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Generating pulsatility by pump speed modulation with continuous-flow total artificial heart in awake calves
Kiyotaka Fukamachi1, Jamshid H Karimov2, Gengo Sunagawa3
1Cardiovascular Dynamics Laboratory, Department of Biomedical Engineering/ND20, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA. fukamak@ccf.org.
Insights
Modulating the speed of the Cleveland Clinic continuous-flow total artificial heart (CFTAH) in calves successfully generated pulsatility. This research demonstrates a method for assessing the hemodynamic effects of artificial heart pulsatility.
Area of Science:
- Biomedical Engineering
- Cardiovascular Physiology
Background:
- Continuous-flow total artificial hearts (CFTAH) lack pulsatility, a natural feature of the native heart.
- Restoring pulsatility may improve device performance and patient outcomes.
Purpose of the Study:
- To evaluate the impact of sinusoidal pump speed modulation in a CFTAH on hemodynamics and pump flow.
- To assess the feasibility of generating pulsatility using CFTAH speed modulation in an awake animal model.
Main Methods:
- Sinusoidal pump speed modulation (±15% and ±25% of mean speed at 80 bpm) was applied to CFTAH devices in four awake calves.
- Hemodynamic parameters including systemic and pulmonary arterial pulse pressures, pulsatility index, and surplus hemodynamic energy were measured.
Main Results:
- Systemic and pulmonary arterial pulse pressures significantly increased with increasing modulation.
- Pulsatility index and surplus hemodynamic energy showed substantial increases at ±15% and ±25% speed modulation.
- Feasible generation of pressure pulsatility was achieved through pump speed modulation.
Conclusions:
- Sinusoidal pump speed modulation is a viable method for introducing pulsatility into CFTAH devices.
- The CFTAH platform facilitates evaluation of pulsatility's physiological impact.
- This approach allows for optimization of speed modulation parameters (magnitude, frequency, profile).
Abstract:
The purpose of this study was to evaluate the effects of sinusoidal pump speed modulation of the Cleveland Clinic continuous-flow total artificial heart (CFTAH) on hemodynamics and pump flow in an awake chronic calf model. The sinusoidal pump speed modulations, performed on the day of elective sacrifice, were set at ±15 and ± 25% of mean pump speed at 80 bpm in four awake calves with a CFTAH. The systemic and pulmonary arterial pulse pressures increased to 12.0 and 12.3 mmHg (±15% modulation) and to 15.9 and 15.7 mmHg (±25% modulation), respectively. The pulsatility index and surplus hemodynamic energy significantly increased, respectively, to 1.05 and 1346 ergs/cm at ±15% speed modulation and to 1.51 and 3381 ergs/cm at ±25% speed modulation. This study showed that it is feasible to generate pressure pulsatility with pump speed modulation; the platform is suitable for evaluating the physiologic impact of pulsatility and allows determination of the best speed modulations in terms of magnitude, frequency, and profiles.