Physiological Control of Realheart Total Artificial Heart

Area of Science:

• Biomedical Engineering
• Cardiovascular Research
• Medical Devices

Background:

• Heart failure (HF) impacts millions globally, necessitating advanced treatments like total artificial hearts (TAHs).
• Effective TAHs must dynamically adapt to patients' varying metabolic needs for improved outcomes.
• Current TAHs require sophisticated control to ensure quality of life and longevity for end-stage HF patients.

Purpose of the Study:

• To evaluate the physiological control performance of the Realheart TAH.
• To assess the TAH's ability to maintain hemodynamic stability across diverse physiological states.
• To test the controller's adaptability under challenging conditions like increased pulmonary vascular resistance (PVR).

Main Methods:

• Utilized a hybrid mock circulation loop simulating dynamic physiological states (sleep, rest, exercise).
• Employed a preload-based control mechanism adjusting heart rate (HR) and stroke volume (SV) based on atrial pressure.
• Tested controller robustness under varying PVR to assess flow balance and pressure regulation.

Main Results:

• The Realheart TAH maintained ventricular flow balance and stabilized atrial pressures across all tested conditions.
• Cardiac output (CO) increased up to 2.1 times during simulated exercise with the controller, compared to 1.2 times without.
• The controller minimized CO fluctuations during sleep (5% decrease vs. 25% without) and managed increased PVR to prevent atrial pressure overload.

Conclusions:

• The Realheart TAH's physiological control system adeptly adapts to physiological transitions, demonstrating potential for advanced HF treatment.
• The device autonomously adjusts to patient needs, showing promise for enhancing quality of life.
• Further optimization of the control system is planned to improve responsiveness during rapid physiological changes.