scholarly journals Use of Impella cardiac axial flow pump for cardiogenic shock (A newer alternative)–How good is the evidence?

BIOCELL ◽  
2022 ◽  
Vol 46 (5) ◽  
pp. 1139-1150
Author(s):  
RAFIQ AHMED BHAT ◽  
SYED MANZOOR ALI ◽  
YOOSUF ALI ASHRAF MUHAMMAD HUSSENBOCUS ◽  
AKANKSHA RATHI ◽  
JAVAID AKHTER BHAT ◽  
...  
Keyword(s):  
Cardiogenic Shock ◽  
Axial Flow ◽  
Axial Flow Pump ◽  
Flow Pump

scholarly journals Early Evaluation of Patients on Axial Flow Pump Support for Refractory Cardiogenic Shock Is Associated with Left Ventricular Recovery

2020 ◽  
Vol 9 (12) ◽  
pp. 4130
Author(s):  
Jérôme Fagot ◽  
Frédéric Bouisset ◽  
Laurent Bonello ◽  
Caroline Biendel ◽  
Thibaut Lhermusier ◽  
...  
Keyword(s):  
Cardiogenic Shock ◽  
Heart Transplant ◽  
Axial Flow ◽  
Left Ventricular ◽  
Early Screening ◽  
Early Evaluation ◽  
Factors Associated ◽  
Coronary Syndrome ◽  
Axial Flow Pump ◽  
Flow Pump

We investigated prognostic factors associated with refractory left ventricle (LV) failure leading to LV assist device (LVAD), heart transplant or death in patients on an axial flow pump support for cardiogenic shock (CS). Sixty-two CS patients with an Impella® CP or 5.0 implant were retrospectively enrolled, and clinical, biological, echocardiographic, coronarographic and management data were collected. They were compared according to the 30-day outcome. Patients were mainly male (n = 55, 89%), 58 ± 11 years old and most had no history of heart failure or coronary artery disease (70%). The main etiology of CS was acute coronary syndrome (n = 57, 92%). They presented with severe LV failure (LV ejection fraction (LVEF) 22 ± 9%), organ malperfusion (lactate 3.1 ± 2.1 mmol/L), and frequent use of inotropes, vasopressors, and mechanical ventilation (59, 66 and 30%, respectively). At 24 h, non-recovery was associated with higher total bilirubin (odds ratios (OR) 1.07 (1.00–1.14); p = 0.039), lower LVEF (OR 0.89 (0.81–0.96); p = 0.006) and the number of administrated amines (OR 4.31 (1.30–14.30); p = 0.016). Early evaluation in patients with CS with an axial flow pump implant may enable the identification of factors associated with an unlikely recovery and would call for early screening for LVAD or heart transplant.

Increased Plasma‐Free Hemoglobin Levels Identify Hemolysis in Patients With Cardiogenic Shock and a Trans valvular Micro‐Axial Flow Pump

2018 ◽  
Vol 43 (2) ◽  
pp. 125-131 ◽  
Author(s):  
Michele L. Esposito ◽  
Kevin J. Morine ◽  
Shiva K. Annamalai ◽  
Ryan O’Kelly ◽  
Nima Aghili ◽  
...  
Keyword(s):  
Cardiogenic Shock ◽  
Axial Flow ◽  
Free Hemoglobin ◽  
Axial Flow Pump ◽  
Flow Pump

scholarly journals Investigation into the Influence of Division Pier on the Internal Flow and Pulsation in the Outlet Conduit of an Axial-Flow Pump

2021 ◽  
Vol 11 (15) ◽  
pp. 6774
Author(s):  
Fan Yang ◽  
Dongjin Jiang ◽  
Tieli Wang ◽  
Pengcheng Chang ◽  
Chao Liu ◽  
...  
Keyword(s):  
Velocity Distribution ◽  
Pressure Pulsation ◽  
Axial Flow ◽  
Hydraulic Loss ◽  
Main Frequency ◽  
Starting Position ◽  
The Difference ◽  
Axial Flow Pump ◽  
Outlet Conduit ◽  
Flow Pump

The outlet conduit is an important construction connecting the outlet of the pump guide vane and the outlet pool; in order to study the hydraulic performance of the straight outlet conduit of the axial-flow pump device, this paper adopts the method of numerical simulation and analyzes the influence of the division pier on the pressure and velocity distribution inside and near the wall of the straight outlet conduit based on three design schemes. Four pressure pulsation measuring points were arranged in the straight outlet conduit, and the low-frequency pulsation characteristic information inside the straight outlet conduit with and without the division pier was extracted by wavelet packet reconstruction. The results show that the addition of a division pier has an effect on the hydraulic loss, near-wall pressure and velocity distribution in the straight outlet conduit. A small high-pressure zone is formed near the wall at the starting position of the division pier, and a large high-speed zone is formed on the left side at the starting position of the division pier. The length of the division pier has no significant effect on the flow distribution of the straight outlet conduit and the pressure and velocity distribution near the wall. Under different working conditions, each monitoring point has the maximum energy in the sub-band (0~31.25 Hz). With the increase of the flow rate, the total pressure energy of the straight outlet conduit decreases gradually. Under each condition, the difference of the energy proportion of the horizontal monitoring points of the straight outlet conduit is small, and the difference of the energy proportion of the two monitoring points at the top and bottom of the outlet channel is relatively large. The energy of the two monitoring points in the straight outlet conduit with a division pier is smaller than that of the two monitoring points in the straight outlet conduit without a division pier. There are differences in the main frequency and the power spectrum corresponding to the main frequency of the monitoring points in the straight outlet conduit, and the reasonable setting of the division pier is conducive to reducing the pressure pulsation of the flow in the straight outlet conduit and is beneficial to the safe and stable operation of the pump device.

Foetal bypass: concepts and controversies

Perfusion ◽  
1998 ◽  
Vol 13 (2) ◽  
pp. 111-117 ◽  
Author(s):  
Joseph J Sistino
Keyword(s):  
Heart Defects ◽  
Open Heart Surgery ◽  
Axial Flow ◽  
Right Atrial ◽  
Cyclooxygenase Inhibitors ◽  
Pump System ◽  
Maternal Risk ◽  
Valvular Stenosis ◽  
Axial Flow Pump ◽  
Flow Pump

One of the most controversial and challenging surgical undertakings of the next century promises to be foetal cardiac surgery. Animal studies have been underway for several years to gain an understanding of the physiological mechanisms required to achieve this undertaking. Not since the days of crosscirculation has there been a maternal risk associated with open-heart surgery. The diagnosis of congenital heart defects with foetal ultrasound can now be made as early as 12 weeks gestation. Simple cardiac abnormalities, such as valvular stenosis or atresia, alter intracardiac flow patterns and affect normal cardiac chamber development. Without early intervention, these complex lesions often require major surgical reconstruction, beginning in the neonatal period. Foetal cardiac bypass techniques have evolved from the use of roller pumps and bubble oxygenators primed with maternal blood to the use of an axial flow pump incorporated in a right atrial to pulmonary artery or aortic shunt. Because the blood entering the right atrium is oxygenated by the placenta, an oxygenator in the bypass circuit is probably not needed. The low prime axial flow pump system avoids the dilution of the foetus with the maternal adult haemoglobin and improves the outcome. A major focus of research has concentrated on maintenance of placental blood flow with the use of vasodilators and cyclooxygenase inhibitors. Investigation with primates will be necessary to confirm the placental physiology before human operations can be performed. As the foetal bypass challenges are overcome, there is the potential for a reduction in the number of complex cardiac lesions requiring early surgical intervention in the twenty-first century.

Performance evaluation of an axial-flow pump with adjustable guide vanes in turbine mode

2016 ◽  
Vol 99 ◽  
pp. 1146-1152 ◽  
Author(s):  
Zhongdong Qian ◽  
Fan Wang ◽  
Zhiwei Guo ◽  
Jie Lu
Keyword(s):  
Performance Evaluation ◽  
Axial Flow ◽  
Guide Vanes ◽  
Axial Flow Pump ◽  
Turbine Mode ◽  
Flow Pump

The Effect of the Thickness and Angle of the Inlet and Outlet Guide Vane on the Performance of Axial-Flow Pump

2016 ◽  
Author(s):  
Sang-Won Kim ◽  
Youn-Jea Kim
Keyword(s):  
Numerical Analysis ◽  
Numerical Study ◽  
Guide Vane ◽  
Axial Flow ◽  
Inlet Guide Vane ◽  
Guide Vanes ◽  
Pump Performance ◽  
Blade Thickness ◽  
Axial Flow Pump ◽  
Flow Pump

An axial-flow pump has a relatively high discharge flow rate and specific speed at a relatively low head and it consists of an inlet guide vane, impeller, and outlet guide vane. The interaction of the flow through the inlet guide vane, impeller, and outlet guide vane of the axial-flow pump has a significant effect on its performance. Of those components, the guide vanes especially can improve the head and efficiency of the pump by transforming the kinetic energy of the rotating flow, which has a tangential velocity component, into pressure energy. Accordingly, the geometric configurations of the guide vanes such as blade thickness and angle are crucial design factors for determining the performance of the axial-flow pump. As the reliability of Computational Fluid Dynamics (CFD) has been elevated together with the advance in computer technology, numerical analysis using CFD has recently become an alternative to empirical experiment due to its high reliability to measure the flow field. Thus, in this study, 1,200mm axial-flow pump having an inlet guide vane and impeller with 4 blades and an outlet guide vane with 6 blades was numerically investigated. Numerical study was conducted using the commercial CFD code, ANSYS CFX ver. 16.1, in order to elucidate the effect of the thickness and angle of the guide vanes on the performance of 1,200mm axial-flow pump. The stage condition, which averages the fluxes between interfaces and is accordingly appropriate for the evaluation of pump performance, was adopted as the interface condition between the guide vanes and the impeller. The rotational periodicity condition was used in order to enable a simplified geometry to be used since the guide vanes feature multiple identical regions. The shear stress transport (SST) k-ω model, predicting the turbulence within the flow in good agreement, was also employed in the CFD calculation. With regard to the numerical simulation results, the characteristics of the pressure distribution were discussed in detail. The pump performance, which will determine how well an axial-flow pump will work in terms of its efficiency and head, was also discussed in detail, leading to the conclusion on the optimal blade thickness and angle for the improvement of the performance. In addition, the total pressure loss coefficient was considered in order to investigate the loss within the flow paths depending on the thickness and angle variations. The results presented in this study may give guidelines to the numerical analysis of the axial-flow pump and the investigation of the performance for further optimal design of the axial-flow pump.

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