Comparison of preload-sensitive pressure and flow controller strategies for a Dual Device Biventricular Support System

Gaddum, Nicholas Richard, Timms, Daniel Lee, Stevens, Michael, Mason, David, Lovell, Nigel and Fraser, John F. (2012) Comparison of preload-sensitive pressure and flow controller strategies for a Dual Device Biventricular Support System. Artificial Organs, 36 3: 256-265. doi:10.1111/j.1525-1594.2011.01344.x


Author Gaddum, Nicholas Richard
Timms, Daniel Lee
Stevens, Michael
Mason, David
Lovell, Nigel
Fraser, John F.
Title Comparison of preload-sensitive pressure and flow controller strategies for a Dual Device Biventricular Support System
Journal name Artificial Organs   Check publisher's open access policy
ISSN 0160-564X
1525-1594
Publication date 2012-03
Year available 2011
Sub-type Article (original research)
DOI 10.1111/j.1525-1594.2011.01344.x
Volume 36
Issue 3
Start page 256
End page 265
Total pages 10
Place of publication Hoboken, NJ, United States
Publisher Wiley-Blackwell Publishing
Collection year 2012
Language eng
Abstract The use of rotary left ventricular assist devices (LVADs) has extended to destination and recovery therapy for end-stage heart failure. Incidence of right ventricular failure while on LVAD support requires a second device be implanted to support the failing right ventricle.Without a commercially available implantable rotary right ventricular assist device, rotary LVADs are cannulated into the right heart and operation modified to provide suitable support for the pulmonary system.While this approach can alleviate the demand for transplant through long-term biventricular support, it uncovers a new challenge with respect to controller strategies for these dual device support systems. This study compares the preload sensitivity of rotary, dual device biventricular assistance controllers in light of their ability to adjust the flow rate according to physiological demand. A Frank–Starling-like flow controller which requires both inlet pressure and flow sensors is compared to pressure controllers which maintain atrial or inlet cannula pressures through the use of a single pressure sensor. It was found that cannula selection and the location of a pressure controller’s single pressure sensor can be tailored to adjust the preload sensitivity. When located within the atria, this sensitivity is effectively infinite. Moving the sensor to the base of a 450-mm cannula, however, decreased the sensitivity to 0.22 (L/min)/mm Hg. This indicates the potential for simple and reliable VAD controllers with increased preload sensitivity without the need for complex controllers requiring an array of hemodynamic sensors.
Keyword Biventricular assist device control
Flow control
Pressure control
Physiological control
Frank
Starling mechanism
Cannula
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Article first published online: 29 SEP 2011

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2012 Collection
School of Information Technology and Electrical Engineering Publications
 
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Created: Fri, 21 Oct 2011, 14:07:28 EST by Dr David Mason on behalf of School of Information Technol and Elec Engineering