Real World Experience with an Optimized Control Scheme for a Ventricular Assist Device

2020 ◽  
Vol 6 (3) ◽  
pp. 307-310
Author(s):  
Robert Steingräber ◽  
Matthias Kiesner
Keyword(s):  
Power Consumption ◽  
Real World ◽  
Pneumatic Cylinder ◽  
Real World Data ◽  
Assist Device ◽  
Ventricular Assist ◽  
Loop Control ◽  
Control Scheme ◽  
Online Verification ◽  
Valve Model

AbstractA closed-loop control software for the new mobile Berlin Heart EXCORR driving unit was optimized to balance usability, durability, pump wash out, blood stress and power consumption. The piston of the electro-pneumatic cylinder is moved on a pump-cannula-specific trajectory. A friction and a valve model are adapted online. Verification and real world data show constant flow, low power consumption and the adherence of all limits.

OP248 A Minimum Data-Set For Left Ventricular Assist Device On Destination Therapy: Cross-Border Collaboration Pilot On Real World Data

2021 ◽  
Vol 37 (S1) ◽  
pp. 9-9
Author(s):  
Leonor Varela-Lema ◽  
Janet Puñal-Rioboo ◽  
María José Faraldo Vallés
Keyword(s):  
Real World ◽  
Left Ventricular ◽  
Real World Data ◽  
Assist Device ◽  
Data Set ◽  
Ventricular Assist ◽  
World Data ◽  
Cross Border ◽  
Minimum Data ◽  
Left Ventricular Assist

IntroductionThe European Health Technology Assessment Network (EUnetHTA) Work Package 5B1, is focused on testing the levels of cross-border collaboration on real world data for supporting reimbursement/pricing decision-making. Within this Work Package, we are conducting a pilot on Left Ventricular Assist Device on destination therapy in collaboration with the National Institute for Health and Care Excellence (NICE, UK), the Belgian Health Care Knowledge Centre (KCE, Belgium) and the Italian National Agency for Regional Health Services (AGENAS, Italy). This pilot aims to define the minimum data set for gathering and sharing high quality registry data on key uncertainties found at the time of the health technology assessment (HTA). Furthermore, the pilot will assess the feasibility of carrying out a common analysis or reusing this data for National or Joint Reassessments.MethodsEvidence gaps were based on the four national assessments. Collaborating partners were responsible for agreeing on the key outcomes and proposing the minimum dataset to be registered. European clinical experts and patients rated and prioritized the dataset using a two round Delphi technique (not relevant, important but not critical; critical). The dataset will confirm the basis for the Spanish LVAD registry, implemented at the national health service level to inform inclusion into the healthcare portfolio.ResultsThe key outcomes agreed upon by agencies relate to safety, effectiveness, satisfaction and acceptability of the patient and cost-effectiveness, budget impact and organizational impact. Expert cardiologists and cardiac surgeons representing the European and Spanish Society, among others, participated in the prioritization of basic data. The final dataset is expected by December 2020.ConclusionsThe variation in the quality and definition of outcome measures for measuring key evidence gaps reduces the utility of registries for HTA, making it difficult to compare, link, and aggregate data across countries. The EUnetHTA pilot is intended to offer a model for cross-border collaboration on real world data for supporting the decision-making process for pricing and reimbursement.

scholarly journals Organic Dissemination and Real-World Implementation of Patient Decision Aids for Left Ventricular Assist Device

2018 ◽  
Vol 3 (1) ◽  
pp. 238146831876765 ◽  
Author(s):  
Jocelyn S. Thompson ◽  
Daniel D. Matlock ◽  
Megan A. Morris ◽  
Colleen K. McIlvennan ◽  
Larry A. Allen
Keyword(s):  
Decision Making ◽  
Left Ventricular Assist Device ◽  
Real World ◽  
Decision Aids ◽  
Left Ventricular ◽  
Shared Decision ◽  
Assist Device ◽  
Ventricular Assist ◽  
Patient Decision ◽  
Left Ventricular Assist

Background. Although patient decision aids (PtDAs) have been shown to improve patient knowledge and satisfaction, they are infrequently used in the real world. We aimed to understand how our publicly available PtDAs developed for destination therapy left ventricular assist device (DT LVAD) were implemented in clinical practice and characterize factors influencing adoption. Methods. We contacted 39 people, 31 who had independently emailed inquiring about our DT LVAD PtDAs and 8 identified through snowball sampling. Thirty people from 23 programs participated in semistructured interviews, which were analyzed using normalization process theory. Results. Eleven programs currently use the PtDAs, 5 plan to use them but have not yet, and 7 do not currently use them nor have active plans to use them. Due to major tradeoffs and preference sensitivity of the DT LVAD decision, participants recognized a role for shared decision making and a need for significant information transfer. Due to a relative lack of resources, participants saw the PtDAs as a way to help facilitate a higher quality decision-making process. Limited time, lack of personnel, and perceived burden to implementing system-level change were cited as barriers to use. Initial implementation was accomplished by a champion of the PtDAs. Actual use of the PtDAs most commonly occurred through LVAD coordinators at the start of formal patient teaching sessions, where the PtDAs could be integrated into the existing LVAD consent and education structure. Conclusion. Interest in and implementation of PtDAs occurred independently at several LVAD programs due to a favorable decisional context, including a perceived role for shared decision making in the high-stakes decision around DT LVAD, unmet informational needs, preexisting education sessions, and invested clinical champions.

A Novel Output Feedback Pusher Plate Controller for the Penn State Electric Ventricular Assist Device

1989 ◽  
Vol 111 (1) ◽  
pp. 69-74 ◽  
Author(s):  
U. Tsach ◽  
D. B. Geselowitz ◽  
A. Sinha ◽  
H. K. Hsu
Keyword(s):  
Power Consumption ◽  
Electric Power ◽  
Ventricular Assist Device ◽  
Output Feedback ◽  
Feedback Gain ◽  
Gain Function ◽  
Assist Device ◽  
Ventricular Assist ◽  
Output Feedback Controller ◽  
Penn State

This paper addresses the development of an output feedback controller for the Penn State Electric Ventricular Assist Device (EVAD). The control law is designed to minimize the electric power consumption of the motor, while utilizing the measured pusher plate position as its only feedback signal. The control algorithm results in a suboptimal performance. The feedback gain function is calculated such that the expected value of the deviations between the suboptimal and full state feedback power consumption values is minimized. The system state initial conditions are treated as random variables with specified probability density functions. Numerical simulations indicate that the output feedback controller of the EVAD has a near optimum performance (the excessive electric power consumption is less than 1 percent), and a time shift manipulation of a single feedback gain function can drive the EVAD in various speeds with minimal energy losses.

Derived and Displayed Power Consumption, Flow, and Pulsatility Over a Range of HeartMate II Left Ventricular Assist Device Settings

ASAIO Journal ◽  
2012 ◽  
Vol 58 (3) ◽  
pp. 183-190 ◽  
Author(s):  
Lars H. Lund ◽  
Anders Gabrielsen ◽  
Linnea Tirén ◽  
Ann Hallberg ◽  
Kerstin El Karlsson ◽  
...  
Keyword(s):  
Power Consumption ◽  
Left Ventricular Assist Device ◽  
Ventricular Assist Device ◽  
Left Ventricular ◽  
Assist Device ◽  
Heartmate Ii ◽  
Ventricular Assist ◽  
Left Ventricular Assist

An Output Feedback Pusher Plate Controller for the Penn State Electric Ventricular Assist Device: Stability Analysis

1990 ◽  
Vol 112 (4) ◽  
pp. 696-702
Author(s):  
U. Tasch ◽  
G. K. Klute ◽  
D. B. Geselowitz
Keyword(s):  
Ventricular Assist Device ◽  
Output Feedback ◽  
Electric Energy ◽  
Feedback Signal ◽  
Assist Device ◽  
Ventricular Assist ◽  
Optimal Output ◽  
Beat Rate ◽  
Control Scheme ◽  
Penn State

The development of an optimal output feedback controller for the Penn State electric ventricular assist device (EVAD) is addressed. The controller is designed to minimize the electric energy consumption of the EVAD, while utilizing the measured pusher plate position as the only feedback signal. The controller incorporates statistical information of the targeted patient population and optimizes the expected value of the system performance. The present paper shows that the optimal output feedback control scheme is asymptotically stable when the EVAD operates in a steady beat rate mode, and bounded-input/bounded-output stable when the beat rate undergoes a transient. Since the EVAD operates in either steady or transient beat rate modes, this optimal control scheme is stable.

scholarly journals HeartWare ventricular assist device experience in the real world

2013 ◽  
Vol 45 (4) ◽  
pp. 765-765 ◽  
Author(s):  
P. N. Mohite ◽  
A. F. Popov ◽  
A. Sabashnikov ◽  
A. R. Simon
Keyword(s):  
Ventricular Assist Device ◽  
Real World ◽  
Assist Device ◽  
Ventricular Assist ◽  
The Real
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