Peristaltic hemodynamics of a new pediatric circulatory assist system for Fontan circulation using shape memory alloy fibers

Yamada, Akihiro; Shiraishi, Yasuyuki; Miura, Hidekazu; Yambe, Tomoyuki; Omran, M. H.; Shiga, Takuya; Tsuboko, Yusuke; Homma, Dai; Yamagishi, Masaaki

doi:10.1109/embc.2013.6609592

Cited by 13 publications

(15 citation statements)

References 12 publications

(7 reference statements)

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“…Yamada et al. are developing an implantable pulsatile device using peristaltic motion to move blood through the ECC using computer‐synchronized contraction of shape memory alloy fibers. Rodefeld et al.…”

Section: Discussionmentioning

confidence: 99%

Pressure–Flow Experimental Performance of New Intravascular Blood Pump Designs for Fontan Patients

et al. 2015

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An intravascular axial flow pump is being developed as a mechanical cavopulmonary assist device for adolescent and adult patients with dysfunctional Fontan physiology. Coupling computational modeling with experimental evaluation of prototypic designs, this study examined the hydraulic performance of 11 impeller prototypes with blade stagger or twist angles varying from 100 to 600 degrees. A refined range of twisted blade angles between 300 and 400 degrees with 20-degree increments was then selected, and four additional geometries were constructed and hydraulically evaluated. The prototypes met performance expectations and produced 3-31 mm Hg for flow rates of 1-5 L/min for 6000-8000 rpm. A regression analysis was completed with all characteristic coefficients contributing significantly (P< 0.0001). This analysis revealed that the impeller with 400 degrees of blade twist outperformed the other designs. The findings of the numerical model for 300-degree twisted case and the experimental results deviated within approximately 20%. In an effort to simplify the impeller geometry, this work advanced the design of this intravascular cavopulmonary assist device closer to preclinical animal testing.

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Section: Discussionmentioning

confidence: 99%

Pressure–Flow Experimental Performance of New Intravascular Blood Pump Designs for Fontan Patients

et al. 2015

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“…Yamada et al are also designing a MCS pump using synchronized peristaltic contraction of shape memory alloy fibers (Fig. A).…”

Section: New Mcs Devices Under Developmentmentioning

confidence: 99%

“…These fibers encircle the extra‐cardiac conduit and induce pulsatile flow into the TCPC. The shape memory alloy fibers are controlled using a special control system . Despite its novel approach using mechanical contraction, peristaltic motion may not adequately produce evenly divided pulsatile flow into the pulmonary arteries.…”

Section: New Mcs Devices Under Developmentmentioning

confidence: 99%

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Mechanical Circulatory Support Devices for Pediatric Patients With Congenital Heart Disease

et al. 2016

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The use of mechanical circulatory support (MCS) devices is a viable therapeutic treatment option for patients with congestive heart failure. Ventricular assist devices, cavopulmonary assist devices, and total artificial heart pumps continue to gain acceptance as viable treatment strategies for both adults and pediatric patients as bridge-to-transplant, bridge-to-recovery, and longer-term circulatory support alternatives. We present a review of the current and future MCS devices for patients having congenital heart disease (CHD) with biventricular or univentricular circulations. Several devices that are specifically designed for patients with complex CHD are in the development pipeline undergoing rigorous animal testing as readiness experiments in preparation for future clinical trials. These advances in the development of new blood pumps for patients with CHD will address a significant unmet clinical need, as well as generally improve innovation of the current state of the art in MCS technology.

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“…However, due to the limited experience on the use of VAD in SV physiology, only 50% of VAD patients with SV survive in comparison with overall pediatric VAD survival of 70–86% . Considering the lack of established experience and the lack of dedicated devices, several groups are developing new dedicated VADs and are performing acute animal experiments . In this innovative field, the development and the use of a dedicated numerical model (15–) could support clinical and experimental strategies designed to test new VADs and their hemodynamic effects.…”

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confidence: 99%

Concurrent use of continuous and pulsatile flow Ventricular Assist Device on a fontan patient: A simulation study

Molfetta

Ferrari²,

Iacobelli

et al. 2016

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The aim of this work is to develop and test a lumped parameter model of the cardiovascular system to simulate the concurrent use of pulsatile (PVAD) and continuous flow (CVAD) ventricular assist device (VAD) on Fontan patients. Echocardiographic and hemodynamic data of five Fontan patients were retrospectively collected and used to simulate the patients' baseline hemodynamics. Then, for each patient, the following assistance modality was simulated for the cavopulmonary and the single ventricle (SV): (a) CVAD for cavopulmonary assistance (RCF) and PVAD assisting the SV (LCF) (RPF + LCF), (b) CVAD assisting SV and PVAD for cavopulmonary assistance (LPF + RCF). The numerical model can well reproduce patients' baseline. The cardiac output increases more importantly in the LCF + RPF configuration (35 vs. 8%). Ventricular volume decreases more evidently in the configuration LCF + RPF (28 vs. 6%), atrial pressure decreases in the LCF + RPF modality (10%), while it slightly increases in the RCF + LPF modality. The pulmonary arterial pressure slightly decreases (increases) in the configuration RCF + LPF (LCF + RPF). Ventricular external work increases in both configurations because of the total increment of the cardiac output. However, artero-ventricular coupling improves in both configurations: RCF + LPF-14%, LCF + RPF-41%. The pulsatility index decreases (increases) by 8% (13.8%) in the configuration LCF + RPF (RCF + LPF). A model could permit us to simulate extreme physiological conditions of the implantation of both CF and PF VAD on the Fontan patient and could permit to choose the proper VAD on the base of patients' condition. The configuration LCF + RPF seems to maximize the hemodynamic benefits.

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Peristaltic hemodynamics of a new pediatric circulatory assist system for Fontan circulation using shape memory alloy fibers

Cited by 13 publications

References 12 publications

Pressure–Flow Experimental Performance of New Intravascular Blood Pump Designs for Fontan Patients

Pressure–Flow Experimental Performance of New Intravascular Blood Pump Designs for Fontan Patients

Mechanical Circulatory Support Devices for Pediatric Patients With Congenital Heart Disease

Concurrent use of continuous and pulsatile flow Ventricular Assist Device on a fontan patient: A simulation study

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