Novel control system to prevent right ventricular failure induced by rotary blood pump
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Right ventricular (RV) failure is a potentially fatal complication after treatment with a left ventricular assist device (LVAD). Ventricular septal shift caused by such devices is an important factor in the progress of RV dysfunction. We developed a control system for a rotary blood pump that can change rotational speed (RS) in synchrony with the cardiac cycle. We postulated that decreasing systolic RS using this system would alter ventricular septal movement and thus prevent RV failure. We implanted the EVAHEART ventricular assist device into seven adult goats weighing 54.1 ± 2.1 kg and induced acute bi-ventricular dysfunction by coronary embolization. Left and RV pressure was monitored, and ventricular septal movement was echocardiographically determined. We evaluated circuit-clamp mode as the control condition, as well as continuous and counter-pulse modes, both with full bypass. As a result, a leftward ventricular septal shift occurred in continuous and counter-pulse modes. The septal shift was corrected as a result of decreased RS during the systolic phase in counter-pulse mode. RV fractional area change improved in counter-pulse (59.0 ± 4.6 %) compared with continuous (44.7 ± 4.0 %) mode. In conclusion, decreased RS delivered during the systolic phase using the counter-pulse mode of our new system holds promise for the clinical correction of ventricular septal shift resulting from a LVAD and might confer a benefit upon RV function.
KeywordsArtificial organs Rotary blood pump LVAD Right ventricular failure
This study was presented at the annual conference of The American Society for Artificial Internal Organs in 2012, in San Francisco, CA and supported by a JSAO Grant in 2013. The authors are grateful to Dr. Daisuke Ogawa at the Sun Medical Technology Research Corporation for creating the programs.
Conflict of interest
The authors have no conflicts of interest to disclose.
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