Short-term physiological response to high-frequency-actuated pVAD support.
Zurich Heart
cardiovascular response
high-frequency actuation
mechanical circulatory support
pulsatile
ventricular assist device
Journal
Artificial organs
ISSN: 1525-1594
Titre abrégé: Artif Organs
Pays: United States
ID NLM: 7802778
Informations de publication
Date de publication:
Dec 2019
Dec 2019
Historique:
received:
12
02
2019
revised:
29
05
2019
accepted:
07
06
2019
pubmed:
19
6
2019
medline:
11
4
2020
entrez:
19
6
2019
Statut:
ppublish
Résumé
Ventricular assist devices (VADs) are an established treatment option for heart failure (HF). However, the devices are often plagued by material-related hemocompatibility issues. In contrast to continuous flow VADs with high shear stresses, pulsatile VADs (pVADs) offer the potential for an endothelial cell coating that promises to prevent many adverse events caused by an insufficient hemocompatibility. However, their size and weight often precludes their intracorporeal implantation. A reduction of the pump body size and weight of the pump could be achieved by an increase in the stroke frequency while maintaining a similar cardiac output. We present a new pVAD system consisting of a pump and an actuator specifically designed for actuation frequencies of up to 240 bpm. In vitro and in vivo results of the short-term reaction of the cardiovascular system show no significant changes in left ventricular and aortic pressure between actuation frequencies from 60 to 240 bpm. The aortic pulsatility increases when the actuation frequency is raised while the heart rate remains unaffected in vivo. These results lead us to the conclusion that the cardiovascular system tolerates short-term increases of the pVAD stroke frequencies.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1170-1181Subventions
Organisme : Stiftung PROPTER HOMINES - Vaduz/Fürstentum Liechtenstein
Organisme : ETH Foundation
Organisme : Schwyzer-Winiker Stiftung
Informations de copyright
© 2019 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.
Références
Kirklin JK, Naftel DC, Pagani D, Kormos RL, Stevenson LW, Blume ED, et al. Seventh INTERMACS annual report. J Heart Lung Transplant. 2015;34:1495-504.
Schumer EM, Black MC, Monreal G, Slaughter MS. Left ventricular assist devices: current controversies and future directions. Eur Heart J. 2016;37:3434-9b.
Schmid Daners M, Kaufmann F, Amacher R, Ochsner G, Wilhelm MJ, Ferrari A, et al. Left ventricular assist devices: challenges toward sustaining long-term patient care. Ann Biomed Eng. 2017;45:1836-51.
van Oeveren W. Obstacles in haemocompatibility testing. Scientifica (Cairo). 2013;2013:1-14.
Schima H, Wieselthaler G. Mechanically induced blood trauma: are the relevant questions already solved, or is it still an important field to be investigated? Artif Organs. 1995;19:563-4.
Timms D. A review of clinical ventricular assist devices. Med Eng Phys. 2011;33:1041-7.
Kirklin JK, Naftel DC, Kormos RL, Stevenson LW, Pagani FD, Miller MA, et al. The fourth INTERMACS annual report: 4,000 implants and counting. J Heart Lung Transplant. 2012;31:117-26.
Kirklin JK, Pagani FD, Kormos RL, Stevenson LW, Blume ED, Myers SL, et al. Eighth annual INTERMACS report: special focus on framing the impact of adverse events. J Heart Lung Transplant. 2017;36:1080-6.
Wendel HP, Ziemer G. Coating-techniques to improve the hemocompatibility of artificial devices used for extracorporeal circulation. Eur J Cardiothorac Surg. 1999;16:342-50.
Gorbet MB, Sefton MV. Biomaterial-associated thrombosis: roles of coagulation factors, complement, platelets and leukocytes. Biomater Silver Jubil Compend 2006;25:219-41.
Zurich Heart Initiative. 2019. [cited 2019 Jan 18]. Available from: https://www.hochschulmedizin.uzh.ch/en/projekte/zurichheart.html
Thamsen B, Blümel B, Schaller J, Paschereit CO, Affeld K, Goubergrits L, et al. Numerical analysis of blood damage potential of the HeartMate II and HeartWare HVAD rotary blood pumps. Artif Organs. 2015;39:651-9.
Horobin JT, Simmonds MJ, Nandakumar D, Gregory SD, Tansley G, Pauls JP, et al. Speed modulation of the HeartWare HVAD to assess in vitro hemocompatibility of pulsatile and continuous flow regimes in a rotary blood pump. Artif Organs. 2018;42:879-90.
Gohean JR, Larson ER, Hsi BH, Kurusz M, Smalling RW, Longoria RG. Scaling the low-shear pulsatile TORVAD for pediatric heart failure. ASAIO J. 2017;63:198-206.
Al-Azawy MG, Turan A, Revell A. Assessment of turbulence models for pulsatile flow inside a heart pump. Comput Methods Biomech Biomed Eng. 2016;19:271-85.
Sonntag SJ, Kaufmann T, Büsen MR, Laumen M, Linde T, Schmitz-Rode T, et al. Simulation of a pulsatile total artificial heart: development of a partitioned Fluid Structure Interaction model. J Fluids Struct. 2013;38:187-204.
Robotti F, Franco D, Bänninger L, Wyler J, Starck CT, Falk V, et al. The influence of surface micro-structure on endothelialization under supraphysiological wall shear stress. Biomaterials. 2014;35:8479-86.
Kroll MH, Hellums JD, McIntire LV, Schafer AI, Moake JL. Platelets and shear stress. Blood. 1996;88:1525-1541.
Koutsiaris AG, Tachmitzi SV, Batis N. Wall shear stress quantification in the human conjunctival pre-capillary arterioles in vivo. Microvasc Res. 2013;85:34-39.
Bachmann BJ, Bernardi L, Loosli C, Marschewski J, Perrini M, Ehrbar M, et al. A novel bioreactor system for the assessment of endothelialization on deformable surfaces. Sci Rep. 2016;6:Article ID: 38861. Available from: https://www.nature.com/articles/srep38861
Rebholz M, Amacher R, Petrou A, Meboldt M, Schmid Daners M. High-frequency operation of a pulsatile VAD - a simulation study. Biomed Eng Biomed Tech. 2017;62:1-10.
Amacher R, Weber A, Brinks H, Axiak S, Ferreira A, Guzzella L, et al. Control of ventricular unloading using an electrocardiogram-synchronized Thoratec paracorporeal ventricular assist device. J Thorac Cardiovasc Surg. 2013;146:710-7.
ZurichHeart Hybrid Membrane. 2019. Available from: http://www.zurichheart.ethz.ch/hybridmembrane/
Loosli C, Rupp S, Thamsen B, Rebholz M, Kress G, Meboldt M, et al. High frequency operation of pulsatile ventricular assist devices: computational fluid dynamics study on circular and elliptically shaped pumps Methods. Int J Artif Organs. 2019*.
Loosli C, Moy L, Kress G, Mazza E, Ermanni P. Corrugated diaphragm shape design study for hemocompatible pulsatile ventricular assist devices. Comput Methods Biomech Biomed Eng. 2018;21:399-407.
Petrou A, Granegger M, Meboldt M, Schmid Daners M. A versatile hybrid mock circulation for hydraulic investigations of active and passive cardiovascular implants. ASAIO J. 2018;1. https://doi.org/10.1097/MAT.0000000000000851
Colacino FM, Moscato F, Piedimonte F, Arabia M, Danieli GA. Left ventricle load impedance control by apical VAD can help heart recovery and patient perfusion: a numerical study. ASAIO J. 2007;53:263-77.
Ochsner G, Amacher R, Schmid Daners M. Emulation of Ventricular Suction in a Hybrid Mock Circulation. In: Proceeding 2013 European Control Conference. Zurich; 2013. p. 3108-12.
Ferrari A, Giampietro C, Bachmann B, Bernardi L, Bezuidenhhout D, Ermanni P, et al. Towards hemocompatible blood propulsion: the hybrid membrane. Zurich: VAD; 2019*.
Boës S, Thamsen B, Haas M, Daners MS, Meboldt M, Granegger M. Hydraulic characterization of implantable rotary blood pumps. IEEE Trans Biomed Eng. 2019;66:1618-27.
Nakamura T, Hayashi K, Seki J, Nakatani T, Noda H, Takano H, et al. Effect of drive mode of left ventricular assist device on the left ventricular mechanics. Artif Organs. 1988;12:56-66.
Khir AW, Swalen MJ, Segers P, Verdonck P, Pepper JR. Hemodynamics of a pulsatile left ventricular assist device driven by a counterpulsation pump in a mock circulation. Artif Organs. 2006;30:308-12.
Acevedo AD, Bowser SS, Gerritsen ME, Bizios R. Morphological and proliferative responses of endothelial cells to hydrostatic pressure: role of fibroblast growth factor. J Cell Physiol. 1993;157:603-14.
Sumpio BE, Widmann MD, Ricotta J, Awolesi MA, Watase M. Increased ambient pressure stimulates proliferation and morphologic changes in cultured endothelial cells. J Cell Physiol. 1994;158:133-9.
Silverman MD, Waters CR, Hayman GT, Wigboldus J, Samet MM, Lelkes PI. Tissue factor activity is increased in human endothelial cells cultured under elevated static pressure. Am J Physiol Physiol. 1999;277:C233-42.
Zanchetti A, Grassi G, Mancia G. When should antihypertensive drug treatment be initiated and to what levels should systolic blood pressure be lowered? A critical reappraisal. J Hypertens. 2009;27:923-34.
Ando M, Takewa Y, Nishimura T, Yamazaki K, Kyo S, Ono M, et al. A novel counterpulsation mode of rotary left ventricular assist devices can enhance myocardial perfusion. J Artif Organs. 2011;14:185-91.
Vetter HO, Kaulbach HG, Schmitz C, Forst A, Überfuhr P, Kreuzer E, et al. Experience with the Novacor left ventricular assist system as a bridge to cardiac transplantation, including the new wearable system. J Thorac Cardiovasc Surg. 1995;109:74-80.
Amacher R, Ochsner G, Schmid Daners M. Synchronized pulsatile speed control of turbodynamic left ventricular assist devices. Rev Prospects Artif Organs. 2014;38:867-99.
Kishimoto S, Date K, Arakawa M, Takewa Y, Nishimura T, Tsukiya T, et al. Influence of a novel electrocardiogram-synchronized rotational-speed-change system of an implantable continuous-flow left ventricular assist device (EVAHEART) on hemolytic performance. J Artif Organs. 2014;17:373-7.
Farrar DJ, Compton PG, Lawson JH, Hershon JJ, Hill JD. Control modes of a clinical ventricular assist device. IEEE Eng Med Biol. 1986;5:19-25.
Moazami N, Dembitsky WP, Adamson R, Steffen RJ, Soltesz EG, Starling RC, et al. Does pulsatility matter in the era of continuous-flow blood pumps? J Heart Lung Transplant. 2015;34:999-1004.
Pirbodaghi T, Axiak S, Weber A, Gempp T, Vandenberghe S. Pulsatile control of rotary blood pumps: does the modulation waveform matter? J Thorac Cardiovasc Surg. 2012;144:970-7.
Jahren SE, Amacher R, Weber A, Most H, Flammer SA, Traupe T, et al. Effects of Thoratec pulsatile ventricular assist device timing on the abdominal aortic wave intensity pattern. Am J Physiol Heart Circ Physiol. 2014;307:H1243-51.