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High-frequency operation of a pulsatile VAD - a simulation study

Rebholz, Mathias ; Amacher, Raffael ; Petrou, Anastasios ; Meboldt, Mirko ; Schmid Daners, Marianne

In: Biomedical Engineering / Biomedizinische Technik, 2017, vol. 62, no. 2, p. 161-170

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    Titre
    • High-frequency operation of a pulsatile VAD - a simulation study
    Auteur
    • Rebholz, Mathias. pd|z Product Development Group Zurich, Department of Mechanical and Process Engineering, ETH Zurich, 8092 Zurich, Switzerland
    • Amacher, Raffael. Wyss Translational Center Zurich, ETH Zurich, 8092 Zurich, Switzerland
    • Petrou, Anastasios. pd|z Product Development Group Zurich, Department of Mechanical and Process Engineering, ETH Zurich, 8092 Zurich, Switzerland
    • Meboldt, Mirko. pd|z Product Development Group Zurich, Department of Mechanical and Process Engineering, ETH Zurich, 8092 Zurich, Switzerland
    • Schmid Daners, Marianne. pd|z Product Development Group Zurich, CLA G21.1 Tannenstr. 3, 8092 Zurich, Switzerland, Phone: +41 44 632 2447
    Type de document
    • Postprint
    Langue
    • Allemand
    Publié dans
    • Biomedical Engineering / Biomedizinische Technik, 2017, vol. 62, no. 2, p. 161-170. De Gruyter
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:333106
    Summary
    Ventricular assist devices (VADs) are mechanical blood pumps that are clinically used to treat severe heart failure. Pulsatile VADs (pVADs) were initially used, but are today in most cases replaced by turbodynamic VADs (tVADs). The major concern with the pVADs is their size, which prohibits full pump body implantation for a majority of patients. A reduction of the necessary stroke volume can be achieved by increasing the stroke frequency, while maintaining the same level of support capability. This reduction in stroke volume in turn offers the possibility to reduce the pump's overall dimensions. We simulated a human cardiovascular system (CVS) supported by a pVAD with three different stroke rates that were equal, two- or threefold the heart rate (HR). The pVAD was additionally synchronized to the HR for better control over the hemodynamics and the ventricular unloading. The simulation results with a HR of 90 bpm showed that a pVAD stroke volume can be reduced by 71%, while maintaining an aortic pulse pressure (PP) of 30 mm Hg, avoiding suction events, reducing the ventricular stroke work (SW) and allowing the aortic valve to open. A reduction by 67% offers the additional possibility to tune the interaction between the pVAD and the CVS. These findings allow a major reduction of the pVAD's body size, while allowing the physician to tune the pVAD according to the patient's needs.