Robust physiological control of rotary blood pumps for heart failure therapy

Abstract

Left ventricular assist devices (LVADs) have become a viable alternative to heart transplantation in heart failure therapy. In clinical practice, rotary blood pumps used as LVADs are operated at a constant rotational speed and thus do not adapt to the varying demand of the patient. This paper presents a robust control approach for automatic adaptation of the blood pump speed to the blood flow demand of the patient’s body, which enables a defined load sharing between an LVAD and the native ventricle. Robust stability was checked using a detailed model of the human cardiovascular system with uncertainties that describe the most important native physiological control loops as well as a range of pathologies. The robust assistance controller was tested in an in vivo setup and was able to stabilize the cardiovascular system after myocardial infarction.

An Intra-Cycle Optimal Control Framework for Ventricular Assist Devices Based on Atrioventricular Plane Displacement Modeling

“…Speed regulation algorithms for generating sufficient perfusion and detecting ventricular suction 10,20 or pulmonary oxygen gas exchange tracking 30 are other goals, and, finally, multi-objective variants exist. 46 Due to the increased necessity of LVADs for clinical use, a wide range of different methods from control engineering has been proposed, such as adaptive, 42,65 robust, 48 model predictive, 1 fuzzy logic, 14 proportional integral derivative, 25 sliding mode, 8 and iterative learning control. 34 We refer to Reference 2 for a detailed review and for a discussion on the applicability of these methods in clinical practice.…”

“…Due to the increased necessity of LVADs for clinical use, a wide range of different methods from control engineering has been proposed, such as adaptive, 42 , 65 robust, 48 model predictive, 1 fuzzy logic, 14 proportional integral derivative, 25 sliding mode, 8 and iterative learning control. 34 We refer to Reference 2 for a detailed review and for a discussion on the applicability of these methods in clinical practice.…”

Improved estimation of left ventricular volume from electric field modeling

“…The advanced monitoring of pressures and flows in the circulation would allow to adapt LVAD therapy to individual needs and reduce adverse events [ 4 , 5 ]. In the past, various control strategies of an LVAD that adapt to the loading conditions of the heart measured by different sensor modalities were studied by several groups [ 6 , 7 , 8 , 9 , 10 , 11 ] without being clinical routine. In general, reliable monitoring of hemodynamics has been shown to reduce rehospitalization [ 12 ].…”

Performance and Reliable Operation of Physiological Controllers Under Various Cardiovascular Models: In Silico and In Vitro Study

“…To address this limitation, several approaches aiming to detect and address these adverse events have been developed, such as the suction detector of Ferreira et al 4 or the suction detection algorithm introduced by Maw et al 5 On the other side, to restore the physiologic response of LVADs, various physiologic control schemes of different complexity have been proposed in literature. [6][7][8][9][10][11][12][13] Although these controllers have showed to improve the response of LVADs, their control parameters are often selected based on the specific cardiovascular model (CVM) used during the development and evaluation phases, raising concerns about their efficacy when applied to different CVMs.…”