title: In vitro hemodynamic evaluation of ventricular suction conditions of the EVAHEART ventricular assist pump.
abstract: OBJECTIVE
  Mismatches between pump output and venous return in a continuous-flow ventricular assist device may elicit episodes of ventricular suction. This research describes a series of in vitro experiments to characterize the operating conditions under which the EVAHEART centrifugal blood pump (Sun Medical Technology Research Corp., Nagano, Japan) can be operated with minimal concern regarding left ventricular (LV) suction.
  
  
  METHODS
  The pump was interposed into a pneumatically driven pulsatile mock circulatory system (MCS) in the ventricular apex to aorta configuration. Under varying conditions of preload, afterload, and systolic pressure, the speed of the pump was increased step-wise until suction was observed. Identification of suction was based on pump inlet pressure.
  
  
  RESULTS
  In the case of reduced LV systolic pressure, reduced preload (=10 mmHg), and afterload (=60 mmHg), suction was observed for speeds=2,200 rpm. However, suction did not occur at any speed (up to a maximum speed of 2,400 rpm) when preload was kept within 10-14 mmHg and afterload=80 mmHg. Although in vitro experiments cannot replace in vivo models, the results indicated that ventricular suction can be avoided if sufficient preload and afterload are maintained.
  
  
  CONCLUSIONS
  Conditions of hypovolemia and/or hypotension may increase the risk of suction at the highest speeds, irrespective of the native ventricular systolic pressure. However, in vitro guidelines are not directly transferrable to the clinical situation; therefore, patient-specific evaluation is recommended, which can be aided by ultrasonography at various points in the course of support.
authors.affiliation: Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, Pennsylvania - USA and Department of Mathematics, Federal University of Maranhão, Maranhão - Brazil.
authors.forename: Antonio L
authors.initials: AL
authors.lastname: Ferreira
authors.forename: Yih-Choung
authors.initials: YC
authors.lastname: Yu
authors.forename: Dorian K
authors.initials: DK
authors.lastname: Arnold
authors.forename: Stijn
authors.initials: S
authors.lastname: Vandenberghe
authors.forename: Jonathan
authors.initials: J
authors.lastname: Grashow
authors.forename: Tomoya
authors.initials: T
authors.lastname: Kitano
authors.forename: David
authors.initials: D
authors.lastname: Borzelleca
authors.forename: James F
authors.initials: JF
authors.lastname: Antaki
mesh_terms: D006352:Heart Ventricles; D006353:Heart-Assist Devices; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D008955:Models, Cardiovascular; D013396:Suction; D016276:Ventricular Function / Q000502:physiology*