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Control strategy for biventricular assistance with mixed-flow pumps
1Second Department of Surgery, Medical Informatics, and Intensive Care Division, Miyazaki Medical College, Miyazaki, Japan.
Artificial Organs
|September 6, 2000
Summary
This study introduces a novel control strategy for biventricular assist devices (BVADs) using rotary pumps in severe heart failure. The method effectively prevents ventricular collapse and allows for automatic weaning of the right ventricular assist device (RVAD).
Area of Science:
- Cardiovascular Surgery
- Biomedical Engineering
- Mechanical Circulatory Support
Background:
- Left ventricular assist devices (LVADs) are crucial for managing severe heart failure.
- Biventricular assist devices (BVADs) are sometimes necessary, but control strategies for rotary pump BVADs are not well-established.
- Effective control is needed to prevent complications like ventricular collapse.
Purpose of the Study:
- To investigate and demonstrate an in vivo control strategy for biventricular assist devices (BVADs) utilizing rotary pumps.
- To establish a method for detecting and preventing ventricular collapse during BVAD support.
- To assess the feasibility of automatic weaning for the right ventricular assist device (RVAD) component.
Main Methods:
- A biventricular assist device (BVAD) was surgically implanted in 5 piglets via left thoracotomy.
- Global ischemia was induced for 30 minutes by aortic base clamping, followed by 6 hours of reperfusion and device support.
- A control strategy was implemented, targeting LVAD flow and limiting RVAD speed to prevent atrial collapse, using motor current waveform analysis to detect collapse.
- Ventricular collapse was monitored indirectly by analyzing motor current amplitude and mean current values.
Main Results:
- The developed control strategy successfully managed BVAD function during reperfusion in a porcine model.
- The method effectively prevented right and left ventricular collapse throughout the 6-hour observation period.
- In all cases, the right ventricular assist device (RVAD) was weaned automatically, indicating successful recovery or adaptation.
Conclusions:
- The proposed control strategy is effective for managing biventricular assist devices (BVADs) with rotary pumps.
- Monitoring motor current provides a viable, sensor-less method for detecting and preventing ventricular collapse.
- This approach facilitates automatic weaning of the RVAD, simplifying management in severe heart failure patients.