Robust physiological control of rotary blood pumps for heart failure therapy

2018 ◽  
Vol 66 (9) ◽  
pp. 767-779 ◽  
Author(s):  
Daniel Rüschen ◽  
Sebastian Opitz ◽  
Philip von Platen ◽  
Leonie Korn ◽  
Steffen Leonhardt ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiovascular System ◽  
Left Ventricular ◽  
Ventricular Assist Devices ◽  
Heart Failure Therapy ◽  
Physiological Control ◽  
Detailed Model ◽  
Blood Pumps ◽  
Rotary Blood Pumps ◽  
Varying Demand

Abstract Left ventricular assist devices (LVADs) have become a viable alternative to heart transplantation in heart failure therapy. In clinical practice, rotary blood pumps used as LVADs are operated at a constant rotational speed and thus do not adapt to the varying demand of the patient. This paper presents a robust control approach for automatic adaptation of the blood pump speed to the blood flow demand of the patient’s body, which enables a defined load sharing between an LVAD and the native ventricle. Robust stability was checked using a detailed model of the human cardiovascular system with uncertainties that describe the most important native physiological control loops as well as a range of pathologies. The robust assistance controller was tested in an in vivo setup and was able to stabilize the cardiovascular system after myocardial infarction.

scholarly journals Stochastic Modeling and Dynamic Analysis of the Cardiovascular System with Rotary Left Ventricular Assist Devices

2019 ◽  
Vol 2019 ◽  
pp. 1-18 ◽  
Author(s):  
Jeongeun Son ◽  
Dongping Du ◽  
Yuncheng Du
Keyword(s):  
Heart Failure ◽  
Cardiac Output ◽  
Pump Power ◽  
Aortic Valve ◽  
Cardiovascular System ◽  
Left Ventricular ◽  
Ventricular Assist Devices ◽  
Left Ventricular Assist Devices ◽  
Ventricular Assist ◽  
Left Ventricular Assist

Left ventricular assist devices (LVADs) have been used for end-stage heart failure patients as a therapeutic option. The aortic valve plays a critical role in heart failure and its treatment with a LVAD. The cardiovascular-LVAD model is often used to investigate the physiological demands required by patients and predict the hemodynamic of the native heart supported with a LVAD. As it is a “bridge-to-recovery” treatment, it is important to maintain appropriate and active dynamics of the aortic valve and the cardiac output of the native heart, which requires that the LVAD pump be adjusted so that a proper balance between the blood contributed through the aortic valve and the pump is maintained. In this paper, we investigate how the pump power of the LVAD pump can affect the dynamic behaviors of the aortic valve for different levels of activity and different severities of heart failure. Our objective is to identify a critical value of the pump power (i.e., breakpoint) to ensure that the LVAD pump does not take over the pumping function in the cardiovascular-pump system and share the ejected blood with the left ventricle to help the heart to recover. In addition, the hemodynamic often involves variability due to patients’ heterogeneity and the stochastic nature of the cardiovascular system. The variability poses significant challenges to understanding dynamic behaviors of the aortic valve and cardiac output. A generalized polynomial chaos (gPC) expansion is used in this work to develop a stochastic cardiovascular-pump model for efficient uncertainty propagation, from which it is possible to rapidly calculate the variance in the aortic valve opening duration and the cardiac output in the presence of variability. The simulation results show that the gPC-based cardiovascular-pump model is a reliable platform that can provide useful information to understand the effect of the LVAD pump on the hemodynamic of the heart.

scholarly journals Physiological Control Law for Rotary Blood Pumps with Full-State Feedback Method

2019 ◽  
Vol 9 (21) ◽  
pp. 4593
Author(s):  
Mohsen Bakouri
Keyword(s):  
Blood Volume ◽  
State Feedback ◽  
Left Ventricular ◽  
State Feedback Control ◽  
Control Law ◽  
Physiological Control ◽  
Blood Pumps ◽  
Full State ◽  
Full State Feedback ◽  
Rotary Blood Pumps

One concern about pulsatile rotary blood pumps is their physiological controller reactions when “venous return” changes. When a patient rises from a supine to a standing position, the blood volume in the leg veins is raised, owing to vasodilation, thus venous returns to the right atrium, and consequently, the left atrium is reduced. In this work, a physiological control law using a full-state feedback control method was developed in order to drive mechanical circulatory support. This strategy was used as a validated state-space pump model, to implement the controller and regulate the desired reference flow. The control law was assessed using a software model of the hemodynamical cardiovascular system interacting with the left ventricular assist device in different physiological conditions ranging from rest to exercise scenarios. Under these scenarios, heart failure disease was simulated by changing the hemodynamic parameters of the total blood volume, heart rate, cardiac contractility, and systemic peripheral resistance. The results were numerically observed during the postural changes. The rate of change in the physiological variables showed that the proposed control law can regulate the desired reference pump flow with minimal error within the acceptable clinical range in order to prevent suction and over perfusion.

Two implantable rotary blood pumps for biventricular heart failure

2013 ◽  
Vol 61 (S 01) ◽  
Author(s):  
T Krabatsch ◽  
E Hennig ◽  
E Potapov ◽  
A Stepanenko ◽  
T Drews ◽  
...  
Keyword(s):  
Heart Failure ◽  
Blood Pumps ◽  
Rotary Blood Pumps
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