First Clinical Experience with an Automatic Control System for Rotary Blood Pumps During Ergometry and Right-Heart Catheterization

Schima, Heinrich; Vollkron, Michael; Jantsch, Ursula; Crevenna, Richard; Roethy, Wilfried; Benkowski, Robert; Morello, Gino; Quittan, Michael; Hiesmayr, Michael; Wieselthaler, Georg

doi:10.1016/j.healun.2005.09.008

Cited by 70 publications

(83 citation statements)

References 23 publications

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“…These observations are consistent with previously reported studies comparing LV pressure and volume unloading characteristics with pulsatile displacement devices and continuous-flow rotary pumps. 12,13 This study importantly extends the findings of these previous observations by demonstrating equivalent degrees of exercise performance with each device design.…”

Section: Discussionsupporting

confidence: 81%

“…Algorithms for demand-responsive control of rotary pumps have been developed to overcome this perceived limitation in pump design. 12 Previous studies have suggested that rotary pumps with an axial design provide similar degrees of pressure unloading but less volume unloading of the LV as compared with pulsatile, volume displacement pumps under resting conditions. 13,14 These previous observations suggest that rotary pumps with an axial design operating at a fixed rotor speed may not adequately adjust to periods of increased LV preload during exercise.…”

mentioning

confidence: 99%

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Hemodynamic and Exercise Performance With Pulsatile and Continuous-Flow Left Ventricular Assist Devices

et al. 2007

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Background-Continuous-flow rotary pumps with axial design are increasingly used for left ventricular assist support. The efficacy of this design compared with pulsatile, volume displacement pumps, with respect to characteristics of left ventricular unloading, and exercise performance remains largely unstudied. Methods and Results-Thirty-four patients undergoing implantation with a pulsatile, volume displacement pump operating in a full-to-empty cycle (HeartMate XVE; Thoratec Inc, Pleasanton, Calif; nϭ16) or continuous-flow rotary pump with an axial design operating at a fixed rotor speed (HeartMate II; Thoratec Inc; nϭ18) were evaluated with right heart catheterization and echocardiography preoperatively and at 3 months postoperatively and cardiopulmonary exercise testing 3 months postoperatively.

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Section: Discussionsupporting

confidence: 81%

mentioning

confidence: 99%

Hemodynamic and Exercise Performance With Pulsatile and Continuous-Flow Left Ventricular Assist Devices

et al. 2007

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“…Feedback control strategies to physiologically adapt the operation of turbo dynamic VADs (tVADs) to the oxygen demand and to optimize left-ventricular unloading have been subject to continuous research [5][6][7][8][9][10]. A number of approaches for realizing a speed modulation of tVADs has been analyzed earlier.…”

Section: Introductionmentioning

confidence: 99%

Numerical Optimal Control of Turbo Dynamic Ventricular Assist Devices

et al. 2013

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Abstract:The current paper presents a methodology for the derivation of optimal operating strategies for turbo dynamic ventricular assist devices (tVADs). In current clinical practice, tVADs are typically operated at a constant rotational speed, resulting in a blood flow with a low pulsatility. Recent research in the field has aimed at optimizing the interaction between the tVAD and the cardiovascular system by using predefined periodic speed profiles. In the current paper, we avoid the limitation of using predefined profiles by formulating an optimal-control problem based on a mathematical model of the cardiovascular system and the tVAD. The optimal-control problem is solved numerically, leading to cycle-synchronized speed profiles, which are optimal with respect to an arbitrary objective. Here, an adjustable trade-off between the maximization of the flow through the aortic valve and the minimization of the left-ventricular stroke work is chosen. The optimal solutions perform better than constant-speed or sinusoidal-speed profiles for all cases studied. The analysis of optimized solutions provides insight into the optimized Bioengineering 2014, 1 23 interaction between the tVAD and the cardiovascular system. The numerical approach to the optimization of this interaction represents a powerful tool with applications in research related to tVAD control. Furthermore, patient-specific, optimized VAD actuation strategies can potentially be derived from this approach.

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“…Another rotary blood pump, DeBakey® (Micromed Cardiovascular Inc., Houston, TX, USA), increased pump flow with constant speed during exercise. 15) It is very important for a VAD pump to increase flow automatically during exercise under certain pump conditions. Moreover, a good way of increasing flow is similar to physiological responses in the human body.…”

Section: Fig 1 Pump Flow During Exercise Visualized With Ultrasoundmentioning

confidence: 99%

Spontaneous Increase in EVAHEART® Pump Flow at a Constant Pump Speed during Exercise Examination

Kurihara

Nishimura

Imanaka

et al. 2012

ATCS

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Purpose: Ventricular assist devices have been used for the treatment of severe heart failure. Recently, many types of blood pumps have been developed to reduce major adverse events. EVAHEART® (Sun Medical Technology Research Corporation, Nagano, Japan) is an implantable centrifugal blood pump. In laboratory animal studies, the pump flow of EVA-HEART® increases spontaneously during exercise with no changes in pump control parameters. However, this has not been confirmed clinically. The aim of this study was to analyze EVAHEART® performance during exercise. Patients and methods: Four male patients were implanted with an EVAHEART®. We evaluated the performance of the EVAHEART® during exercise. Fixed pump speeds were maintained during each test. Measurements during exercise were peak load, peak oxygen consumption (peak VO 2 ), pre exercise pump flow, and peak velocity. Results: Pump flow significantly increased from 4.1 ± 0.5 liters per minute (L/min) to 7.2 ± 1.8 L/min during exercise. VO 2 increased from 4.0 ± 0.7 milliliters per kilogram per minute (ml/kg/min) to 14.7 ± 3.3 ml/kg/min. Conclusion: These results indicate that EVAHEART® may support severe heart failure patients not only under static but also under dynamic conditions. Pump flow spontaneously increased during exercise at a constant pump speed.

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First Clinical Experience with an Automatic Control System for Rotary Blood Pumps During Ergometry and Right-Heart Catheterization

Cited by 70 publications

References 23 publications

Hemodynamic and Exercise Performance With Pulsatile and Continuous-Flow Left Ventricular Assist Devices

Hemodynamic and Exercise Performance With Pulsatile and Continuous-Flow Left Ventricular Assist Devices

Numerical Optimal Control of Turbo Dynamic Ventricular Assist Devices

Spontaneous Increase in EVAHEART® Pump Flow at a Constant Pump Speed during Exercise Examination

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