Current Status of the Gyro Centrifugal Blood Pump—Development of the Permanently Implantable Centrifugal Blood Pump as a Biventricular Assist Device (NEDO Project)

Nosé, Yukihiko; Furukawa, Kojiro

doi:10.1111/j.1525-1594.2004.00073.x

Cited by 34 publications

(18 citation statements)

References 22 publications

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“…The Gyro centrifugal pump, suspended by two pivots, has been developed as an implantable LVAD and RVAD, 17,18 and animal experiments are ongoing. The Jarvik 2000 FlowMaker (Jarvik Heart, Inc., New York, NY) has been developed as an implantable LVAD.…”

Section: Discussionmentioning

confidence: 99%

Initial In Vivo Evaluation of the DexAide Right Ventricular Assist Device

et al. 2005

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Despite the increasing use of left ventricular assist devices for patients with end-stage congestive heart failure, no implantable, centrifugal right ventricular assist devices (RVADs) are available for those patients with significant right ventricular failure. The DexAide RVAD was developed to provide an implantable RVAD option to surgeons. The aim of this study was to evaluate pump performance in an acute in vivo model. The DexAide RVAD, developed as a modified CorAide left ventricular assist device, was implanted between the right ventricle and the pulmonary artery in four healthy calves. Pump speed was varied from 1800 rpm to 3600 rpm. RVAD performance was analyzed acutely at baseline and under conditions of low circulating volume, high contractility, high pulmonary arterial pressure, vasodilation, and low contractility. Pump flow was well maintained even under conditions of high pulmonary arterial pressure and vasodilation, with the exception of low circulating volume. Under all conditions, pulmonary arterial pressures were not affected by changing pump speed. The DexAide RVAD demonstrated acceptable hemodynamic characteristics for use as an implantable RVAD in the initial acute studies. Further studies are ongoing to examine the biocompatibility of the pump under chronic conditions.

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Section: Discussionmentioning

confidence: 99%

Initial In Vivo Evaluation of the DexAide Right Ventricular Assist Device

et al. 2005

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“…Clearly then, balancing of circuit volumes is crucial for any rotary support device, especially rotary BiVADs. In order to balance flows with two Gyro pumps, Nose´et al 49 incorporated inlet pressure sensors in each VAD to regulate flow, like the FrankStarling mechanism. However, blood pump control systems like these can be limited by the low reliability of long-term blood pressure and flow sensors.…”

Section: Requirement For Biventricular Supportmentioning

confidence: 99%

“…Left-right flow control was reported to be achieved with a Starling-like regulation, which increases flow with increased preload, however, no mention was made on how preload will be measured in the longterm. 49 Meanwhile, a transcutaneous energy transfer system has been developed for the Gyro pump, with a maximum transmission efficiency of 87.3%. 50…”

Section: Gyromentioning

confidence: 99%

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Biventricular Assist Devices: A Technical Review

et al. 2011

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The optimal treatment option for end stage heart failure is transplantation; however, the shortage of donor organs necessitates alternative treatment strategies such as mechanical circulatory assistance. Ventricular assist devices (VADs) are employed to support these cases while awaiting cardiac recovery or transplantation, or in some cases as destination therapy. While left ventricular assist device (LVAD) therapy alone is effective in many instances, up to 50% of LVAD recipients demonstrate clinically significant postoperative right ventricular failure and potentially need a biventricular assist device (BiVAD). In these cases, the BiVAD can effectively support both sides of the failing heart. This article presents a technical review of BiVADs, both clinically applied and under development. The BiVADs which have been used clinically are predominantly first generation, pulsatile, and paracorporeal systems that are bulky and prone to device failure, thrombus formation, and infection. While they have saved many lives, they generally necessitate a large external pneumatic driver which inhibits normal movement and quality of life for many patients. In an attempt to alleviate these issues, several smaller, implantable second and third generation devices that use either immersed mechanical blood bearings or hydrodynamic/magnetic levitation systems to support a rotating impeller are under development or in the early stages of clinical use. Although these rotary devices may offer a longer term, completely implantable option for patients with biventricular failure, their control strategies need to be refined to compete with the inherent volume balancing ability of the first generation devices. The BiVAD systems potentially offer an improved quality of life to patients with total heart failure, and thus a viable alternative to heart transplantation is anticipated with continued development.

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“…All report vascular circuit edema and incidence of ventricular suckdown (4,9–12) indicating that balancing the VAD outputs is crucial for rotary biventricular assist devices (BiVADs). In order to balance flows with two Gyro pumps Nosé and Furukawa incorporated inlet pressure sensors in each VAD to regulate flow like the Frank–Starling mechanism (13). However, blood‐pump control systems like these can be complicated by the low reliability of long‐term blood pressure and flow sensors (14).…”

mentioning

confidence: 99%

Optimizing the Response From a Passively Controlled Biventricular Assist Device

2010

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Recent studies into rotary biventricular support have indicated that inadequate left/right flow balancing may lead to vascular congestion and/or ventricular suckdown. The implementation of a passive controller that automatically adjusts left/right flow during total and partial cardiac support would improve physiological interaction. This has encouraged the development of a biventricular assist device (BiVAD) prototype that achieves passive control of the two rotary pumps' hydraulic output by way of a nonrotating double pressure plate configuration, the hub, suspended between the ventricular assist device (VAD) impellers. Fluctuations in either the VAD's inlet or outlet pressure will cause the hub to translate, and in doing so, affect each pump's hydraulic outputs. In order to achieve partial support, the floating assembly needed to respond to pathologic blood pressure signals while being insensitive to residual ventricular function. An incorporated mechanical spring-mass-damper assembly affects the passive response to optimize the dynamic interaction between the prototype and the supported cardiovascular system. It was found that increasing the damping from a medium to a high level was effective in filtering out the higher frequency ventricular pressure signals, reducing a modified amplitude ratio by up to 72%. A spring response was also identified as being inherent in the passive response and was characterized as being highly nonlinear at the extremes of the floating assembly's translation range. The results from this study introduce a new means of BiVAD control as well as the characterization of a fully passive mechanical physiological controller.

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Current Status of the Gyro Centrifugal Blood Pump—Development of the Permanently Implantable Centrifugal Blood Pump as a Biventricular Assist Device (NEDO Project)

Cited by 34 publications

References 22 publications

Initial In Vivo Evaluation of the DexAide Right Ventricular Assist Device

Initial In Vivo Evaluation of the DexAide Right Ventricular Assist Device

Biventricular Assist Devices: A Technical Review

Optimizing the Response From a Passively Controlled Biventricular Assist Device

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