scholarly journals Asynchronous Pumping of a Pulsatile Ventricular Assist Device in a Pediatric Anastomosis Model

2017 ◽  
Vol 8 (4) ◽  
pp. 511-519 ◽  
Author(s):  
Bryan C. Good ◽  
William J. Weiss ◽  
Steven Deutsch ◽  
Keefe B. Manning
Keyword(s):  
Phase Shift ◽  
Continuous Flow ◽  
Power Loss ◽  
Graft Failure ◽  
Congenital Heart ◽  
Ventricular Assist Devices ◽  
Oscillatory Shear Index ◽  
Assist Device ◽  
Ventricular Assist ◽  
Aortic Anastomosis

Background: Both pulsatile and continuous flow ventricular assist devices are being developed for pediatric congenital heart defect patients. Pulsatile devices are often operated asynchronously with the heart in either an “automatic” or a fixed beat rate mode. However, most studies have only investigated synchronized ejection. Methods: A previously validated viscoelastic blood solver is used to investigate the parameters of pulsatility, power loss, and graft failure in a pediatric aortic anastomosis model. Results: Pulsatility was highest with synchronized flow and lowest at a 90° phase shift. Power loss decreased at 90° and 180° phase shifts but increased at a 270° phase shift. Similar regions of potential intimal hyperplasia and graft failure were seen in all cases but with phase-shifted ejection leading to higher wall shear stress on the anastomotic floor and oscillatory shear index on the anastomotic toe. Conclusion: The ranges of pulsatility and hemodynamics that can result clinically using asynchronous pulsatile devices were investigated in a pediatric anastomosis model. These results, along with the different postoperative benefits of pump modulation, can be used to design an optimal weaning protocol.

The Fluid Dynamic Effects Within the 12cc Penn State Pediatric Ventricular Assist Device When Altering the End Diastolic Delay

2009 ◽  
Author(s):  
Benjamin T. Cooper ◽  
Breigh N. Roszelle ◽  
Tobias C. Long ◽  
Steven Deutsch ◽  
Keefe B. Manning
Keyword(s):  
Congenital Heart Disease ◽  
Birth Defect ◽  
Congenital Heart ◽  
Fluid Dynamic ◽  
Ventricular Assist Devices ◽  
Bridge To Recovery ◽  
Dynamic Effects ◽  
Assist Device ◽  
Ventricular Assist ◽  
Penn State

Congenital heart disease is the most common and leading cause of birth-defect related deaths [1]. While many of these patients have damaged or deformed hearts that require transplantation, recovery may be possible for a select population [2]. Extracorporeal membrane oxygenation or ventricular assist devices are often used in a bridge-to-recovery situation to sustain a patient with the expectation of recovery of natural ventricular function [3].

scholarly journals Review and reflections about pulsatile ventricular assist devices from history to future: concerning safety and low haemolysis—still needed

2020 ◽  
Vol 23 (4) ◽  
pp. 303-314
Author(s):  
Inge Köhne
Keyword(s):  
Continuous Flow ◽  
Pediatric Patients ◽  
Low Cost ◽  
Ventricular Assist Devices ◽  
Assist Device ◽  
Ventricular Assist ◽  
Pump Failure ◽  
Blood Pumps ◽  
Rotary Pumps

AbstractSince the first use of a ventricular assist device in 1963 many extracorporeal and implantable pulsatile blood pumps have been developed. After the invention of continuous flow blood pumps the implantable pulsatile pumps are not available anymore. The new rotary pumps spend a better quality of life because many of the patients can go home. Nevertheless, the extracorporeal pulsatile pumps have some advantages. They are low-cost systems, produce less haemolysis and heart-recovery can be tested easily. Pump failure is easy to realize because the pumps can be observed visually. Pump exchange can be done easily without any chirurgic surgery. As volume displacement pumps they can produce high blood pressure, so they are the only ones suitable for pediatric patients. Therefore, they are indispensable for clinical use today and in the future. In this work, nearly all pulsatile blood pumps used in clinical life are described.

P3141Transvenous lead extractions in patients on continuous flow left ventricular assist device support

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
C T Starck ◽  
J J Eulert-Grehn ◽  
P Lanmueller ◽  
E Potapov ◽  
V Falk
Keyword(s):  
Left Ventricular Assist Device ◽  
Ventricular Assist Device ◽  
Continuous Flow ◽  
Left Ventricular ◽  
Ventricular Assist Devices ◽  
Lead Extraction ◽  
Bleeding Complications ◽  
Assist Device ◽  
Ventricular Assist ◽  
Left Ventricular Assist

Abstract Objectives The outcomes of transvenous lead extractions in patients with left ventricular assist device support and a cardiac implantable electronic device (CIED) are not well studied. The purpose of this study was to examine the feasibility and safety of transvenous lead extraction in this patient cohort. Methods We performed a retrospective single-center analysis of patients with a left ventricular assist device and a CIED undergoing a transvenous lead extraction procedure. Between October 2014 and November 2018 we overall performed transvenous lead extractions (TLE) of 622 leads in 286 patients. During this time period we performed transvenous lead extractions In 34 patients (mean age 60.9±9.4 years; 32 male, 2 female) with different continuous flow left ventricular assist devices (LVAD). A total of 91 leads were targeted for extraction in these LVAD patients. Indication for extraction was infection in 79.4% (n=27; systemic infection=15 (44.1%), local pocket infection n=12 (35.3%)) and lead failure in 20.6% (n=7). Mean lead implant duration was 80.7 (1–252) months. 55 pacemaker leads and 36 ICD leads (30 dual coil, 6 single coil) were extracted. Results Complete procedural success could be achieved in 86 of 91 leads (94.5%). In 79.1% (n=72) a locking stylet and a compression coil, in 73.6% (n=67) a bidirectional rotational extraction sheath was used. No operative mortality and no major complications were observed. 30-day mortality was 5.9% (n=2). Minor complications occurred in 7 patients (20.6%), mainly consisting of bleeding complications: pocket hematoma (n=5; 14.7%) and hematothorax (n=1; 2.9%). Conclusions Patients on continuous flow left ventricular assist device support represent a challenging population in many regards, especially considering the altered coagulation system and device associated infection management. TLE procedures in LVAD patients are feasible and safe, however associated with an increased risk for postoperative bleeding complications.

scholarly journals Long-term continuous flow mechanical biventricular support: 9 years and counting

2019 ◽  
Vol 30 (1) ◽  
pp. 81-84
Author(s):  
Einar Gude ◽  
Tom N Hoel ◽  
Gro Sørensen ◽  
Kaspar Broch ◽  
Anders Meyer ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Ventricular Assist Device ◽  
Continuous Flow ◽  
Left Ventricular ◽  
Ventricular Assist Devices ◽  
Left Ventricular Assist Devices ◽  
Assist Device ◽  
Ventricular Assist ◽  
Left Ventricular Assist ◽  
Right Ventricular Assist Device

Abstract We report 2 continuous flow HeartWareTM left ventricular assist devices successfully used in a patient with advanced heart failure of giant cell myocarditis origin in a biventricular configuration. Despite technical challenges of adapting a left ventricular assist device engineered for systemic pressure to function as a right ventricular assist device, the addition of dynamic banding on the right ventricular assist device outflow graft allowed successful adaptation of afterload. This patient has now been on biventricular configuration support for 9 years, and remains stable to this day.

Haemodynamic evaluation of the new pulsatile-flow generation method in vitro

2019 ◽  
Vol 43 (3) ◽  
pp. 157-164
Author(s):  
George P Itkin ◽  
Alexander S Bychnev ◽  
Arkady P Kuleshov ◽  
Alexander A Drobyshev
Keyword(s):  
Ventricular Assist Device ◽  
Pulsatile Flow ◽  
Continuous Flow ◽  
Ventricular Assist Devices ◽  
Circulatory Support ◽  
Assist Device ◽  
Ventricular Assist ◽  
Assist Devices ◽  
Mock Circulation ◽  
Flow Generation

Continuous-flow ventricular-assist devices are widely used to support patients with advanced heart failure, because continuous-flow ventricular-assist devices are more durable, have smaller sizes and have better survival rates for patients compared to the pulsatile-flow ventricular-assist devices. Nevertheless, continuous-flow ventricular-assist devices often cause complications such as gastrointestinal bleeding, haemorrhagic stroke, and aortic insufficiency and have a negative impact on the microcirculation for both long-time implantable and short-time extracorporeal systems. The aim of this study is the evaluation of the pulsatile-flow generation method in continuous-flow ventricular-assist device without pump speed changes. The method may be used for short-time extracorporeal continuous-flow mechanical circulatory support and long-time implantable mechanical circulatory support. A shunt with a controlled adjustable valve, that clamps periodically, is connected in parallel to the continuous-flow ventricular-assist device. We compared the continuous-flow ventricular-assist device operating with and without the shunt on the mock circulation loop. The continuous-flow ventricular-assist device–shunt system was connected according to the left ventricle–aorta circuit and worked in phase with the ventricle. Heart failure was simulated on the mock circulation circuit. Rotaflow (Maquet Inc.) was used as the continuous-flow pump. Haemolysis studies of the system for generating a pulse flow were carried out at a flow rate of 5 L/min and a pressure drop of 100 mm Hg. To compare the haemodynamic efficiency, we used the aortic pulsation index Ip, the equivalent energy pressure and the surplus haemodynamic energy. These indexes were higher in the pulsatile mode ( Ip – 4 times, equivalent energy pressure by 7.36% and surplus haemodynamic energy – 10 times), while haemolysis was the same. The normalised index of haemolysis was 0.0015 ± 0.001. The results demonstrate the efficiency of the pulsatile-flow generation method for continuous-flow ventricular-assist devices without impeller rotation rate changes.

Sign in / Sign up

Export Citation Format

Share Document