Left Ventricular Assist Device Evaluation With a Model-Controlled Mock Circulation

Vaes, Mark; Rutten, Marcel; Molengraft, René van de; Vosse, Frans van de

doi:10.1115/sbc2007-176372

Cited by 9 publications

(9 citation statements)

References 7 publications

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“…To enable the evaluation of mechanical support under identical physiological conditions, experiments in a model‐controlled mock loop, based on the work of Vaes et al. (25), featuring a systemic, pulmonary, and coronary vascular bed were performed (Fig. 1).…”

Section: Methodsmentioning

confidence: 99%

In Vitro Comparison of Support Capabilities of Intra‐Aortic Balloon Pump and Impella 2.5 Left Percutaneous

et al. 2011

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The Impella 2.5 left percutaneous (LP), a relatively new transvalvular assist device, challenges the position of the intra-aortic balloon pump (IABP), which has a long record in supporting patients after myocardial infarction and cardiac surgery. However, while more costly and more demanding in management, the advantages of the Impella 2.5 LP are yet to be established. The aim of this study was to evaluate the benefits of the 40 cc IABP and the Impella 2.5 LP operating at 47,000 rpm in vitro, and compare their circulatory support capabilities in terms of cardiac output, coronary flow, cardiac stroke work, and arterial blood pressure. Clinical scenarios of cardiogenic preshock and cardiogenic shock (CS), with blood pressure depression, lowered cardiac output, and constant heart rate of 80 bpm, were modeled in a model-controlled mock circulation, featuring a systemic, pulmonary, and coronary vascular bed. The ventricles, represented by servomotor-operated piston pumps, included the Frank-Starling mechanism. The systemic circulation was modeled with a flexible tube having close-to-human aortic dimensions and compliance properties. Proximally, it featured a branch mimicking the brachiocephalic arteries and a physiological correct coronary flow model. The rest of the systemic and pulmonary impedance was modeled by four-element Windkessel models. In this system, the enhancement of coronary flow and blood pressure was tested with both support systems under healthy and pathological conditions. Hemodynamic differences between the IABP and the Impella 2.5 LP were small. In our laboratory model, both systems approximately yielded a 10% cardiac output increase and a 10% coronary flow increase. However, since the Impella 2.5 LP provided significantly better left ventricular unloading, the circulatory support capabilities were slightly in favor of the Impella 2.5 LP. On the other hand, pulsatility was enhanced with the IABP and lowered with the Impella 2.5 LP. The support capabilities of both the IABP and the Impella 2.5 LP strongly depended on the simulated hemodynamic conditions. Maximum hemodynamic benefits were achieved when mechanical circulatory support was applied on a simulated scenario of deep CS.

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Section: Methodsmentioning

confidence: 99%

In Vitro Comparison of Support Capabilities of Intra‐Aortic Balloon Pump and Impella 2.5 Left Percutaneous

et al. 2011

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“…For example, the HR in Huang at al., Ochsner et al, and Yu and Gopalakrishnan was kept constant (3,9,14). In Huang et al and Pantalos et al, Emax was not regarded (9,11 (12,13). In contrast, the MHCLAUTO presented in this work was able to change in preload, Emax, HR, afterload, and the UVV completely with hydraulic components.…”

Section: Discussionmentioning

confidence: 61%

“…For example, the HR in Huang at al., Ochsner et al, and Yu and Gopalakrishnan was kept constant (3,9,14 (12,13). For example, the HR in Huang at al., Ochsner et al, and Yu and Gopalakrishnan was kept constant (3,9,14 (12,13).…”

Section: Discussionmentioning

confidence: 99%

“…Lately, hybrid MHCLs were developed to simulate the native physiologic hemodynamics (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). With a numeric-hydraulic interface, and so-called "Hardware in the Loop" (HIL) concept, control mechanisms and the hydraulic components of the MHCL are brought together.…”

mentioning

confidence: 99%

“…The physical components of the hybrid MHCL, including mechanical elements like pipes, proportional valves, and volume tanks, represent vascular resistance and compliances in the cardiovascular system. A current difficulty of HIL MHCL development is the integration of autoregulation mechanisms (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). The fastest internal autoregulation of the heart is the Frank-Starling mechanism (FSM), also known as preload sensitivity of the heart, which beat-to-beat regulates the cardiac output (CO).…”

mentioning

confidence: 99%

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Effects of Interaction Between Ventricular Assist Device Assistance and Autoregulated Mock Circulation Including Frank–Starling Mechanism and Baroreflex

et al. 2015

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A mock heart circulation loop (MHCL) is a hydraulic model simulating the human circulatory system. It allows in vitro investigations of the interaction between cardiac assist devices and the human circulatory system. In this study, a preload sensitive MHCL, the MHCL , was developed to investigate the interaction between the left ventricle and left ventricular assist devices (LVADs). The Frank-Starling mechanism was modeled by regulating the stroke volume (SV) based on the measured mean diastolic left atrial pressure (MLAP ). The baroreflex autoregulation mechanism was implemented to maintain a constant mean aortic pressure (MAP) by varying ventricular contractility (E ), heart rate (HR), afterload/systemic vascular resistance (SVR) and unstressed venous volume (UVV). The DP3 blood pump (Medos Medizintechnik GmbH) was used to simulate the LVAD. Characteristic parameters were measured in pathological conditions both with and without LVAD to assess the hemodynamic effect of LVAD on the MHCL . The results obtained from the MHCL show a high correlation to literature data. The study demonstrates the possibility of using the MHCL as a research tool to better understand the physiological interactions between cardiac implants and human circulation.

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State-of-the-Art Mock Human Blood Circulation Loop

Baturalp

Ertaş

2016

Emerging Trends in Applications and Infrastructures for Computational Biology, Bioinformatics, and Systems Biology

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Left Ventricular Assist Device Evaluation With a Model-Controlled Mock Circulation

Cited by 9 publications

References 7 publications

In Vitro Comparison of Support Capabilities of Intra‐Aortic Balloon Pump and Impella 2.5 Left Percutaneous

In Vitro Comparison of Support Capabilities of Intra‐Aortic Balloon Pump and Impella 2.5 Left Percutaneous

Effects of Interaction Between Ventricular Assist Device Assistance and Autoregulated Mock Circulation Including Frank–Starling Mechanism and Baroreflex

State-of-the-Art Mock Human Blood Circulation Loop

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