortic valve dysfunction and hemorrhagic strokes. To overcome this limitation, we are developing algorithms to provide vascular pulsatility using a CF LVAD. The effects of timing and synchronizing the CF LVAD flow modulation to the native myocardium, modulation amplitude, and modulation widths were studied on the native ventricle and vasculature using a computer simulation model of the circulatory system simulating heart failure. A total of over 150 combinations of varying pulse widths, beat frequencies, time shifts, and amplitudes to modulate CF LVAD flow were tested. All control algorithms maintained a mean CF LVAD flow of 5.0 ± 0.1 L/min (full support) or 2.5 ± 0.1 L/min (partial support). These algorithms resulted in an increased arterial pressure pulsatility of up to 59 mmHg, reduced left ventricular external work (LVEW) by 10-75%, and increased myocardial perfusion by up to 44% from baseline heart failure condition. Importantly, reduction in LVEW and increase in pulsatility may be adjusted to userdefined values while maintaining the same average CF LVAD flow rate. These methods of CF LVAD flow modulation may enable tailored unloading of the native ventricle to provide rest and rehabilitation (maximal unloading to rest followed by gradual reloading to wean), which may promote sustainable myocardial recovery. Further, these LVAD flow modulation patterns may reduce the incidence of adverse events associated with the CF LVAD therapy by increasing vascular pulsatility.

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Section: Introductionmentioning

confidence: 99%

Flow Modulation Algorithms for Continuous Flow Left Ventricular Assist Devices to Increase Vascular Pulsatility: A Computer Simulation Study

Ising

Warren

Sobieski

et al. 2011

Cardiovasc Eng Tech

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show abstract

“…Encouraged by the success of continuous-flow LVADs in supporting patients with advanced heart failure over the last 15 years, several groups have begun to focus intently in the current era on rotary blood pump technology to craft the next generation of TAH. BiVACOR (Houston, TX, USA) [10] and Cleveland Heart (Cleveland, OH, USA) [11,12] each have developed rotary TAHs that leverage the advantages of centrifugal pumps. These rotary pumps lacked any mechanical bearings or other sources of mechanical wear and no flexible components or valves, and both utilize a two-sided impeller, with blades on one face that accelerate the systemic blood and on the other face that pump pulmonary blood.…”

Section: Future Tah Technologymentioning

confidence: 99%

Previous challenges and current progress–the use of total artificial hearts in patients with end-stage heart failure

Goerlich¹,

Frazier²,

Cohn³

2016

Expert Review of Cardiovascular Therapy

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“…The HeartWare HVAD, Jarvik 2000, Trumo DuraHeart and Ventracor VentrAssist devices are in clinical trials. The Cleveland Clinic TAH (Fumoto et al 2010;Fukamachi et al 2010) can transition continuous flow principles to a TAH and allow the technology to be used in patients requiring biventricular support. Compared with previous pulsatile devices, continuous-flow pumps cannot completely decompress the left ventricle as the native heart must have some residual volume to prevent suction events.…”

Section: Continuous Versus Pulsatile-flow Pumpsmentioning

confidence: 99%

Ventricular Assist Device – How to Obtain Optimal Benefits?

Bielecka‐Dąbrowa¹,

Banach²,

Rysz³

et al. 2011

Ventricular Assist Devices

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An innovative, sensorless, pulsatile, continuous-flow total artificial heart: Device design and initial in vitro study

Abstract: Background-We are developing a very small, innovative, continuous-flow total artificial heart (CFTAH) that passively self-balances left and right pump flows and atrial pressures without sensors. This report details the CFTAH design concept and our initial in vitro data.

Cited by 86 publications

References 33 publications

Flow Modulation Algorithms for Continuous Flow Left Ventricular Assist Devices to Increase Vascular Pulsatility: A Computer Simulation Study

Flow Modulation Algorithms for Continuous Flow Left Ventricular Assist Devices to Increase Vascular Pulsatility: A Computer Simulation Study

Previous challenges and current progress–the use of total artificial hearts in patients with end-stage heart failure

Ventricular Assist Device – How to Obtain Optimal Benefits?

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