Control of a Pediatric Pulsatile Ventricular Assist Device: A Hybrid Cardiovascular Model Study

Gianfranco Ferrari, Arianna Di Molfetta, Krzysztof Zieliński, Libera Fresiello, Krystyna Górczyńska, Krzysztof Jakub Pałko, Marek Darowski, Antonio Amodeo, Maciej Kozarski

Research output: Contribution to journalArticle

Abstract

The aim of this work is to study pediatric pneumatic ventricle (PVAD) performance, versus VAD rate (VADR) and native heart rate (HR) ratio Rr (VADR/HR). The study uses a hybrid model of the cardiovascular system (HCS). HCS consists of a computational part (a lumped parameter model including left and right ventricles, systemic and pulmonary arterial and venous circulation) interfaced to a physical part. This permits the connection of a VAD (15 mL PVAD). Echocardiographic and hemodynamic data of a pediatric patient (average weight 14.3 kg, HR 100 bpm, systemic pressure 75/44 mm Hg, CO 1.5 L/min) assisted apically with asynchronous PVAD were used to set up a basal condition in the model. After model tuning, the assistance was started, setting VAD parameters (ejection and filling pressures, systole duration) to completely fill and empty the PVAD. The study was conducted with constant HR and variable VADR (50-120, step 10, bpm). Experiments were repeated for two additional patients' HRs, 90 and 110 bpm and for two values of systemic arterial resistance (Ras) and Emax. Experimental data were collected and stored on disk. Analyzed data include average left and right ventricular volumes (LVV, RVV), left ventricular flow (LVF), VAD flow (VADF), and total cardiac output (COt). Data were analyzed versus Rr. LVV and RVV are sensitive to Rr and a left ventricular unloading corresponds in general to a right ventricular loading. In the case of asynchronous assistance, frequency beats are always present and the beat rate is equal to the difference between HR and VADR. In the case of pulsatile asynchronous LVAD assistance, VADR should be chosen to minimize frequency beat effects and right ventricular loading and to maximize left ventricular unloading.

Original languageEnglish
Pages (from-to)1099-1108
Number of pages10
JournalArtificial Organs
Volume41
Issue number12
DOIs
Publication statusPublished - Dec 1 2017

Keywords

  • Hybrid cardiovascular model
  • Hybrid circulatory model
  • Lumped parameter model
  • Pulsatile flow ventricular assist device
  • Variable elastance model

ASJC Scopus subject areas

  • Bioengineering
  • Medicine (miscellaneous)
  • Biomaterials
  • Biomedical Engineering

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  • Cite this

    Ferrari, G., Di Molfetta, A., Zieliński, K., Fresiello, L., Górczyńska, K., Pałko, K. J., Darowski, M., Amodeo, A., & Kozarski, M. (2017). Control of a Pediatric Pulsatile Ventricular Assist Device: A Hybrid Cardiovascular Model Study. Artificial Organs, 41(12), 1099-1108. https://doi.org/10.1111/aor.12929