Pitfalls in the development of a rotary blood pump controller.
The controller presents a major obstacle in the development of the rotary blood pump as a left ventricular assist device (LVAD). Clinically, LVAD flow is a good indicator in the regulation of circulatory conditions and pump flow changes, depending on pump preload and afterload. Many investigators have tried estimating pump flow by referencing the motor current. There have been pitfalls in in vitro experimental settings, however. Using a test loop with a pneumatically driven LV chamber and a centrifugal pump as an LVAD, we monitored pump flow and pressure head to evaluate the pump performance curve (H-Q curve). Under pulsatile LV conditions, the H-Q curve was a loop that changed, depending on LV contractility. The pneumatically driven LV chamber cannot mimic the Starling phenomenon, so the developed LV pressure does not change according to the LV preload. Rotary pump flow estimation is the most effective control method. In pulsatile conditions, however, the H-Q curve is a loop that changes under various LV contractility conditions, complicating determination of linear equation for calculating flow. In addition, the LV chamber in the test loop cannot mimic native heart contractility as described by Starling's law. This finding can lead to a misanalysis of the H-Q curve under pulsatile conditions.
Konishi
H
H
Department of Thoracic and Cardiovascular Surgery, Jichi Medical School, Tochigi, Japan.
Misawa
Y
Y
Fuse
K
K
Sohara
Y
Y
D002302:Cardiac Output; D006353:Heart-Assist Devices; D006801:Humans; D011312:Pressure; D011474:Prosthesis Design; D011673:Pulsatile Flow; D016277:Ventricular Function, Left