An innovative, sensorless, pulsatile, continuous-flow total artificial heart: device design and initial in vitro study.
BACKGROUND
We are developing a very small, innovative, continuous-flow total artificial heart (CFTAH) that passively self-balances left and right pump flows and atrial pressures without sensors. This report details the CFTAH design concept and our initial in vitro data.


METHODS
System performance of the CFTAH was evaluated using a mock circulatory loop to determine the range of systemic and pulmonary vascular resistance (SVR and PVR) levels over which the design goal of a maximum absolute atrial pressure difference of 10 mm Hg is achieved for a steady-state flow condition. Pump speed was then modulated at 2,600 +/- 900 rpm to induce flow and arterial pressure pulsation to evaluate the effects of speed pulsations on the system performance. An automatic control mode was also evaluated.


RESULTS
Using only passive self-regulation, pump flows were balanced and absolute atrial pressure differences were maintained at <10 mm Hg over a range of SVR (750 to 2,750 dyne.sec.cm(-5)) and PVR (135 to 600 dyne.sec.cm(-5)) values far exceeding normal levels. The magnitude of induced speed pulsatility affected relative left/right performance, allowing for an additional active control to improve balanced flow and pressure. The automatic control mode adjusted pump speed to achieve targeted pump flows based on sensorless calculations of SVR and CFTAH flow.


CONCLUSIONS
The initial in vitro testing of the CFTAH with a single, valveless, continuous-flow pump demonstrated its passive self-regulation of flows and atrial pressures and a new automatic control mode.
Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio 44195, USA.
Kiyotaka
K
Fukamachi
David J
DJ
Horvath
Alex L
AL
Massiello
Hideyuki
H
Fumoto
Tetsuya
T
Horai
Santosh
S
Rao
Leonard A R
LA
Golding
D000465:Algorithms; D001243:Assisted Circulation / Q000295:instrumentation*; D001794:Blood Pressure; D004867:Equipment Design; D006354:Heart, Artificial / Q000639:trends*; D006353:Heart-Assist Devices / Q000639:trends*; D066298:In Vitro Techniques; D011673:Pulsatile Flow; D014655:Vascular Resistance