Evaluation of an intraventricular balloon pump for short‐term support of patients with heart failure

Abstract

The high cost of ventricular assist devices results in poor cost‐effectiveness when used as a short‐term bridging solution, thus a low‐cost alternative is desirable. The present study aimed to develop an intraventricular balloon pump (IVBP) for short‐term circulatory support, and to evaluate the effect of balloon actuation timing on the degree of cardiac support provided to a simulated in vitro severe heart failure (SHF) patient. A silicone IVBP was designed to avoid contact with internal left ventricular (LV) features (ie, papillary muscles, chordae, aortic, and mitral valves) based on LV computed tomography data of 10 SHF patients with dilated cardiomyopathy. The hemodynamic effects of varying balloon inflation and deflation timing parameters (inflation duty [D] and end‐inflation point [σ]) were evaluated in a purpose‐built systemic mock circulatory loop. Three IVBP actuation timing categories were defined: co‐, transitional, and counterpulsation. Compared to the SHF baseline, co‐pulsation increased aortic flow from 3.5 to 5.2 L/min, mean arterial pressure from 72.1 to 94.8 mmHg and ejection fraction from 14.4% to 21.5%, while mean left atrial pressure decreased from 14.6 to 10 mmHg. Transitional and counterpulsation resulted in a double ventricular pulse and extended the duration of increased ventricular pressure, potentially impeding diastolic filling and coronary perfusion. This in vitro study showed the IVBP could restore the hemodynamic balance of a simulated SHF patient with dilated cardiomyopathy to healthy levels.

Mock circulatory loops used for testing cardiac assist devices: A review of computational and experimental models

“…74 Anatomical models of arterial beds 7,75 and pulmonary trunks 76 were developed to study haemodynamics of CADs. Patient-specific left ventricles were developed to assess intraventricular balloon pump 77 and for in vitro flow visualisation studies. [78][79][80][81] Several studies include anatomical models of the aortic arch, 78,82,83 for example, Litwak et al 84 used an anatomical model of the ascending and descending aorta to study the aortic blood flow of continues flow and pulsatile flow VADs.…”

Artificial Organs 2019: A year in review

“…Alice C. Boone et al of the School of Engineering and Built Environment, Griffith University, Queensland, Australia investigated in vitro the development of an intraventricular balloon pump (IVBP) for short‐term circulatory support, and to evaluate the effect of balloon actuation timing on the degree of cardiac support provided to a simulated in vitro severe heart failure (SHF) patient. Three IVBP actuation timing categories were defined: co‐, transitional, and counterpulsation.…”

Proof of principle of a novel co‐pulsating intra‐ventricular membrane pump

“…To prevent possible mitral valve regurgitation induced by an intra-ventricular balloon, 30,31 Boone et al redesigned the balloon according to the anatomical shape of the heart. 12 Their balloon has a wide body placed below the papillary muscles, and a smaller neck placed toward the outflow tract. With this approach they intend to increase the ejection fraction without obstruction of the mitral valve apparatus.…”

“…In light of these considerations, current research is in search for new modalities 11,12 to support patients through the critical phase of CS. Our group is developing a new mechanical circulatory support device, which is based on the concept of co-pulsatile and directed volume displacement, called the Intra-Ventricular Membrane Pump (IVMP).…”