A mathematical model to evaluate control strategies for mechanical circulatory support
| Autor: | Frans N. van de Vosse, Mcm Marcel Rutten, S Sandra Loerakker, Bajm Bas de Mol, Lge Lieke Cox |
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| Přispěvatelé: | Orthopaedic Biomechanics, Soft Tissue Biomech. & Tissue Eng., Cardiovascular Biomechanics, ACS - Amsterdam Cardiovascular Sciences, Cardiothoracic Surgery |
| Jazyk: | angličtina |
| Rok vydání: | 2009 |
| Předmět: |
medicine.medical_specialty
Engineering medicine.medical_treatment Biomedical Engineering Pulsatile flow Cardiac index Medicine (miscellaneous) Hemodynamics Bioengineering Biomaterials Coronary circulation Internal medicine medicine Humans Computer Simulation Cardiac cycle business.industry Models Cardiovascular General Medicine medicine.disease medicine.anatomical_structure Ventricle Heart failure Ventricular assist device Pulsatile Flow Cardiology Heart-Assist Devices business |
| Zdroj: | Artificial Organs, 33(8), 593-603. Wiley-Blackwell Artificial organs, 33(8), 593-603. Wiley-Blackwell |
| ISSN: | 0160-564X |
| Popis: | Continuous flow ventricular assist devices (VADs) for mechanical circulatory support (MCS) are generally smaller and believed to be more reliable than pulsatile VADs. However, regarding continuous flow, there are concerns about the decreased pulsatility and ventricular unloading. Moreover, pulsatile VADs offer a wider range in control strategies. For this reason, we used a computer model to evaluate whether pulsatile operation of a continuous flow VAD would be more beneficial than the standard constant pump speed. The computer model describes the left and right ventricle with one-fiber heart contraction models, and the systemic, pulmonary, and coronary circulation with lumped parameter hemodynamical models, while the heart rate is regulated with a baroreflex model. With this computer model, both normal and heart failure hemodynamics were simulated. A HeartMate II left ventricular assist device model was connected to this model, and both constant speed and pulsatile support were simulated. Pulsatile support did not solve the decreased pulsatility issue, but it did improve perfusion (cardiac index and coronary flow) and unloading (stroke work and heart rate) compared with constant speed. Also, pulsatile support would be beneficial for developing control strategies, as it offers more options to adjust assist device settings to the patient's needs. Because the mathematical model used in this study can simulate different assist device settings, it can play a valuable role in developing mechanical circulatory support control strategies. © 2009, International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc. |
| Databáze: | OpenAIRE |
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