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

Dort, Daniël I. M. van; Thannhauser, Jos; Gommans, Frank; Cate, Tim J. ten; Duncker, Dirk J.; Suryapranata, Harry; Morshuis, Wim J.; Geuzebroek, Guillaume S.C.

doi:10.1111/aor.13757

Cited by 3 publications

(2 citation statements)

References 35 publications

(58 reference statements)

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“…Overall, it is believed that counterpulsation control of the LVAD can improve the long-term safety of heart failure patients equipped with LVADs. 44,46 VADs have been attached to the ventricle traditionally. Atrial placement is less common and is very patient-and device-specific, usually depending on surgical needs.…”

Section: Discussionmentioning

confidence: 99%

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Flow assessment as a function of pump timing of tubular pulsatile pump for use as a ventricular assist device in a left heart simulator

Sharifi

Bark

2022

Artificial Organs

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Introduction Although mechanical circulatory support saved many lives during the last decade, clinical observations have shown that the continuous flow pumps are associated with a much higher incidence of gastrointestinal bleeding and kidney problems, among others, compared with the earlier generation pulsatile pumps. However, the presence of several moving mechanical components made pulsatile pumps less durable, bulky, and prone to malfunction, ultimately leading to bias in favor of continuous flow designs. Objective The aim of the current work is to create a prototype tubular pulsatile pump and to test the timing of the pump in a left heart simulator. Methods A left heart simulator to mimic pumping from a failing heart was created. This was used to experimentally test the output of a prototype ventricular assist device relative to a failing heart in the form of flow and pressure. The effect of pulsation timing was quantified. Results A failing heart was simulated with an average flow rate of 1.1 L/min and a systolic pressure of 47 mm Hg. With the pump, the flow rate increases to 4.8 L/min and a systolic pressure of 110 mm Hg, in a copulsation mode, while activating for 300–400 ms. If the activation time is reduced, or increased, the pump becomes less effective. Load on the heart is reduced when the pump operates in a counterpulsation mode. Conclusion A pulsatile pump, like the one proposed, provides adequate output for mechanical circulatory support, while minimizing the number of moving parts that could otherwise lead to tribological wear.

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Section: Discussionmentioning

confidence: 99%

“…A drawback with counterpulsation is that the aortic pressure is reduced when compared to copulsation. Overall, it is believed that counterpulsation control of the LVAD can improve the long‐term safety of heart failure patients equipped with LVADs 44,46 …”

Section: Discussionmentioning

confidence: 99%

Flow assessment as a function of pump timing of tubular pulsatile pump for use as a ventricular assist device in a left heart simulator

Sharifi

Bark

2022

Artificial Organs

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Direct Cardiac Compression Devices to Augment Heart Biomechanics and Function

Bonnemain

Nido

Roche

2022

Annu. Rev. Biomed. Eng.

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The treatment of end-stage heart failure has evolved substantially with advances in medical treatment, cardiac transplantation, and mechanical circulatory support (MCS) devices such as left ventricular assist devices and total artificial hearts. However, current MCS devices are inherently blood contacting and can lead to potential complications including pump thrombosis, hemorrhage, stroke, and hemolysis. Attempts to address these issues and avoid blood contact led to the concept of compressing the failing heart from the epicardial surface and the design of direct cardiac compression (DCC) devices. We review the fundamental concepts related to DCC, present the foundational devices and recent devices in the research and commercialization stages, and discuss the milestones required for clinical translation and adoption of this technology. Expected final online publication date for the Annual Review of Biomedical Engineering, Volume 24 is June 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

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A novel intra-ventricular assist device enhances cardiac performance in normal and acutely failing isolated porcine hearts

et al. 2021

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Background: We recently demonstrated that a novel intra-ventricular membrane pump (IVMP) was able to increase the pump function of isolated beating porcine hearts. In follow-up, we now investigated the impact of the IVMP on myocardial oxygen consumption and total mechanical efficiency (TME) and assessed the effect of IVMP-support in acutely failing hearts. Methods: In 10 ex vivo beating porcine hearts, we studied hemodynamic parameters, as well as arterial and coronary venous oxygen content. We assessed cardiac power (CP), myocardial oxygen consumption (MVO2), and TME (CP divided by MVO2) under baseline conditions and during IVMP-support. Additionally, five isolated hearts were subjected to global hypoxia to investigate the effects of IVMP-support on CP under conditions of acute heart failure. Results: Under physiological conditions, baseline CP was 0.36 ± 0.10 W, which increased to 0.65 ± 0.16 W during IVMP-support (increase of 85% ± 24, p < 0.001). This was accompanied by an increase in MVO2 from 18.6 ± 6.2 ml/min at baseline, to 22.3 ± 5.0 ml/min during IVMP-support (+26 ± 31%, p = 0.005). As a result, TME (%) increased from 5.9 ± 1.2 to 8.8 ± 1.8 (50 ± 22% increase, p < 0.001). Acute hypoxia-induced cardiac pump failure reduced CP by 35 ± 6%, which was fully restored to baseline levels during IVMP-support in all hearts. Conclusion: IVMP-support improved mechanical efficiency under physiological conditions, as the marked increase in cardiac performance only resulted in a modest increase in oxygen consumption. Moreover, the IVMP rapidly restored cardiac performance under conditions of acute pump failure. These observations warrant further study, to evaluate the effects of IVMP-support in in vivo animal models of acute cardiac pump failure.

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

Cited by 3 publications

References 35 publications

Flow assessment as a function of pump timing of tubular pulsatile pump for use as a ventricular assist device in a left heart simulator

Flow assessment as a function of pump timing of tubular pulsatile pump for use as a ventricular assist device in a left heart simulator

Direct Cardiac Compression Devices to Augment Heart Biomechanics and Function

A novel intra-ventricular assist device enhances cardiac performance in normal and acutely failing isolated porcine hearts

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