Regulation of Pneumatic Total Artificial Heart Function: A Review

Ph, Deleuze; Jb, Riebman; R, De Paulis; Olsen, D. B.; Dy, Loisance

doi:10.1177/039139888801100303

Cited by 8 publications

(2 citation statements)

References 8 publications

(8 reference statements)

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“…Others have done an excellent job of documenting the current state of TAH and VAD research and control mechanisms (16,17). We would like to present a new concept for multitiered control of cardiac assist and replacement devices orchestrated by a microprocessor with multiple sensory inputs.…”

mentioning

confidence: 99%

Physiologic Control of Cardiac Assist Devices

1996

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Total artificial hearts (TAHs) and biventricular assist devices (BVADs) have varying levels of acceptance and reliability, and the research on both focuses on their control mechanisms. Efforts generally aim to achieve a response to physiologic demand and left/right output balance, and beneficial cardiac output (CO) and effective control mechanisms have been achieved by eliciting a Starting-like response to preload and afterload. Such control mechanisms, however, generally base device output on a single parameter, such as the preload on the heart. Current TAHs and BVADs provide relatively fixed oxygen delivery to patients with large physiologically induced variations in oxygen consumption. This paper aims to document fluctuations in oxygen consumption that are normal in BVAD and TAH patients, identify a number of patient-generated signals that reflect these fluctuations, and describe a multitiered control algorithm based upon these signals. Such a control system may offer better response times and more physiologic cardiac outputs. There currently exists a microprocessor-based control mechanism that can be adapted to control TAHs and BVADs using input from a variety of sensors, and it can be found in modern implantable pulse generators (IPGs). Today's pacemakers are capable of rate control and can run diagnostic programs and store data that could be valuable in the evaluation of the patient's condition.

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confidence: 99%

Physiologic Control of Cardiac Assist Devices

1996

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“…However, the control of the TAH operation is disconnected from this loop. Several physiological problems have been reported in the recipients or experimental animals implanted with TAHs, and it has been pointed out that one of the important factors responsible for such disorders is the mismatched flow supply of the TAH for the recipients' flow demands ( 1, 2). Therefore, to prevent abnormal reactions, the TAH output should meet the recipients' flow demands and metabolic needs.…”

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confidence: 99%

The Development of a Control Method for a Total Artificial Heart Using Mixed Venous Oxygen Saturation

et al. 1999

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For physiological control of a total artificial heart (TAH), applying mixed venous oxygen saturation (SVO2) as a parameter for TAH control is a promising approach regarding sensitivity to the recipient's oxygen demand and the practical possibility of continuous monitoring using near infrared rays through transparent blood pump housings. To develop a control method for the TAH using SVO2, the relationship between SVO2 and cardiac output (CO) was investigated in a normal calf, and a control algorithm was developed based on this correlation. Then the feasibility of this method (SVO2 mode) was evaluated in a calf implanted with a pneumatic TAH and compared with the fixed drive control mode (fixed mode) in which the drive parameters were unchanged. The calf performed a graded exercise test in both modes. The CO was effectively increased from 7.3 to 13.0 L/min in the SVO2 mode, and the capacity for exercise was augmented compared to the fixed mode. We conclude that this SVO2 mode is feasible and may be effectively applied in TAH control.

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