1
|
Horie H, Isoyama T, Ishiyama K. Design of a hybrid left ventricular assist device with a new wireless charging system. Artif Organs 2024; 48:309-314. [PMID: 37877220 DOI: 10.1111/aor.14666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 09/07/2023] [Accepted: 10/06/2023] [Indexed: 10/26/2023]
Abstract
BACKGROUND The objective of this study was to design a new wireless left ventricular assist device (LVAD) that can be charged without using a conventional transcutaneous energy transfer system (TETS). METHODS Our new wireless LVAD was a hybrid pump operating in two different modes: magnetic and electric modes. The pump was driven wirelessly by extracorporeal rotating magnets in magnetic mode, whereas it was driven by electricity provided by an intracorporeal battery in electric mode. A magnetic torque transmission system was introduced to wirelessly transmit torque to the pump impeller. The intracorporeal battery was charged in magnetic mode making use of electromagnetic coils as a generator, whereas the coils were used as a motor in electric mode. To demonstrate the feasibility of our system, we conducted a bench-top durability test for 1 week. RESULTS Our hybrid pump had shown sufficient pump performance as a LVAD, with a head pressure of approximately 80 mm Hg and a flow volume of 5.0 L/min, for 1 week. The intracorporeal battery was wirelessly charged enough to power electric mode for 2.5 h a day throughout the 1-week durability test. CONCLUSIONS Our hybrid wireless LVAD system demonstrated the possibility of a wireless LVAD and has the potential to reduce medical complications of LVAD therapy.
Collapse
Affiliation(s)
- Hideyuki Horie
- Biomedical Engineering, Tohoku University, Sendai, Japan
- Research Institute of Electrical Communication, Tohoku University, Sendai, Japan
| | - Takashi Isoyama
- Department of Clinical Engineering, Kyorin University, Tokyo, Japan
| | - Kazushi Ishiyama
- Research Institute of Electrical Communication, Tohoku University, Sendai, Japan
| |
Collapse
|
2
|
Hazan Shenberger S, Avrahami I. The Effect of Mechanical Circulatory Support on Blood Flow in the Ascending Aorta: A Combined Experimental and Computational Study. Bioengineering (Basel) 2024; 11:238. [PMID: 38534512 DOI: 10.3390/bioengineering11030238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 02/11/2024] [Accepted: 02/22/2024] [Indexed: 03/28/2024] Open
Abstract
Percutaneous mechanical circulatory support (MCS) devices are designed for short-term treatment in cases of acute decompensated heart failure as a bridge to transplant or recovery. Some of the known complications of MCS treatments are related to their hemodynamics in the aorta. The current study investigates the effect of MCS on the aortic flow. The study uses combined experimental and numerical methods to delineate complex flow structures. Particle image velocimetry (PIV) is used to capture the vortical and turbulent flow characteristics in a glass model of the human aorta. Computational fluid dynamics (CFD) analyses are used to complete the 3D flow in the aorta. Three specific MCS configurations are examined: a suction pump with a counterclockwise (CCW) rotating impeller, a suction pump with a clockwise (CW) rotating impeller, and a discharge pump with a straight jet. These models were examined under varying flow rates (1-2.5 L/min). The results show that the pump configuration strongly influences the flow in the thoracic aorta. The rotating impeller of the suction pump induces a dominant swirling flow in the aorta. The swirling flow distributes the incoming jet and reduces the turbulent intensity near the aortic valve and in the aorta. In addition, at high flow rates, the local vortices formed near the pump are washed downstream toward the aortic arch. Specifically, an MCS device with a CCW rotating impeller induces a non-physiological CCW helical flow in the descending aorta (which is opposite to the natural helical flow), while CW swirl combines better with the natural helical flow.
Collapse
Affiliation(s)
- Sapir Hazan Shenberger
- Department of Mechanical Engineering and Mechatronics, Ariel University, Ariel 40700, Israel
| | - Idit Avrahami
- Department of Mechanical Engineering and Mechatronics, Ariel University, Ariel 40700, Israel
| |
Collapse
|
3
|
Mainwaring E, Patel R, Desai C, Acharya R, Raveshia D, Shah S, Panesar H, Patel N, Singh R. Five historical innovations that have shaped modern cardiothoracic surgery. J Perioper Pract 2023:17504589231212967. [PMID: 38149619 DOI: 10.1177/17504589231212967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2023]
Abstract
Throughout history, many innovations have contributed to the development of modern cardiothoracic surgery, improving patient outcomes and expanding the range of treatment options available to patients. This article explores five key historical innovations that have shaped modern cardiothoracic surgery: cardiopulmonary bypass, surgical pacemakers, video assisted thoracic surgery, robotic surgery and mechanical circulatory support. We will review the development, impact and significance of each innovation, highlighting their contributions to the field of cardiothoracic surgery and their ongoing relevance in contemporary and perioperative practice.
Collapse
Affiliation(s)
- Elizabeth Mainwaring
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
- Addenbrooke's Hospital, Cambridge, UK
| | - Ravi Patel
- Department of Trauma and Orthopaedics, Shrewsbury and Telford Trust, The Princess Royal Hospital, Telford, UK
- Department of Trauma and Orthopaedics, Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, UK
| | - Chaitya Desai
- Department of Urology, Walsall Manor Hospital, Walsall Healthcare NHS Trust, Walsall, UK
| | - Radhika Acharya
- Department of Intensive Care, Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Dimit Raveshia
- Department of General Surgery, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Saumil Shah
- Department of Otolaryngology, The Princess Royal Hospital, Telford, UK
| | - Harrypal Panesar
- Department of Otolaryngology, The Princess Royal Hospital, Telford, UK
| | | | - Rohit Singh
- Department of Trauma and Orthopaedics, Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, UK
| |
Collapse
|
4
|
Karigyo CJT, Fonseca JWG, Boscarato AG, Matsumoto MMS, Andrade AJP. Ventricular Assist Device Research and Development in Brazil: A Long and Promising Relationship Between Medicine and Engineering. Braz J Cardiovasc Surg 2023; 38:e20230074. [PMID: 37801429 PMCID: PMC10550219 DOI: 10.21470/1678-9741-2023-0074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/08/2023] Open
Affiliation(s)
- Carlos J. T. Karigyo
- Centro de Engenharia em Assistência Circulatória,
Instituto Dante Pazzanese de Cardiologia, São Paulo, São Paulo, Brazil
- Programa de Pós-graduação em
Medicina/Tecnologia e Intervenção em Cardiologia, Universidade de
São Paulo, São Paulo, São Paulo, Brazil
| | - Jeison W. G. Fonseca
- Centro de Engenharia em Assistência Circulatória,
Instituto Dante Pazzanese de Cardiologia, São Paulo, São Paulo, Brazil
- Programa de Pós-graduação em
Medicina/Tecnologia e Intervenção em Cardiologia, Universidade de
São Paulo, São Paulo, São Paulo, Brazil
| | - André G. Boscarato
- Programa de Pós-graduação em Ciência
Animal com Ênfase em Produtos Bioativos, Universidade Paranaense, Umuarama,
Paraná, Brazil
- Clínica Cirúrgica de Grandes Animais, Hospital
Veterinário, Universidade Paranaense, Umuarama, Paraná, Brazil
| | - Mônica M. S. Matsumoto
- Medical Electrical Devices Laboratory, Electronics Engineering
Division, Instituto Tecnológico de Aeronáutica, São José
dos Campos, São Paulo, Brazil
| | - Aron J. P. Andrade
- Centro de Engenharia em Assistência Circulatória,
Instituto Dante Pazzanese de Cardiologia, São Paulo, São Paulo, Brazil
- Programa de Pós-graduação em
Medicina/Tecnologia e Intervenção em Cardiologia, Universidade de
São Paulo, São Paulo, São Paulo, Brazil
| |
Collapse
|
5
|
Garcia LP, Walther CP. Kidney health and function with left ventricular assist devices. Curr Opin Nephrol Hypertens 2023; 32:439-444. [PMID: 37195244 PMCID: PMC10524584 DOI: 10.1097/mnh.0000000000000896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
PURPOSE OF REVIEW Mechanical circulatory support (MCS) is a group of evolving therapies used for indications ranging from temporary support during a cardiac procedure to permanent treatment of advanced heart failure. MCS is primarily used to support left ventricle function, in which case the devices are termed left ventricular assist devices (LVADs). Kidney dysfunction is common in patients requiring these devices, yet the impact of MCS itself on kidney health in many settings remains uncertain. RECENT FINDINGS Kidney dysfunction can manifest in many different forms in patients requiring MCS. It can be because of preexisting systemic disorders, acute illness, procedural complications, device complications, and long-term LVAD support. After durable LVAD implantation, most persons have improvement in kidney function; however, individuals can have markedly different kidney outcomes, and novel phenotypes of kidney outcomes have been identified. SUMMARY MCS is a rapidly evolving field. Kidney health and function before, during, and after MCS is relevant to outcomes from an epidemiologic perspective, yet the pathophysiology underlying this is uncertain. Improved understanding of the relationship between MCS use and kidney health is important to improving patient outcomes.
Collapse
Affiliation(s)
- Leonardo Pozo Garcia
- Selzman Institute for Kidney Health, Section of Nephrology, Department of Medicine, Baylor College of Medicine, Houston, TX
| | - Carl P. Walther
- Selzman Institute for Kidney Health, Section of Nephrology, Department of Medicine, Baylor College of Medicine, Houston, TX
| |
Collapse
|
6
|
Rocchi M, Gross C, Moscato F, Schlöglhofer T, Meyns B, Fresiello L. An in vitro model to study suction events by a ventricular assist device: validation with clinical data. Front Physiol 2023; 14:1155032. [PMID: 37560156 PMCID: PMC10407082 DOI: 10.3389/fphys.2023.1155032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 07/11/2023] [Indexed: 08/11/2023] Open
Abstract
Introduction: Ventricular assist devices (LVADs) are a valuable therapy for end-stage heart failure patients. However, some adverse events still persist, such as suction that can trigger thrombus formation and cardiac rhythm disorders. The aim of this study is to validate a suction module (SM) as a test bench for LVAD suction detection and speed control algorithms. Methods: The SM consists of a latex tube, mimicking the ventricular apex, connected to a LVAD. The SM was implemented into a hybrid in vitro-in silico cardiovascular simulator. Suction was induced simulating hypovolemia in a profile of a dilated cardiomyopathy and of a restrictive cardiomyopathy for pump speeds ranging between 2,500 and 3,200 rpm. Clinical data collected in 38 LVAD patients were used for the validation. Clinical and simulated LVAD flow waveforms were visually compared. For a more quantitative validation, a binary classifier was used to classify simulated suction and non-suction beats. The obtained classification was then compared to that generated by the simulator to evaluate the specificity and sensitivity of the simulator. Finally, a statistical analysis was run on specific suction features (e.g., minimum impeller speed pulsatility, minimum slope of the estimated flow, and timing of the maximum slope of the estimated flow). Results: The simulator could reproduce most of the pump waveforms observed in vivo. The simulator showed a sensitivity and specificity and of 90.0% and 97.5%, respectively. Simulated suction features were in the interquartile range of clinical ones. Conclusions: The SM can be used to investigate suction in different pathophysiological conditions and to support the development of LVAD physiological controllers.
Collapse
Affiliation(s)
- Maria Rocchi
- Unit of Cardiac Surgery, Department of Cardiovascular Sciences, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Christoph Gross
- Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Francesco Moscato
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
- Ludwig Boltzmann Institute for Cardiovascular Research, Vienna, Austria
- Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Thomas Schlöglhofer
- Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
- Ludwig Boltzmann Institute for Cardiovascular Research, Vienna, Austria
| | - Bart Meyns
- Unit of Cardiac Surgery, Department of Cardiovascular Sciences, Katholieke Universiteit Leuven, Leuven, Belgium
- Department of Cardiac Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Libera Fresiello
- Unit of Cardiac Surgery, Department of Cardiovascular Sciences, Katholieke Universiteit Leuven, Leuven, Belgium
- Cardiovascular and Respiratory Physiology, University of Twente, Enschede, Netherlands
| |
Collapse
|
7
|
Del Rio-Pertuz G, Paz P, Argueta-Sosa E, Hirsch B, Nair N. Complete Pump Stop as the Presentation of Left Ventricular Recovery in a Patient With Left Ventricular Assist Device. INTERNATIONAL JOURNAL OF HEART FAILURE 2023; 5:169-171. [PMID: 37554689 PMCID: PMC10406558 DOI: 10.36628/ijhf.2023.0008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 05/07/2023] [Accepted: 05/28/2023] [Indexed: 08/10/2023]
Affiliation(s)
- Gaspar Del Rio-Pertuz
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Pablo Paz
- Division of Cardiology, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Erwin Argueta-Sosa
- Division of Cardiology, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Benjamin Hirsch
- Department of Surgery/Cardiothoracic Surgery, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Nandini Nair
- Division of Cardiology, Texas Tech University Health Sciences Center, Lubbock, TX, USA
- Division of Cardiology, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA
| |
Collapse
|