Sensor-Based Physiologic Control Strategy for Biventricular Support with Rotary Blood Pumps.

Area of Science:

• Cardiovascular Engineering
• Biomedical Engineering
• Medical Devices

Background:

• End-stage biventricular failure necessitates advanced mechanical circulatory support.
• Rotary biventricular assist devices (BiVAD) offer a viable treatment option.
• Current BiVAD systems require improved control strategies for optimal efficacy and safety.

Purpose of the Study:

• To develop and validate a novel control algorithm for rotary BiVAD.
• To achieve clinical objectives: left-right balance, physiologic flows, and prevention of ventricular suction.
• To ensure device independence and applicability to existing rotary blood pumps.

Main Methods:

• Implementation of two proportional-integral (PI) controllers for left (LVAD) and right (RVAD) ventricular assist devices.
• Maintenance of differential pump pressures (ΔPL, ΔPR) for hemodynamic balance.
• Prevention of ventricular suction by managing pump speed differentials (ΔRPML, ΔRPMR).
• In silico testing under various physiological and pathological conditions, including altered resistances and ventricular fibrillation.

Main Results:

• The proposed BiVAD control algorithm successfully achieved the clinical objectives in simulations.
• The algorithm demonstrated robustness across diverse simulated scenarios, including significant changes in vascular resistance and transient load conditions.
• Continuous measurement of differential pressures (ΔPL, ΔPR) via pressure sensors was identified as a requirement for the algorithm's implementation.

Conclusions:

• The developed BiVAD control algorithm effectively meets key clinical goals for biventricular support.
• The algorithm is device-independent and adaptable to current rotary blood pump technology.
• This approach holds significant potential for enhancing the safety and efficacy of BiVAD therapy.