Review and reflections about pulsatile ventricular assist devices from history to future: concerning safety and low haemolysis—still needed

Köhne, Inge

doi:10.1007/s10047-020-01170-3

Cited by 8 publications

(5 citation statements)

References 85 publications

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“…In the 1990s, the application of the first successful long-term intracorporeal pulsatile assist devices dramatically changed the field of MCS therapy. Unlike previous models, these devices did not require large control consoles and constant monitoring, allowing patients to be mobile and even discharged with the device [ 13 ].…”

Section: Results Of Bridge To Transplant Lvad Therapymentioning

confidence: 99%

LVAD as a Bridge to Transplantation—Current Status and Future Perspectives

Roesel,

Nersesian,

Neuber

et al. 2024

Rev. Cardiovasc. Med.

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Heart failure (HF) is a common disease associated with high morbidity and mortality rates despite advanced pharmacological therapies. Heart transplantation remains the gold standard therapy for end-stage heart failure; however, its application is curtailed by the persistent shortage of donor organs. Over the past two decades, mechanical circulatory support, notably Left Ventricular Assist Devices (LVADs), have been established as an option for patients waiting for a donor organ. This comprehensive review focuses on elucidating the benefits and barriers associated with this application. We provide an overview of landmark clinical trials that have evaluated the use of LVADs as a bridge to transplantation therapy, with a particular focus on post-transplant outcomes. We discuss the benefits of stabilizing patients with these systems, weighing associated complications and limitations. Further technical advancements and research on optimal implantation timing are critical to ultimately improve outcomes and securing quality of life. In a world where the availability of donor organs remains constrained, LVADs are an increasingly important piece of patient care, bridging the critical gap to transplantation in advanced heart failure management.

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Section: Results Of Bridge To Transplant Lvad Therapymentioning

confidence: 99%

LVAD as a Bridge to Transplantation—Current Status and Future Perspectives

Roesel,

Nersesian,

Neuber

et al. 2024

Rev. Cardiovasc. Med.

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“…124 Nevertheless, pulsatile flow ventricular assist devices are associated with reduced hemolytic complications because of diminished shear stress on blood vessels. 125 In EVLP settings, pulsatile flow perfusion has not been studied extensively and existing data do not show significant differences between pulsatile and continuous perfusions. 110,126 Although, current evidence does not endorse the use of pulsatile pumps during EVLP, pulsatile flow perfusion merits further research especially during prolonged cEVLP to reduce hemolysis.…”

Section: Pulsatile Flow Perfusionmentioning

confidence: 99%

Technical Advances Targeting Multiday Preservation of Isolated Ex Vivo Lung Perfusion

Iskender

2024

Transplantation

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Indications for ex vivo lung perfusion (EVLP) have evolved from assessment of questionable donor lungs to treatment of some pathologies and the logistics. Yet up to 3 quarters of donor lungs remain discarded across the globe. Multiday preservation of discarded human lungs on EVLP platforms would improve donor lung utilization rates via application of sophisticated treatment modalities, which could eventually result in zero waitlist mortality. The purpose of this article is to summarize advances made on the technical aspects of the protocols in achieving a stable multiday preservation of isolated EVLP. Based on the evidence derived from large animal and/or human studies, the following advances have been considered important in achieving this goal: ability to reposition donor lungs during EVLP; perfusate adsorption/filtration modalities; perfusate enrichment with plasma and/or donor whole blood, nutrients, vitamins, and amino acids; low-flow, pulsatile, and subnormothermic perfusion; positive outflow pressure; injury specific personalized ventilation strategies; and negative pressure ventilation. Combination of some of these advances in an automatized EVLP device capable of managing perfusate biochemistry and ventilation would likely speed up the processes of achieving multiday preservation of isolated EVLP.

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“…[48] Image of the mechanical pulsatile pump is readapted from Köhne et al, and image of the soft total artificial heart is readapted with permission from Cohrs et al, 2022, John Wiley and Sons. [16,49] (VAMPs). [32] Others include dielectric elastomer actuators, [33,34] thermal actuators, [35] chemically responsive actuators, and [36] magneto-responsive actuators.…”

Section: Design Variablesmentioning

confidence: 99%

“…[ 48 ] Image of the mechanical pulsatile pump is readapted from Köhne et al., and image of the soft total artificial heart is readapted with permission from Cohrs et al., 2022, John Wiley and Sons. [ 16,49 ]…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Computational Design of a Soft Robotic Myocardium for Biomimetic Motion and Function

Park

Ozturk

Roche

2022

Adv Funct Materials

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Soft robotic devices containing multiple actuating elements have successfully recapitulated complex biological motion, leading to their utility in biomedical applications. However, there are inherent nonlinear mechanics associated with soft composite materials where soft actuators are embedded in elastomeric matrices. Predicting their overall behavior prior to fabrication and subsequent experimental characterization can therefore present a hurdle in the design process and in efficiently satisfying functional requirements and specifications. In this work, a computational design framework for optimizing the motion and function of biomimetic soft robotic composites is demonstrated by conducting a design case study of soft robotic cardiac muscle (myocardium) with a particular focus on applications including replicating and assisting cardiac motion and function. A finite element model of a soft robotic myocardium is built, in which actuators are prescribed with anisotropic strain to simulate local deformation, and various design parameters are investigated by evaluating the performance of each configuration in terms of ventricular twist, volumetric output, and pressure generation. Then, an optimized design is proposed that recapitulates the physiological motion and hemodynamics of the heart, and its thrombogenicity is further explored using a fluid-structure interaction model. This framework has broader utility in predicting the performance of other soft robotic embedded composites.

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Review and reflections about pulsatile ventricular assist devices from history to future: concerning safety and low haemolysis—still needed

Cited by 8 publications

References 85 publications

LVAD as a Bridge to Transplantation—Current Status and Future Perspectives

LVAD as a Bridge to Transplantation—Current Status and Future Perspectives

Technical Advances Targeting Multiday Preservation of Isolated Ex Vivo Lung Perfusion

Computational Design of a Soft Robotic Myocardium for Biomimetic Motion and Function

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