• Title/Summary/Keyword: ventricular assist

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Blood Flow and Pressure Evaluation for a Pulsatile Conduit-Shaped Ventricular Assist Device with Structural Characteristic of Conduit Shape (관형의 구조적 특징을 갖춘 박동형 관형 심실보조장치의 혈류, 혈압 평가)

  • Kang, Seong-Min;Choi, Seong-Wook
    • Transactions of the Korean Society of Mechanical Engineers B
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    • v.35 no.11
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    • pp.1191-1198
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    • 2011
  • The use of a ventricular assist device (VAD) can raise the one-year survival rate without cardiac transplantation from 25% to 52%. However, malfunction of the VAD system causes 6% of VAD patients' deaths, which could possibly be avoided through the development of new VADs in which VAD malfunctions do not affect the patient's heart movement or hemodynamic state. A conventional VAD has an impeller or vane for propelling blood that can allow blood to regurgitate when the propelling force is weaker than the aortic pressure. In this paper, we developed a new pulsatile conduit-shaped VAD that has two valves. This device removes the possibility of blood regurgitation and has a small stationary area even when the pumping force is extremely weak. We estimated the characteristics of the device by measuring the outflow and the pressure of the pump in in-vitro and in-vivo experiments.

Estimation of Ventricular Assist Device Outflow with the Pressures in Air Pressure Line (공압식 박동형 심실보조장치의 공압관 내 압력 측정을 통한 박출량 추정)

  • Kim, Young Il;Her, Keun;Kang, Seong Min;Choi, Seong Wook
    • Journal of Biomedical Engineering Research
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    • v.35 no.5
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    • pp.119-124
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    • 2014
  • A Ventricular assist device (VAD) is one of the most efficient treatments to raise the survivability of the end stage heart failure patient. However, some of LVAD patients have died for the failures and improper control of LVAD. To detect critical dangers in LVAD, the monitoring methods of LVAD outflow have been requested, because it can be affected by patient's hemodynamic states and abnormal conditions of LVAD. In the case of an external pulsatile LVAD, the air movement through the air line can be used to estimate LVAD outflow. In this study, the air movement in the air-line of the extracorporeal pulsatile LVAD was measured with a differential pressure sensor between different points. The precise estimation of air movement could be achieved by additional measurement of air pressure. In a series of in-vitro experiments, the LVAD outflow were changed according to the afterload of LVAD and the differential pressure of LVAD didn't have close correlation with the LVAD outflow that were measured with an ultrasonic flowmeter at the same time. However, new precise estimation with the data from differential pressure and one point pressure in the air-line showed higher correlations with LVAD outflow.

Estimation of Stroke Volume Based on Air Pressure in Air Tube with Pneumatic Pulsatile Ventricular Assist Device (공압식 박동형 심실보조장치에서 공압관 내 공기압에 따른 박출량 추정)

  • Kang, Yu Min;Lee, Jin Hong;Her, Keun;Choi, Seong Wook
    • Transactions of the Korean Society of Mechanical Engineers B
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    • v.38 no.12
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    • pp.971-974
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    • 2014
  • A ventricular assist device (VAD) is used for bridge to heart transplantation and heart diseases. Knowing the status of a pneumatic pulsatile VAD when implanting it into the body is important: when the velocity of blood flow through the VAD is slow, a thrombus may occur, and thrombosis can be fatal to a patient. In order to determine the state of a VAD, various sensors need to be implanted. Because this introduces the risk of infection and difficulties with sensor management, we developed a method for estimating the state of a VAD indirectly via the pressure in an air tube that can be measured in vitro. We compared the measured values to in vitro experimental results. The estimated and measured values showed some errors, but the accuracy can be improved by refining the estimation process to minimize the risk of infection.

Postcardiotomy Ventricular Assist Device (개심술후 심실 보조장치)

  • 나찬영
    • Journal of Chest Surgery
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    • v.27 no.5
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    • pp.390-393
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    • 1994
  • 의료기술의 발달로 오늘날의 개심술은 대부분 성공적으로 시행되고 있지만 극히 일부분은 아직도 개심술후 심한 심실기능의 저하로 사망하는 겨우가 있다. 1960년대 중반 Spencer와 DeBakey에 의해 개심술후 심한 심실기능이 저하된 환자에게 심실보조장치를 이용하여 성공적으로 치험한 이후로 많은 발전을 거듭해 왔다. 저자들은 4개월 (6.5Kg)된 남아에서 개심술후 심한 저심박출증으로 인공심폐기의 제거를 못하여 좌심실 보조장치(Centrifugal Biopump)를 사용하여 성공적으로 치험하였기에 보고하는 바이다.

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Postcaroiomy Heart or Heart/Lung Assist Experiences in Children (소아연령의 개심술후 시행한, 심장 혹은 심장-폐 순환보조장치의 임상적 고찰(Royal Children's Hospital, Australia의 경험))

  • 한재진
    • Journal of Chest Surgery
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    • v.27 no.12
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    • pp.977-983
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    • 1994
  • From April 1989 to December 1993, total 39 patients who were unable to be weaned off CPB or expected fatal immediate postoperiatively, were treated with ventricular assist device [VAD] or extracorporeal membrane oxygenator[ECMO] at the Royal Children`s Hospital, Melbourne. Ages ranged from 3 day to 19.4 year old and body weights from 2.0Kg to 70Kg. Twenty-seven[69.2%] of 39 patients were weaned to be decannulated successfully and sixteen[41.0%] survived to hospital discharge and late survival rate was twelve[30.8%] of 39 patients. The total follow-up period was 4 to 56 months [32.92$\pm$20.77months] and most of the late survivals showed good myocardial recovery state. From the viewpoint of the assist modality, 29 patients were treated with VAD and among them, 23 were weaned from assist successfully, but among the 8 ECMO patients, only 3 could be weaned, and both modalities were performed to the 2 patients with one weaned. The total duration of assist was from 8 to 428 hours and there was a significant difference between hospital discharged group and hospital death group, which were 83.13$\pm$31.29 hours vs 147.52$\pm$112.03 hours[P=0.032]. Conclusively, at the critical postcardiotomy situation of the paediatrtic patients including various congenital complex disease and procedures, we can choose this VAD or ECMO treatment strategy as the reasonable life saving way except transplantation.

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Development and Animal Tests of Pneumatic Ventricular Assist Device (공압식 심실보조장치의 개발 및 동물실험)

  • 박영환;김상현
    • Journal of Chest Surgery
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    • v.30 no.3
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    • pp.247-252
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    • 1997
  • Ten acute and chronic in vivo studies were utilized to develop a pneumatic ventricular assist device (VAD) as a bridge to heart transplantation or a circulatory assist device for patients with end-stage heart disease or poor myocardial funct on after cardiac surgery. Two sizes of blood pump of 70cc for adult patients and 34cc for pediatric patients were implanted in the animals. Ventricle of the blood pump was made from the polyurethaae to enhance antithrombogenecity. The VAD was implanted between the left atrium and the descending aorta. Average flow rate was 2.38 L/min for adult and 0.41 L/min for pediatric VAD at the rate of 60 bum. The duration of support ranged from 1 to 26 hours. The most frequent complication was bleeding. Main causes of death were heart failure and respiratory failure. The device function was good for short term use. Studies to date suggest that, with further refinement, a reliable long term VAD that will have clinical application can be developed.

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Postcardiotomy Ventricular Support with Biomedicus Pump (Biomedicus pump를 이용한 개심술후 심실보조)

  • Kim, Won-Gon;Lee, Chang-Ha;Kim, Ki-Bong;Ahn, Hyuk;Rho, Ryang-Joon
    • Journal of Chest Surgery
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    • v.29 no.11
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    • pp.1218-1222
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    • 1996
  • The reported incidence of postcardiotomy cardiogenic shock not responding to conventional therapy is still 0.1 to 0.8%. For this group of patients, more aggressive form of circulatory support must be employed. Centrifugal pumps are a ventricular assist device most commonly used on this purpose, due to low cost and easy availability. Currently, however, clinical experience of centrifugal pumps as a ventricular assist device is rarely reported in Korea. From January 1992 to January 1996, 2986 patients underwent cardiac operations on cardiopulmonary bypass at Seoul National University Hospital. Refractory postcardiotomy cardiac failure requring ventricular support with a Biomedicus centrifugal pump developed in ten of these patients. There were eight men and two women, ranged in age from nine years to 77 years with a mean of 50$\pm$20 years. The primary surgical procedures consisted of isolated coronary revascularization in four patients, combined coronary revascularization and aortic valve replacement in two, aortic dissection repair in two, pulmonary embolectomy in one, and heart transplantation in one. Of the ten patients, five had left ventricular assistance, one had right ventricular assistance, and four had biventricular assistance. Duration of ventricular assistance ranged from 24 to 175 hours, with a mean of 76$\pm$51 hours. Seven patients were weaned from ventricular assistance, and four of them discharged. The causes of death for nonsurvivors were progressive cardiac failure in two patients and multiorgan failure, intractable ventricular fibrillation, irreversible brain injury, and mechanical problem, respectively, in the other four. Survival was not predicted by time on cardiopulmonary bypass, aortic cross-clamp time, or duration of ventricular support. Major complications included bleeding(7), renal failure(6), infection(3) and neurologic complication(2). These results indicate that a centrifugal pump can provide reasonably satisfactory short-term circulatory support.

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인공심장의 발전을 가져온 항공우주왕복선의 CFD 기술

  • Gwak, Do-Chan;Han, Jun-Hui;Cha, Dae-Ho;Lee, Do-Hyeong
    • Journal of the KSME
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    • v.50 no.8
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    • pp.51-53
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    • 2010
  • 이 글에서는 항공우주왕복선의 엔진설계 시 사용되었던 CFD(Computational Fluid Dynamics) 기술을 인공심장 개발에 어떻게 적용하여 심장보조장치(Ventricular Assist Device)를 만들었는지 소개하고자 한다.

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Evaluation of Pneumatic Left Ventricular Assist Device for Animal Experiment (동물실험을 통한 공압식 좌심실보조장치의 평가)

  • Lee, H.S.;Oh, H.J.;Lee, S.H.;Kim, S.H.;Seo, P.W.;Park, S.S.;Rhee, K.H.;Ahn, H.;Hwang, S.O.
    • Proceedings of the KOSOMBE Conference
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    • v.1998 no.11
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    • pp.235-236
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    • 1998
  • The purpose of this paper is to develop diaphragm type pneumatic Left Ventricular Assist Device(LVAD) for clinical application and to evaluate its performance through the mock circulation and animal experiment. The blood housing and diaphragm are made by polyurethane. The relations of cardiac output us. beat rate and cardiac output vs. systolic-to-diastolic rate was estimated through the mock test and hemodynamic waves are recorded for the evaluation of VAD. We performed animal experiment and 4 animals survived more than 24hrs. As a result, the hemodynamic data and waves showed this system can be applicable to the animal experiment.

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