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Generation of Pulsatile Flow using Clinical Continuous Flow Pumps.

Joav Birjiniuk1, Deane E Smith2, Eugene A Grossi2

  • 1Department of Surgery, New York University Langone Medical Center, New York, New York.

JHLT Open
|March 27, 2025
PubMed
Summary
This summary is machine-generated.

Generating pulsatile flow from continuous flow devices is challenging due to viscous effects. New positive displacement pumps are needed to create physiologic pulsatile flow and improve mechanical circulatory support safety.

Keywords:
continuous flowfluid mechanicsmechanical circulatory supportpulsatile flow

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Area of Science:

  • Biomedical Engineering
  • Cardiovascular Physiology

Background:

  • Mechanical circulatory support (MCS) is increasingly used for long-term cardiopulmonary function augmentation.
  • Current MCS devices face risks like pump thrombosis, failure, inadequate ventricular unloading, right-sided dysfunction, and end-organ hypoperfusion.
  • Generating pulsatile flow is proposed to mitigate these risks by mimicking natural physiologic flow and pressure profiles.

Purpose of the Study:

  • To describe efforts in generating pulsatile flow with continuous flow devices.
  • To present mechanical arguments regarding challenges in achieving physiologic pulsatile flow.
  • To highlight the need for novel pulsatile pump designs.

Main Methods:

  • Review of prior literature and textbooks to establish theoretical basis.
  • Analysis of mechanical challenges associated with modifying continuous flow devices for pulsatility.

Main Results:

  • Attempts to create pulsatile flow from continuous flow devices are hindered by viscous effects in oscillating systems.
  • Existing devices and research setups cannot generate truly physiologic pulsatile flow.
  • New devices employing positive displacement are required to mimic native heart waveforms.

Conclusions:

  • Mechanical challenges in generating pulsatile flow with continuous flow devices limit clinical adoption.
  • Development of new pulsatile pumps is essential for achieving adequate physiologic pulsatility.
  • Improved pulsatile pumps could lead to a better side-effect profile in mechanical circulatory support.