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Wang L, Yun Z, Tang X, Xiang C. Influence of circumferential annular grooving design of impeller on suspended fluid force of axial flow blood pump. Int J Artif Organs 2022; 45:360-370. [PMID: 35000480 DOI: 10.1177/03913988211064912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aiming at insufficient suspension force on the impeller when the hydraulic suspension axial flow blood pump is start at low speed, the impeller suspension stability is poor, and can't quickly enter the suspended working state. By establishing the mathematical model of the suspension force on the impeller, then the influence of the circumferential groove depth of the impeller on the suspension force is analyzed, and the annular groove depth on the impeller blade in the direction of fluid inlet and outlet was determined as (0.26, 0.02 mm). When the blood pump starts, there is an eccentricity between the impeller and the pump tube, the relationship between the suspension force and the speed of the impeller under different eccentricities is analyzed. Combined with the prototype experiment, the circumferential annular grooving design of the impeller can make the blood pump rotate at about 3500 rpm into the suspension state, when the impeller is at 8000 rpm, the impeller can basically achieve stable suspension at the eccentricity of 0.1 mm in the gravity direction, indicating that the reasonable circumferential annular grooving design of the impeller can effectively improve the suspension hydraulic force of the impeller and improve the stability of the hydraulic suspension axial flow blood pump.
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Affiliation(s)
- Liang Wang
- School of Mechanical and Electrical Engineering, Central South University, Changsha, Hunan, China.,College of Mechanical Engineering, Hunan University of Arts and Science, Changde, Hunan, China
| | - Zhong Yun
- School of Mechanical and Electrical Engineering, Central South University, Changsha, Hunan, China
| | - Xiaoyan Tang
- School of Mechanical and Electrical Engineering, Central South University, Changsha, Hunan, China
| | - Chuang Xiang
- College of Mechanical Engineering, Hunan University of Arts and Science, Changde, Hunan, China
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de Andrade G, Horikawa O, Drigo E, Andrade A, Cardoso J. Impeller geometry definition of the transventricular assist device. Artif Organs 2020; 44:803-810. [PMID: 32410254 DOI: 10.1111/aor.13708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 04/10/2020] [Accepted: 04/14/2020] [Indexed: 11/29/2022]
Abstract
According to the World Health Organization, cardiovascular disease is the number one cause of death worldwide, except Africa, where Acquired Immune Deficiency Syndrome is the leading cause of death. In this scenario, the ventricular assist device (VAD) remains the unique alternative to extend patient life until heart transplantation. At Dante Pazzanese Institute of Cardiology, the research and development of an axial flow VAD to be fully implantable within the heart was started. This pump, denominated Transventricular Assist Device (TVAD), can be surgically implanted through a small left intercostal incision in a minimally invasive manner. The goal of this work is to analyze the impeller geometries of the TVAD, to avoid high shear stresses in the fluid and aim for the best conditions to support the circulatory system using computational fluid dynamics and in vitro tests. Different rotor geometries were selected according to the literature; based on the results, the best rotor was elected. This rotor contains a pair of spiral blades of constant and relatively high pitch, which pumps liquid at a flow rate of 3 L/min at 73 mm Hg. It is also expected that this rotor presents a moderate hemolysis since the shear rate is acceptable.
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Affiliation(s)
- Gustavo de Andrade
- CEAC, Instituto Dante Pazzanese de Cardiologia, Sao Paulo, Brazil.,Polytechnic School of the University of São Paulo (EPUSP), Sao Paulo, Brazil
| | - Oswaldo Horikawa
- CEAC, Instituto Dante Pazzanese de Cardiologia, Sao Paulo, Brazil
| | - Evandro Drigo
- CEAC, Instituto Dante Pazzanese de Cardiologia, Sao Paulo, Brazil
| | - Aron Andrade
- CEAC, Instituto Dante Pazzanese de Cardiologia, Sao Paulo, Brazil
| | - Jose Cardoso
- CEAC, Instituto Dante Pazzanese de Cardiologia, Sao Paulo, Brazil
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Arrigo M, Huber LC, Winnik S, Mikulicic F, Guidetti F, Frank M, Flammer AJ, Ruschitzka F. Right Ventricular Failure: Pathophysiology, Diagnosis and Treatment. Card Fail Rev 2019; 5:140-146. [PMID: 31768270 PMCID: PMC6848943 DOI: 10.15420/cfr.2019.15.2] [Citation(s) in RCA: 90] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 07/05/2019] [Indexed: 12/20/2022] Open
Abstract
The prognostic significance of the right ventricle (RV) has recently been recognised in several conditions, primarily those involving the left ventricle, the lungs and their vascular bed, or the right-sided chambers. Recent advances in imaging techniques have created new opportunities to study RV anatomy, physiology and pathophysiology, and contemporary research efforts have opened the doors to new treatment possibilities. Nevertheless, the treatment of RV failure remains challenging. Optimal management should consider the anatomical and physiological particularities of the RV and include appropriate imaging techniques to understand the underlying pathophysiological mechanisms. Treatment should include rapid optimisation of volume status, restoration of perfusion pressure and improvement of myocardial contractility and rhythm, and, in case of refractory RV failure, mechanical circulatory support.
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Affiliation(s)
- Mattia Arrigo
- Department of Cardiology, University Hospital Zurich Zurich, Switzerland
| | - Lars Christian Huber
- Department of Internal Medicine, Clinic for Internal Medicine, City Hospital Triemli Zurich, Switzerland
| | - Stephan Winnik
- Department of Cardiology, University Hospital Zurich Zurich, Switzerland
| | - Fran Mikulicic
- Department of Cardiology, University Hospital Zurich Zurich, Switzerland
| | - Federica Guidetti
- Department of Cardiology, University Hospital Zurich Zurich, Switzerland
| | - Michelle Frank
- Department of Cardiology, University Hospital Zurich Zurich, Switzerland
| | - Andreas J Flammer
- Department of Cardiology, University Hospital Zurich Zurich, Switzerland
| | - Frank Ruschitzka
- Department of Cardiology, University Hospital Zurich Zurich, Switzerland
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Development of a Transventricular Assist Device (TVAD) – Influence of the Volute Vanes. ACTA ACUST UNITED AC 2018. [DOI: 10.1016/j.ifacol.2018.11.650] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Sunagawa G, Koprivanac M, Karimov JH, Moazami N, Fukamachi K. Current status of mechanical circulatory support for treatment of advanced end-stage heart failure: successes, shortcomings and needs. Expert Rev Cardiovasc Ther 2017; 15:377-387. [PMID: 28351172 DOI: 10.1080/14779072.2017.1313114] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Heart failure (HF) remains a major global burden in terms of morbidity and mortality. Despite advances in pharmacological and resynchronization device therapy, many patients worsen to end-stage HF. Although the gold-standard treatment for such patients is heart transplantation, there will always be a shortage of donor hearts. Areas covered: A left ventricular assist device (LVAD) is a valuable option for these patients as a bridge measure (to recovery, to candidacy for transplant, or to transplant itself) or as destination therapy. This review describes the current indications for and complications of the most commonly implanted LVADs. In addition, we review the potential and promising new LVADs, including the HeartMate 3, MVAD, and other LVADs. Studies investigating each were identified through a combination of online database and direct extraction of studies cited in previously identified articles. Expert commentary: The goal of LVADs has been to fill the gap between patients with end-stage HF who would likely not benefit from heart transplantation and those who could benefit from a donor heart. As of now, the use of LVADs has been limited to patients with end-stage HF, but next-generation LVAD therapy may improve both survival and quality of life in less sick patients.
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Affiliation(s)
- Gengo Sunagawa
- a Department of Biomedical Engineering , Lerner Research Institute, Cleveland Clinic , Cleveland , OH , USA
| | - Marijan Koprivanac
- b Department of Thoracic and Cardiovascular Surgery, Kaufman Center for Heart Failure , Cardiac Transplantation and Mechanical Circulatory Support, Miller Family Heart and Vascular Institute, Cleveland Clinic , Cleveland , OH , USA
| | - Jamshid H Karimov
- a Department of Biomedical Engineering , Lerner Research Institute, Cleveland Clinic , Cleveland , OH , USA
| | - Nader Moazami
- a Department of Biomedical Engineering , Lerner Research Institute, Cleveland Clinic , Cleveland , OH , USA.,b Department of Thoracic and Cardiovascular Surgery, Kaufman Center for Heart Failure , Cardiac Transplantation and Mechanical Circulatory Support, Miller Family Heart and Vascular Institute, Cleveland Clinic , Cleveland , OH , USA
| | - Kiyotaka Fukamachi
- a Department of Biomedical Engineering , Lerner Research Institute, Cleveland Clinic , Cleveland , OH , USA
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Karimov JH, Sunagawa G, Horvath D, Fukamachi K, Starling RC, Moazami N. Limitations to Chronic Right Ventricular Assist Device Support. Ann Thorac Surg 2016; 102:651-8. [DOI: 10.1016/j.athoracsur.2016.02.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 01/20/2016] [Accepted: 02/01/2016] [Indexed: 12/16/2022]
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Right ventricular failure after left ventricular assist devices. J Heart Lung Transplant 2015; 34:1123-30. [DOI: 10.1016/j.healun.2015.06.015] [Citation(s) in RCA: 254] [Impact Index Per Article: 28.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Revised: 06/11/2015] [Accepted: 06/24/2015] [Indexed: 01/31/2023] Open
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