Marcus Granegger1,2, Hitendu Dave3,4, Walter Knirsch5,4, Bente Thamsen3,4, Martin Schweiger3,4, Michael Hübler3,4. 1. Pediatric Cardiovascular Surgery, Department of Surgery, Pediatric Heart Center, University Children's Hospital Zurich, Zurich, Switzerland. marcus.granegger@kispi.uzh.ch. 2. Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland. marcus.granegger@kispi.uzh.ch. 3. Pediatric Cardiovascular Surgery, Department of Surgery, Pediatric Heart Center, University Children's Hospital Zurich, Zurich, Switzerland. 4. Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland. 5. Pediatric Cardiology, Department of Surgery, Pediatric Heart Center, University Children's Hospital Zurich, Zurich, Switzerland.
Abstract
PURPOSE: Effective treatment of patients with terminal heart failure and preserved ejection fraction (HFpEF) is an unmet medical need. The aim of this study was to investigate a novel valveless pulsatile pump as a therapeutic option for the HFpEF population through comprehensive in silico investigations. METHODS: The pump was simulated in a numerical model of the cardiovascular system of four HFpEF phenotypes and compared to a typical case of heart failure with reduced ejection fraction (HFrEF). The proposed pump, which was modeled as being directly connected to the left ventricle, features a single valveless inlet and outlet cannula and is driven in co-pulsation with the left ventricle. We collected hemodynamics for two different pump volumes (30 and 60 mL). RESULTS: In all HFpEF conditions, the 30 mL pump improved the cardiac output by approximately 1 L/min, increased the mean arterial pressure by > 11% and lowered the mean left atrial pressure by > 30%. With the larger (60 mL) stroke volume, these hemodynamic improvements were more pronounced. In the HFrEF condition however, these effects were three times less in magnitude. CONCLUSIONS: In this simulation study, the valveless pulsatile device improves hemodynamics in HFpEF patients by increasing the total stroke volume. The hemodynamic benefits are achieved with a small device volume comparable to implantable rotary blood pumps.
PURPOSE: Effective treatment of patients with terminal heart failure and preserved ejection fraction (HFpEF) is an unmet medical need. The aim of this study was to investigate a novel valveless pulsatile pump as a therapeutic option for the HFpEF population through comprehensive in silico investigations. METHODS: The pump was simulated in a numerical model of the cardiovascular system of four HFpEF phenotypes and compared to a typical case of heart failure with reduced ejection fraction (HFrEF). The proposed pump, which was modeled as being directly connected to the left ventricle, features a single valveless inlet and outlet cannula and is driven in co-pulsation with the left ventricle. We collected hemodynamics for two different pump volumes (30 and 60 mL). RESULTS: In all HFpEF conditions, the 30 mL pump improved the cardiac output by approximately 1 L/min, increased the mean arterial pressure by > 11% and lowered the mean left atrial pressure by > 30%. With the larger (60 mL) stroke volume, these hemodynamic improvements were more pronounced. In the HFrEF condition however, these effects were three times less in magnitude. CONCLUSIONS: In this simulation study, the valveless pulsatile device improves hemodynamics in HFpEF patients by increasing the total stroke volume. The hemodynamic benefits are achieved with a small device volume comparable to implantable rotary blood pumps.
Entities:
Keywords:
Heart failure; Heart failure with preserved ejection fraction (HFpEF); Mechanical circulatory support (MCS); Ventricular assist devices (VADs)
Authors: Chihiro Miyagi; Barry D Kuban; Christine R Flick; Anthony R Polakowski; Takuma Miyamoto; Jamshid H Karimov; Randall C Starling; Kiyotaka Fukamachi Journal: Heart Fail Rev Date: 2021-05-01 Impact factor: 4.214
Authors: Marcus Granegger; Christoph Gross; David Siemer; Andreas Escher; Sigrid Sandner; Martin Schweiger; Günther Laufer; Daniel Zimpfer Journal: Sci Rep Date: 2022-04-06 Impact factor: 4.379
Authors: Andrew Malone; Sean Gallagher; Jemil Saidi; Gina Rizq; Enda O'Dowd; Derek Vallence; Aamir Hameed Journal: Front Cardiovasc Med Date: 2022-07-22
Authors: Andreas Escher; Young Choi; Fraser Callaghan; Bente Thamsen; Ulrich Kertzscher; Martin Schweiger; Michael Hübler; Marcus Granegger Journal: Ann Biomed Eng Date: 2020-03-30 Impact factor: 3.934