Effect of a delay mode of a ventricular assist device on hemodynamics of the cardiovascular system_Journal of Biomedical Engineering

Authors：

REN Yiliang ¹ , WANG Shaojun ¹ , GAO Yu ¹ , LI Zijian ¹ , ZHANG Yao ² ,  WANG Fangqun ¹

1. School of Electrical and Information Engineering, Jiangsu University, Zhenjiang, Jiangsu 212013, P. R. China;
2. School of Medical Imaging, North Sichuan Medical College, Nanchong, Sichuan 637000, P. R. China;

Corresponding author：

WANG Fangqun, Email: lingo@ujs.edu.cn

Keywords：

Ventricular assist device; Numerical simulation; Delay assist; Hemodynamics; Aortic valve function

DOI：

10.7507/1001-5515.202109043

Video：

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The implantation of biventricular assist device (BiVAD) is more challenging than that of left ventricular assist device for the interaction in the process of multiple input and output. Besides, ventricular assist device (VAD) often runs in constant speed (CS) mode in clinical use and thus BiVAD also faces the problems of low pulsation and imbalance of blood volume between systemic circulation and pulmonary circulation. In this paper, a delay assist mode for a VAD by shortening the support time of VAD was put forward. Then, the effect of the delay mode on cardiac output, pulsation and the function of the aortic valve was observed by numerical method and the rules of hemodynamics were revealed. The research showed that compared with VAD supported in CS mode, the VAD using delay mode in systolic and diastolic period proposed in this paper could meet the demand of cardiac output perfusion and restore the function of the arterial valves. The open ratio of aortic valve (AV) and pulmonary valve (PV) increased with the time set in delay mode, and the blood through the AV/PV helped to balance the left and the right cardiac volume. Besides, delay mode also improved the pulsation index of arterial blood flow, which is conducive to the recovery of the ventricular pulse function of patients.

Citation： REN Yiliang, WANG Shaojun, GAO Yu, LI Zijian, ZHANG Yao, WANG Fangqun. Effect of a delay mode of a ventricular assist device on hemodynamics of the cardiovascular system. Journal of Biomedical Engineering, 2022, 39(2): 329-338. doi: 10.7507/1001-5515.202109043 Copy

1.	吕鹏飞, 刘盛. 连续血流左心室辅助装置的发展现状. 临床和实验医学杂志, 2019, 18(8): 894-897.
2.	Ogawa D, Kobayashi S, Yamazaki K, et al. Evaluation of cardiac beat synchronization control for a rotary blood pump on valvular regurgitation with a mathematical model. Artif Organs, 2020, 45(2): 124-134.
3.	Faragallah G, Simaan M. An engineering analysis of the aortic valve dynamics in patients with rotary left ventricular assist devices. J Healthc Eng, 2013, 4(3): 307-327.
4.	Kirklin J K, Naftel D C, Kormos R L, et al. Fifth INTERMACS annual report: risk factor analysis from more than 6,000 mechanical circulatory support patients. J Heart Lung Transplant, 2013, 32(2): 141-156.
5.	Pagani F D. Right heart failure after left ventricular assist device placement. Cardiol Clin, 2020, 38(2): 227-238.
6.	Volkovicher N, Kurihara C, Critsinelis A. Outcomes in patients with advanced heart failure and small body size undergoing continuous-flow left ventricular assist device implantation. J Artif Organs, 2018, 21: 31-38.
7.	王芳群, 张瑶, 贺万堑, 等. 左心室辅助装置控制模式影响双心室搏动同步性的数值研究. 生物医学工程学杂志, 2021, 38(1): 72-79.
8.	Lee S, Kamdar F, Madlon K R, et al. Effects of the HeartMate II continuous-flow left ventricular assist device on right ventricular function. J Heart Lung Transplant, 2010, 29: 209-215.
9.	Ng B C, Salamonsen R F, Gregory S D, et al. Application of multiobjective neural predictive control to biventricular assistance using dual rotary blood pumps. Biomed Signal Proces, 2018, 39: 81-93.
10.	Koh V, Pauls J P, Wu E L, et al. A centralized multi-objective model predictive control for a biventricular assist device: An in vitro evaluation. Biomed Signal Proces, 2020, 59: 101914.
11.	Slaughter M S, Pagani F D, Rogers J G, et al. Clinical management of continuous-flow left ventricular assist devices in advanced heart failure. J Heart Lung Transplant, 2010, 29(4 Suppl): S1-S39.
12.	Gregory S D, Stevens M C, Pauls J P, et al. In vivo evaluation of active and passive physiological control systems for rotary left and right ventricular assist devices. Artif Organs, 2016, 40(9): 894-903.
13.	Saito T, Toda K, Nakamura T, et al. Biventricular support using implantable continuous-flow ventricular assist devices. J Card Fail, 2014, 20(10): S177.
14.	Arakawa M, Nishimura T, Takewa Y, et al. Novel control system to prevent right ventricular failure induced by rotary blood pump. J Artif Organs, 2014, 17(2): 135-141.
15.	Vasudevan V S, Yu W, Simaan M A. Aortic valve dynamics and blood flow control in continuous flow left ventricular assist devices// 2017 American Control Conference (ACC). Seattle: IEEE, 2017: 1456-1461.
16.	Yu W, Faragallah G, Simaan M A. Detection of aortic valve dynamics in bridge-to-recovery feedback control of the Left Ventricular Assist Device// 2014 European Control Conference (ECC). Strasbourg: IEEE, 2014: 140-145.
17.	Imamura T, Kinugawa K, Fujino T, et al. Aortic insufficiency in patients with sustained left ventricular systolic dysfunction after axial flow assist device implantation. Circ J, 2015, 79(1): 104-111.
18.	Holley C T, Fitzpatrick M, Roy S S, et al. Aortic insufficiency in continuous-flow left ventricular assist device support patients is common but does not impact long-term mortality. J Heart Lung Transplant, 2017, 36(1): 91-96.
19.	Nadia B, Ismail E H, Magali P, et al. Aortic regurgitation in patients with a left ventricular assist device: a contemporary review. J Heart Lung Transplant, 2018, 37(11): 1289-1297.
20.	高斌, 张琪, 潘光亮, 等. 人工心脏辅助水平对主动脉瓣生物力学状态的影响//第十二届全国生物力学学术会议暨第十四届全国生物流变学学术会议会议论文摘要汇编. 西安: 中国力学学会, 2018: 53-54.
21.	Uriel N, Burkhoff D, Rich J D, et al. Impact of hemodynamic ramp test-guided HVAD speed and medication adjustments on clinical outcomes. Cir Heart Fail, 2019, 12(4): e006067.
22.	Suga H, Sagawa K. Instantaneous pressure-volume relationships and their ratio in the excised, supported canine left ventricle. Circ Res, 1974, 35(1): 117-126.
23.	Korakianitis T, Shi Y. Numerical simulation of cardiovascular dynamics with healthy and diseased heart valves. J Biomech, 2006, 39(11): 1964-1982.

1. 吕鹏飞, 刘盛. 连续血流左心室辅助装置的发展现状. 临床和实验医学杂志, 2019, 18(8): 894-897.
2. Ogawa D, Kobayashi S, Yamazaki K, et al. Evaluation of cardiac beat synchronization control for a rotary blood pump on valvular regurgitation with a mathematical model. Artif Organs, 2020, 45(2): 124-134.
3. Faragallah G, Simaan M. An engineering analysis of the aortic valve dynamics in patients with rotary left ventricular assist devices. J Healthc Eng, 2013, 4(3): 307-327.
4. Kirklin J K, Naftel D C, Kormos R L, et al. Fifth INTERMACS annual report: risk factor analysis from more than 6,000 mechanical circulatory support patients. J Heart Lung Transplant, 2013, 32(2): 141-156.
5. Pagani F D. Right heart failure after left ventricular assist device placement. Cardiol Clin, 2020, 38(2): 227-238.
6. Volkovicher N, Kurihara C, Critsinelis A. Outcomes in patients with advanced heart failure and small body size undergoing continuous-flow left ventricular assist device implantation. J Artif Organs, 2018, 21: 31-38.
7. 王芳群, 张瑶, 贺万堑, 等. 左心室辅助装置控制模式影响双心室搏动同步性的数值研究. 生物医学工程学杂志, 2021, 38(1): 72-79.
8. Lee S, Kamdar F, Madlon K R, et al. Effects of the HeartMate II continuous-flow left ventricular assist device on right ventricular function. J Heart Lung Transplant, 2010, 29: 209-215.
9. Ng B C, Salamonsen R F, Gregory S D, et al. Application of multiobjective neural predictive control to biventricular assistance using dual rotary blood pumps. Biomed Signal Proces, 2018, 39: 81-93.
10. Koh V, Pauls J P, Wu E L, et al. A centralized multi-objective model predictive control for a biventricular assist device: An in vitro evaluation. Biomed Signal Proces, 2020, 59: 101914.
11. Slaughter M S, Pagani F D, Rogers J G, et al. Clinical management of continuous-flow left ventricular assist devices in advanced heart failure. J Heart Lung Transplant, 2010, 29(4 Suppl): S1-S39.
12. Gregory S D, Stevens M C, Pauls J P, et al. In vivo evaluation of active and passive physiological control systems for rotary left and right ventricular assist devices. Artif Organs, 2016, 40(9): 894-903.
13. Saito T, Toda K, Nakamura T, et al. Biventricular support using implantable continuous-flow ventricular assist devices. J Card Fail, 2014, 20(10): S177.
14. Arakawa M, Nishimura T, Takewa Y, et al. Novel control system to prevent right ventricular failure induced by rotary blood pump. J Artif Organs, 2014, 17(2): 135-141.
15. Vasudevan V S, Yu W, Simaan M A. Aortic valve dynamics and blood flow control in continuous flow left ventricular assist devices// 2017 American Control Conference (ACC). Seattle: IEEE, 2017: 1456-1461.
16. Yu W, Faragallah G, Simaan M A. Detection of aortic valve dynamics in bridge-to-recovery feedback control of the Left Ventricular Assist Device// 2014 European Control Conference (ECC). Strasbourg: IEEE, 2014: 140-145.
17. Imamura T, Kinugawa K, Fujino T, et al. Aortic insufficiency in patients with sustained left ventricular systolic dysfunction after axial flow assist device implantation. Circ J, 2015, 79(1): 104-111.
18. Holley C T, Fitzpatrick M, Roy S S, et al. Aortic insufficiency in continuous-flow left ventricular assist device support patients is common but does not impact long-term mortality. J Heart Lung Transplant, 2017, 36(1): 91-96.
19. Nadia B, Ismail E H, Magali P, et al. Aortic regurgitation in patients with a left ventricular assist device: a contemporary review. J Heart Lung Transplant, 2018, 37(11): 1289-1297.
20. 高斌, 张琪, 潘光亮, 等. 人工心脏辅助水平对主动脉瓣生物力学状态的影响//第十二届全国生物力学学术会议暨第十四届全国生物流变学学术会议会议论文摘要汇编. 西安: 中国力学学会, 2018: 53-54.
21. Uriel N, Burkhoff D, Rich J D, et al. Impact of hemodynamic ramp test-guided HVAD speed and medication adjustments on clinical outcomes. Cir Heart Fail, 2019, 12(4): e006067.
22. Suga H, Sagawa K. Instantaneous pressure-volume relationships and their ratio in the excised, supported canine left ventricle. Circ Res, 1974, 35(1): 117-126.
23. Korakianitis T, Shi Y. Numerical simulation of cardiovascular dynamics with healthy and diseased heart valves. J Biomech, 2006, 39(11): 1964-1982.

Journal of Biomedical Engineering

Effect of a delay mode of a ventricular assist device on hemodynamics of the cardiovascular system

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