Starling-like flow control of a left ventricular assist device: in vitro validation

Gaddum, Nicholas R., Stevens, Michael, Lim, Einly, Fraser, John, Lovell, Nigel, Mason, David and Timms, Daniel (2014) Starling-like flow control of a left ventricular assist device: in vitro validation. Artificial Organs, 38 3: E46-E56. doi:10.1111/aor.12221

Author Gaddum, Nicholas R.
Stevens, Michael
Lim, Einly
Fraser, John
Lovell, Nigel
Mason, David
Timms, Daniel
Title Starling-like flow control of a left ventricular assist device: in vitro validation
Journal name Artificial Organs   Check publisher's open access policy
ISSN 0160-564X
Publication date 2014-01-01
Year available 2013
Sub-type Article (original research)
DOI 10.1111/aor.12221
Open Access Status
Volume 38
Issue 3
Start page E46
End page E56
Total pages 11
Place of publication Hoboken, NJ, United States
Publisher Wiley-Blackwell
Language eng
Abstract The application of rotary left ventricular (LV) assist devices (LVADs) is expanding from bridge to transplant, to destination and bridge to recovery therapy. Conventional constant speed LVAD controllers do not regulate flow according to preload, and can cause over/underpumping, leading to harmful ventricular suction or pulmonary edema, respectively. We implemented a novel adaptive controller which maintains a linear relationship between mean flow and flow pulsatility to imitate native Starling-like flow regulation which requires only the measurement of VAD flow. In vitro controller evaluation was conducted and the flow sensitivity was compared during simulations of postural change, pulmonary hypertension, and the transition from sleep to wake. The Starling-like controller's flow sensitivity to preload was measured as 0.39L/min/mmHg, 10 times greater than constant speed control (0.04L/min/mmHg). Constant speed control induced LV suction after sudden simulated pulmonary hypertension, whereas Starling-like control reduced mean flow from 4.14 to 3.58L/min, maintaining safe support. From simulated sleep to wake, Starling-like control increased flow 2.93 to 4.11L/min as a response to the increased residual LV pulsatility. The proposed controller has the potential to better match device outflow to patient demand in comparison with conventional constant speed control.
Keyword Flow control
Frank-Starling mechanism
Heart failure
Left ventricular assist device control
Pulsatility index
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
School of Information Technology and Electrical Engineering Publications
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