Detection of Total Assist and Sucking Points Based on the Pulsatility of a Continuous Flow Artificial Heart: In Vivo Evaluation

Abstract

Our novel control strategy for a continuous flow artificial heart by detecting the total assist and sucking points based on pump pulsatility was evaluated in acute animal experiments using beagle dogs and our mixed flow pump. The pump was installed as a left ventricular (LV) bypass through a left thoracotomy. To change LV contractility, the left coronary arteries were occluded for 30 min, followed by a 120 min reperfusion. To change LV end diastolic pressure (LVEDP), dextran solution was rapidly infused. To estimate the pump pulsatility without any specific sensor, we calculated the index of current amplitude (ICA), which was obtained from the amplitude of the motor current waveform divided by the simultaneous mean value. To investigate the basic characteristics of the ICA, the pump speed was changed temporarily from 2,300 rpm to 5,000 rpm. In 92% of all measurements, the ICA plotted against the pump speed had a peak point (t-point) that corresponded highly with the turning point from partial to total assistance. The ICA also had a trough (s-point) that corresponded with the beginning of severe sucking in most cases. Only preload significantly influenced pump flow rate at the t-point from among preload (LVEDP), afterload (SAoP), and contractility (max LV dP/dt), by which we can simulate Starling's law of the natural heart. We concluded that a continuous flow artificial heart could be well controlled by detecting the t-point and s-point.