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Ferrari A, Giampietro C, Bachmann B, Bernardi L, Bezuidenhhout D, Ermanni P, Hopf R, Kitz S, Kress G, Loosli C, Marina V, Meboldt M, Pellegrini G, Poulikakos D, Rebholz M, Schmid Daners M, Schmidt T, Starck C, Stefopoulos G, Sündermann S, Thamsen B, Zilla P, Potapov E, Falk V, Mazza E. A Novel Hybrid Membrane VAD as First Step Toward Hemocompatible Blood Propulsion. Ann Biomed Eng 2020; 49:716-731. [PMID: 32901382 PMCID: PMC7851026 DOI: 10.1007/s10439-020-02590-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 08/11/2020] [Indexed: 12/31/2022]
Abstract
Heart failure is a raising cause of mortality. Heart transplantation and ventricular assist device (VAD) support represent the only available lifelines for end stage disease. In the context of donor organ shortage, the future role of VAD as destination therapy is emerging. Yet, major drawbacks are connected to the long-term implantation of current devices. Poor VAD hemocompatibility exposes the patient to life-threatening events, including haemorrhagic syndromes and thrombosis. Here, we introduce a new concept of artificial support, the Hybrid Membrane VAD, as a first-of-its-kind pump prototype enabling physiological blood propulsion through the cyclic actuation of a hyperelastic membrane, enabling the protection from the thrombogenic interaction between blood and the implant materials. The centre of the luminal membrane surface displays a rationally-developed surface topography interfering with flow to support a living endothelium. The precast cell layer survives to a range of dynamically changing pump actuating conditions i.e., actuation frequency from 1 to 4 Hz, stroke volume from 12 to 30 mL, and support duration up to 313 min, which are tested both in vitro and in vivo, ensuring the full retention of tissue integrity and connectivity under challenging conditions. In summary, the presented results constitute a proof of principle for the Hybrid Membrane VAD concept and represent the basis for its future development towards clinical validation.
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Affiliation(s)
- Aldo Ferrari
- Laboratory of Thermodynamics in Emerging Technologies, Department of Mechanical and Process Engineering, ETH Zurich, Sonneggstrasse 3, 8092, Zurich, Switzerland. .,EMPA, Swiss Federal Laboratories for Material Science and Technologies, Überlandstrasse 129, 8600, Dübendorf, Switzerland. .,Institute for Mechanical Systems, ETH Zurich, 8092, Zurich, Switzerland.
| | - Costanza Giampietro
- Laboratory of Thermodynamics in Emerging Technologies, Department of Mechanical and Process Engineering, ETH Zurich, Sonneggstrasse 3, 8092, Zurich, Switzerland.,EMPA, Swiss Federal Laboratories for Material Science and Technologies, Überlandstrasse 129, 8600, Dübendorf, Switzerland
| | - Björn Bachmann
- Laboratory of Thermodynamics in Emerging Technologies, Department of Mechanical and Process Engineering, ETH Zurich, Sonneggstrasse 3, 8092, Zurich, Switzerland
| | - Laura Bernardi
- Institute for Mechanical Systems, ETH Zurich, 8092, Zurich, Switzerland
| | - Deon Bezuidenhhout
- Christiaan Barnard Division of Cardiothoracic Surgery, University of Cape Town, Cape Town, South Africa
| | - Paolo Ermanni
- Laboratory of Composite Materials and Adaptive Structures, ETH Zurich, 8092, Zurich, Switzerland
| | - Raoul Hopf
- EMPA, Swiss Federal Laboratories for Material Science and Technologies, Überlandstrasse 129, 8600, Dübendorf, Switzerland.,Institute for Mechanical Systems, ETH Zurich, 8092, Zurich, Switzerland
| | - Sarah Kitz
- Laboratory for Animal Model Pathology, Institute of Veterinary Pathology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Gerald Kress
- Laboratory of Composite Materials and Adaptive Structures, ETH Zurich, 8092, Zurich, Switzerland
| | - Christian Loosli
- Laboratory of Composite Materials and Adaptive Structures, ETH Zurich, 8092, Zurich, Switzerland
| | - Vita Marina
- Institute for Mechanical Systems, ETH Zurich, 8092, Zurich, Switzerland
| | - Mirko Meboldt
- Product Development Group Zurich, Department of Mechanical and Process Engineering, ETH Zurich, Zurich, Switzerland
| | - Giovanni Pellegrini
- Laboratory for Animal Model Pathology, Institute of Veterinary Pathology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Dimos Poulikakos
- Laboratory of Thermodynamics in Emerging Technologies, Department of Mechanical and Process Engineering, ETH Zurich, Sonneggstrasse 3, 8092, Zurich, Switzerland
| | - Mathias Rebholz
- Product Development Group Zurich, Department of Mechanical and Process Engineering, ETH Zurich, Zurich, Switzerland
| | - Marianne Schmid Daners
- Product Development Group Zurich, Department of Mechanical and Process Engineering, ETH Zurich, Zurich, Switzerland
| | - Tanja Schmidt
- Julius Wolff Institute and Center for Musculoskeletal Surgery, Charité - Universitätsmedizin, Berlin, Germany
| | - Christoph Starck
- Department of Cardiothoracic and Vascular Surgery, German Heart Institute Berlin, Berlin, Germany
| | - Georgios Stefopoulos
- Laboratory of Thermodynamics in Emerging Technologies, Department of Mechanical and Process Engineering, ETH Zurich, Sonneggstrasse 3, 8092, Zurich, Switzerland
| | - Simon Sündermann
- Department of Cardiothoracic and Vascular Surgery, German Heart Institute Berlin, Berlin, Germany.,Department of Cardiovascular Surgery, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Deutsches Zentrum für Herz-Kreislaufforschung, Standort Berlin, Germany
| | - Bente Thamsen
- Product Development Group Zurich, Department of Mechanical and Process Engineering, ETH Zurich, Zurich, Switzerland
| | - Peter Zilla
- Christiaan Barnard Division of Cardiothoracic Surgery, University of Cape Town, Cape Town, South Africa
| | - Evgenij Potapov
- Department of Cardiothoracic and Vascular Surgery, German Heart Institute Berlin, Berlin, Germany.,Department of Cardiovascular Surgery, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Deutsches Zentrum für Herz-Kreislaufforschung, Standort Berlin, Germany.,Translational Cardiovascular Technologies, Institute of Translational Medicine, Department of Health Sciences and Technology, Swiss Federal Institute of Technology (ETH), Zurich, Switzerland
| | - Volkmar Falk
- Department of Cardiothoracic and Vascular Surgery, German Heart Institute Berlin, Berlin, Germany. .,Department of Cardiovascular Surgery, Charité - Universitätsmedizin Berlin, Berlin, Germany. .,Deutsches Zentrum für Herz-Kreislaufforschung, Standort Berlin, Germany. .,Translational Cardiovascular Technologies, Institute of Translational Medicine, Department of Health Sciences and Technology, Swiss Federal Institute of Technology (ETH), Zurich, Switzerland.
| | - Edoardo Mazza
- EMPA, Swiss Federal Laboratories for Material Science and Technologies, Überlandstrasse 129, 8600, Dübendorf, Switzerland. .,Institute for Mechanical Systems, ETH Zurich, 8092, Zurich, Switzerland.
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Rebholz M, Dual S, Batliner M, Meboldt M, Schmid Daners M. Short-term physiological response to high-frequency-actuated pVAD support. Artif Organs 2019; 43:1170-1181. [PMID: 31211873 DOI: 10.1111/aor.13521] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 05/29/2019] [Accepted: 06/07/2019] [Indexed: 01/04/2023]
Abstract
Ventricular assist devices (VADs) are an established treatment option for heart failure (HF). However, the devices are often plagued by material-related hemocompatibility issues. In contrast to continuous flow VADs with high shear stresses, pulsatile VADs (pVADs) offer the potential for an endothelial cell coating that promises to prevent many adverse events caused by an insufficient hemocompatibility. However, their size and weight often precludes their intracorporeal implantation. A reduction of the pump body size and weight of the pump could be achieved by an increase in the stroke frequency while maintaining a similar cardiac output. We present a new pVAD system consisting of a pump and an actuator specifically designed for actuation frequencies of up to 240 bpm. In vitro and in vivo results of the short-term reaction of the cardiovascular system show no significant changes in left ventricular and aortic pressure between actuation frequencies from 60 to 240 bpm. The aortic pulsatility increases when the actuation frequency is raised while the heart rate remains unaffected in vivo. These results lead us to the conclusion that the cardiovascular system tolerates short-term increases of the pVAD stroke frequencies.
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Affiliation(s)
- Mathias Rebholz
- Product Development Group Zurich, ETH Zurich, Zurich, Switzerland
| | - Seraina Dual
- Product Development Group Zurich, ETH Zurich, Zurich, Switzerland
| | - Martin Batliner
- Product Development Group Zurich, ETH Zurich, Zurich, Switzerland
| | - Mirko Meboldt
- Product Development Group Zurich, ETH Zurich, Zurich, Switzerland
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