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Alteration of LV end-diastolic volume by controlling the power of the continuous-flow LVAD, so it is synchronized with cardiac beat: development of a native heart load control system (NHLCS)

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Abstract

There are many reports comparing pulsatile and continuous-flow left ventricular assist devices (LVAD). But continuous-flow LVAD with the pulsatile driving technique had not been tried or discussed before our group’s report. We have previously developed and introduced a power-control unit for a centrifugal LVAD (EVAHEART®; Sun Medical), which can change the speed of rotation so it is synchronized with the heart beat. By use of this unit we analyzed the end-diastolic volume (EDV) to determine whether it is possible to change the native heart load. We studied 5 goats with normal hearts and 5 goats with acute LV dysfunction because of micro-embolization of the coronary artery. We used 4 modes, “circuit-clamp”, “continuous”, “counter-pulse”, and “co-pulse”, with the bypass rate (BR) 100%. We raised the speed of rotation of the LVAD in the diastolic phase with the counter-pulse mode, and raised it in the systolic phase with the co-pulse mode. As a result, the EDV decreased in the counter-pulse mode and increased in the co-pulse mode, compared with the continuous mode (p < 0.05), in both the normal and acute-heart-failure models. This result means it may be possible to achieve favorable EDV and native heart load by controlling the rotation of continuous-flow LVAD, so it is synchronized with the cardiac beat. This novel driving system may be of great benefit to patients with end-stage heart failure, especially those with ischemic etiology.

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Authors and Affiliations

  1. Department of Artificial Organ, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565, Japan

    Akihide Umeki, Yoshiaki Takewa, Tomonori Tsukiya, Toshihide Mizuno, Yoshiyuki Taenaka & Eisuke Tatsumi

  2. Department of Cardiothoracic Surgery, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan

    Akihide Umeki, Takashi Nishimura, Masahiko Ando, Shunei Kyo & Minoru Ono

  3. Department of Cardiovascular Surgery, Tokyo Women’s Medical University, Tokyo, Japan

    Kenji Yamazaki

Authors
  1. Akihide Umeki
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  2. Takashi Nishimura
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  3. Masahiko Ando
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  4. Yoshiaki Takewa
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  5. Kenji Yamazaki
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  6. Shunei Kyo
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  7. Minoru Ono
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  8. Tomonori Tsukiya
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  9. Toshihide Mizuno
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  10. Yoshiyuki Taenaka
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  11. Eisuke Tatsumi
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Correspondence to Akihide Umeki or Takashi Nishimura.

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Umeki, A., Nishimura, T., Ando, M. et al. Alteration of LV end-diastolic volume by controlling the power of the continuous-flow LVAD, so it is synchronized with cardiac beat: development of a native heart load control system (NHLCS). J Artif Organs 15, 128–133 (2012). https://doi.org/10.1007/s10047-011-0615-3

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  • DOI: https://doi.org/10.1007/s10047-011-0615-3

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