Characterization of a pulsatile rotary total artificial heart

Glynn, Jeremy J.; Dykan, Igor V.; Hagen, Matthew; Kaul, Sanjiv; Wampler, Richard K.; Hinds, Monica T.; Giraud, G

doi:10.1111/aor.13810

Cited by 4 publications

(8 citation statements)

References 15 publications

(15 reference statements)

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“…In summary, shared characteristics of these TAHs include: 1) All are valveless. OregonHeart, 29 RollingHeart, 30 MagVad TAH, 31 and the centrifugal/axial family of TAHs (Dragon Heart, 32 CFTAH, 33 p-CFTAH, 34 IB-Heart, 35 etc) are also valveless designs. OregonHeart uses a rotor to alternatively shuttle between the systemic and pulmonic positions without the need of valves.…”

Section: Discussionmentioning

confidence: 99%

“…OregonHeart uses a rotor to alternatively shuttle between the systemic and pulmonic positions without the need of valves. 29 RollingHeart utilizes two rotating disks that separate a circular chamber into four areas that fill and empty during the rotation without the need for valves. 30 MagVad TAH uses a nutating disc mechanism with a two-chamber design that also does not require valves.…”

Section: Discussionmentioning

confidence: 99%

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Anatomical and hemodynamic characterization of totally artificial hearts

Monreal,

Koenig,

Huang

et al. 2024

ASAIO Journal

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We characterize the anatomy and function of never before studied total artificial hearts (TAHs) using established methods for testing mechanical circulatory support (MCS) devices. A historical review of TAHs is also presented to aid in benchmarking performance metrics. Six TAHs, ranging from spooky Halloween beating hearts to a cute colorful plush heart, were imaged, instrumented (mock flow loops) to measure their pressure, volume, and flow, and qualitatively evaluated by 3rd party cardiac surgeons for anatomical accuracy and surgical considerations. Imaging of Claw, Beating, and Frankenstein TAHs revealed internal motors, circuit boards, and speakers. Gummy TAH was ranked favorite TAH for tactile realism, while Frankenstein TAH had the most favorable audible/visual indicators, including an illuminated Jacob’s Ladder. Beating TAH demonstrated superior pulsatile hemodynamic performance compared to Claw TAH (16mL vs 1.3mL stroke volume). Light Up TAH and Gummy TAH functioned only as passive compliance chambers. Cute TAH rapidly exsanguinated due to its porosity (-3.0 L/min flow). These TAHs demonstrated a wide range of anatomical accuracy, surgeon appeal, unique features, and hemodynamic performance. While Claw TAH and Beating TAH successfully generated a modicum of pulsatility, we recommend the clinical community continue to support pre-clinical development of emerging or use of clinically-approved TAHs.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Anatomical and hemodynamic characterization of totally artificial hearts

Monreal,

Koenig,

Huang

et al. 2024

ASAIO Journal

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“…The main features of this TAH include no valves, no mechanical contact, single moving parts, lightweight, compact size, freedom for clinicians to adjust pressure and flow rate as per patient requirement, low hemolysis, and reduced thrombosis . 37,38 Figure 1 shows a continuous VAD, Heartmate II. This is the world's most implanted VAD.…”

Section: Heart Failurementioning

confidence: 99%

Analysis of rotary ventricular assist devices using CFD technique—A Review

Shukla

Mishra

Tewari

2022

Proceedings of the Institution of Mechanical Engineers, Part E:

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With the increasing focus on reducing deaths because of heart ailments, considerable emphasis has been directed toward the development of ventricular assist devices (VADs) that work on the principle of mechanical pumps for supporting an infirm heart. The VADs are used primarily to assist the left ventricle, but their use has been extended for supporting the right ventricle as well as for supporting both ventricles simultaneously. In this connection, computational fluid dynamics (CFD) has evolved as an efficient technique for the design, development, evaluation, and optimization of VADs, enabling the prediction of operational characteristics of VADs as well as detailed global and local flow characteristics for an extensive set of working environments even before the manufacture and use of the actual device. CFD techniques yield valuable insight into the VADs’ effectiveness that enhances its operational behavior and decreases the risk associated with the use of the device, and at the same time decreases the manufacturing lead time and costs associated with the device. CFD has been quite beneficially used for the performance evaluation of VADs, but it still needs further development as hemolysis and thrombosis models cannot be easily integrated with the flow simulations. This review article presents abrief introduction to rotary VADs with a primary focus on the current status of CFD analysis of axial VADs, which provide the most suitable methods for computational design and optimization of VADs. It also identifies critical knowledge gaps and outlines the hematological models and the difficulties encountered in integrating them into CFD. Finally, future work based on the current scenario is also included.

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“…For more than half a century, several TAHs have been developed. Currently, two TAHs: SynCardia (SynCardia Systems, Tucson, AZ, USA) 3,4 and Carmat (Aeson; Carmat, Vélizy‐Villacoublay, France) 5,6 are approved for clinical use, and many other TAHs are under development 7–10 …”

Section: Introductionmentioning

confidence: 99%

“…Currently, two TAHs: SynCardia (SynCardia Systems, Tucson, AZ, USA) 3,4 and Carmat (Aeson; Carmat, Vélizy-Villacoublay, France) 5,6 are approved for clinical use, and many other TAHs are under development. [7][8][9][10] Achieving and maintaining a balance between the left and right ventricular outputs is a major hurdle that has to be overcome when developing a TAH. A TAH has to continuously adapt its cardiac outputs to changing hemodynamic conditions.…”

Section: Introductionmentioning

confidence: 99%

Balancing the ventricular outputs of pulsatile total artificial hearts

Gülcher,

Vis,

Peirlinck

et al. 2023

Artificial Organs

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BackgroundMaintaining balanced left and right cardiac outputs in a total artificial heart (TAH) is challenging due to the need for continuous adaptation to changing hemodynamic conditions. Proper balance in ventricular outputs of the left and right ventricles requires a preload‐sensitive response and mechanisms to address the higher volumetric efficiency of the right ventricle.MethodsThis review provides a comprehensive overview of various methods used to balance left and right ventricular outputs in pulsatile total artificial hearts, categorized based on their actuation mechanism.ResultsReported strategies include incorporating compliant materials and/or air cushions inside the ventricles, employing active control mechanisms to regulate ventricular filling state, and utilizing various shunts (such as hydraulic or intra‐atrial shunts). Furthermore, reducing right ventricular stroke volume compared to the left often serves to balance the ventricular outputs. Individually controlled actuation of both ventricles in a pulsatile TAH seems to be the simplest and most effective way to achieve proper preload sensitivity and left–right output balance. Pneumatically actuated TAHs have the advantage to respond passively to preload changes.ConclusionTherefore, a pneumatic TAH that comprises two individually actuated ventricles appears to be a more desirable option—both in terms of simplicity and efficacy—to respond to changing hemodynamic conditions.

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Characterization of a pulsatile rotary total artificial heart

Cited by 4 publications

References 15 publications

Anatomical and hemodynamic characterization of totally artificial hearts

Anatomical and hemodynamic characterization of totally artificial hearts

Analysis of rotary ventricular assist devices using CFD technique—A Review

Balancing the ventricular outputs of pulsatile total artificial hearts

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