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Designing an Active Valvulated Outflow Conduit for a Continuous-Flow Left Ventricular Assist Device to Increase
Valerio Cusimano1, Arianna Di Molfetta2, Gianfranco Ferrari3
1From the Istituto di Analisi dei Sistemi ed Informatica, Antonio Ruberti Consiglio Nazionale delle Ricerche, Rome, Italy.
ASAIO Journal (American Society for Artificial Internal Organs : 1992)
|April 26, 2021
Summary
This study explored increasing arterial pulsatility with a ventricular assist device (VAD) using a novel valvulated outflow cannula. Optimized configurations significantly boosted pulsatility, demonstrating potential for improved VAD therapy.
Area of Science:
- Biomedical Engineering
- Cardiovascular Devices
- Hemodynamics
Background:
- Continuous-flow ventricular assist devices (VADs) improve cardiac function but often lack pulsatility.
- Restoring arterial pulsatility is crucial for optimizing VAD therapy and patient outcomes.
Purpose of the Study:
- To investigate the feasibility of enhancing VAD-induced arterial pulsatility using an active valvulated outflow cannula.
- To model and simulate different operational modes of the VAD with the valvulated cannula.
Main Methods:
- A lumped parameter model was developed to simulate VAD performance.
- The valvulated outflow conduit was modeled as an active resistance.
- Simulations included copulsation and counterpulsation with varying VAD valve timing relative to heart rate.
Main Results:
- Specific configurations (1:1 copulsation, 0.3s-close-0.7s-open asynchrony) maximized hemodynamic benefits, increasing arterial pulsatility by up to 14.98%.
- The active valve decreased left ventricular unloading and VAD flow, which could be mitigated by increasing VAD speed.
- Arterial pulsatility enhancement was achieved without requiring left ventricular output.
Conclusions:
- An active valvulated outflow cannula can significantly increase arterial pulsatility in VADs.
- The device offers flexible working modalities and broad applicability across VAD types.
- While reducing LV unloading, VAD speed adjustments can maintain pulsatility benefits.
