The Lavare Cycle: A Novel Pulsatile Feature of the HVAD Continuous-Flow Left Ventricular Assist Device

Kumar, Julia; Elhassan, Amir; Dimitrova, Galina; Essandoh, Michael

doi:10.1053/j.jvca.2018.11.029

Cited by 16 publications

(12 citation statements)

References 2 publications

(2 reference statements)

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“…84 HVAD Lavare cycle is a speed modulation algorithm, and has shown promising clinical performance with significantly lower stroke, sepsis, and RHF rate. 85 However, speed modulation of continuous-flow blood pumps doesn’t generate sufficient pulsatility. 8 Furthermore, the drastic acceleration and deceleration will introduce additional shear stress, which may increase blood damage.…”

Section: Discussionmentioning

confidence: 99%

A review of implantable pulsatile blood pumps: Engineering perspectives

Khir

Kütting

et al. 2020

Int J Artif Organs

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It has been reported that long-term use of continuous-flow mechanical circulatory support devices (CF-MCSDs) may induce complications associated with diminished pulsatility. Pulsatile-flow mechanical circulatory support devices (PF-MCSDs) have the potential of overcoming these shortcomings with the advance of technology. In order to promote in-depth understanding of PF-MCSD technology and thus encourage future mechanical circulatory support device innovations, engineering perspectives of PF-MCSD systems, including mechanical designs, drive mechanisms, working principles, and implantation strategies, are reviewed in this article. Some emerging designs of PF-MCSDs are introduced, and possible elements for next-generation PF-MCSDs are identified.

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Section: Discussionmentioning

confidence: 99%

A review of implantable pulsatile blood pumps: Engineering perspectives

Khir

Kütting

et al. 2020

Int J Artif Organs

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“…In this study, the operating speed of HM3 was set to 5200 rpm. Lavare cycle in Heartware HVAD was set by decreasing the pump operating speed by 200 rpm for 2 s and increasing by 400 rpm in the following 1 s over each 60 s cycle [24]. Artificial pulse in the HM3 device was simulated by decreasing the pump speed by 2000 rpm for 0.15 s, then increasing it by 4000 rpm for 0.20 s, before operating HM3 at the set speed over each 2 s cycle [25].…”

Section: Methodsmentioning

confidence: 99%

Computational Evaluation of Cardiac Function in Children Supported with Heartware VAD, HeartMate 2 and HeartMate 3 Left Ventricular Assist Devices

2022

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Heart failure is one of the principal causes of morbidity and mortality in children. Treatment techniques may not work, and heart transplantation may be required as a result. The current state of donor-organ supply means that many patients cannot undergo transplantation. In these patients, ventricular assist devices (VADs) may be used to bridge the time until the transplantation. Continuous-flow VADs are increasingly being implanted to paediatric patients. The aim of this study was to evaluate cardiac function in children supported with Heartware HVAD, HeartMate2 and HeartMate3 devices using computational simulations. A lumped-parameter model simulating cardiac function in children around 12 years of age was used to simulate dilated cardiomyopathy and heart-pump support. The operating speeds in HVAD, HeartMate2 and HeartMate3 were selected as 2600 rpm, 8700 rpm and 5200 rpm constant speed, respectively, while the Lavare cycle and artificial-pulse modes were used to generate mean pump outputs at around 4.40 L/min and mean arterial pressures at around 82 mmHg in each device. Aortic pulse pressure was 11 mmHg, 14 mmHg and 6 mmHg under HVAD, HeartMate2 and HeartMate3 support, respectively. HVAD’s Lavare cycle and HeartMate3’s artificial pulse increased aortic pulse pressure to 15 mmHg and 20 mmHg. HeartMate3 with artificial-pulse mode may be more beneficial in reducing arterial-pulsatility-associated problems.

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“…The only setting that clinicians can adjust on an LVAD is the speed of the motor in revolutions per minute (RPM). Both third‐generation LVADs have preprogrammed features that periodically vary clinician‐set RPMs in order to decrease stagnant areas of blood in the left ventricle 15,17 . Based on the patient's cardiovascular dynamics, several dependent variables are recorded by the LVAD system.…”

Section: Lvad Parametersmentioning

confidence: 99%

Continuous‐flow left ventricular assist devices: Management in the emergency department

Hockstein

2020

JACEP Open

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With an increasing number of left ventricular assist devices (LVADs) being placed every year, emergency clinicians are increasingly likely to encounter them in their practice. Patients may present to the emergency department (ED) with significant hemodynamic perturbations with an LVAD and it is imperative that emergency clinicians are able to assess and treat conditions contributing to low cardiac output states. This review describes the important aspects of the third generation of LVADs and their complications as well as common management approaches for the emergency physician.

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The Lavare Cycle: A Novel Pulsatile Feature of the HVAD Continuous-Flow Left Ventricular Assist Device

Abstract: The effect of inhaled milrinone versus levosimendan in pulmonary hypertension patients undergoing mitral valve surgery À a pilot randomized double-blind study.

Cited by 16 publications

References 2 publications

A review of implantable pulsatile blood pumps: Engineering perspectives

A review of implantable pulsatile blood pumps: Engineering perspectives

Computational Evaluation of Cardiac Function in Children Supported with Heartware VAD, HeartMate 2 and HeartMate 3 Left Ventricular Assist Devices

Continuous‐flow left ventricular assist devices: Management in the emergency department

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