Detection of aortic valve dynamics in bridge-to-recovery feedback control of the Left Ventricular Assist Device

Aortic valve dynamics - which implies continuous opening and closing of the aortic valve in each cardiac cycle during the feedback control of the rotary Left Ventricular Assist Devices (LVAD) support - has important clinical implications for patients with mild congestive heart failure. When the LVAD is implanted in such patients as a bridge-to-recovery device, permanent closure of the aortic valve must be avoided by maintaining proper control on the power delivered to the device. In this paper, a new aortic valve dynamics detection algorithm based on a Lagrangian Support Vector Machine (LSVM) model is presented. A detection indicator is derived from the systemic vascular flow signal in the circulatory system using a nonlinear mathematical model of the combined cardiovascular-LVAD system and forms the input to the LSVM classifier. The LSVM classifier is trained and tested to classify the aortic valve dynamics into two states: aortic valve opening and closing (i.e. operating normally) and aortic valve permanently closed. Our results show that the proposed algorithm can detect the aortic valve dynamics effectively in terms of classification accuracy and stability. This classifier will be an integral part in the development of a feedback controller for the LVAD when used on patients as a bridge-to-recovery device. The output of the classifier will be used to adjust the power delivered to the LVAD to ensure that the aortic valve opens and closes normally within each cardiac cycle while at the same time making sure that the physiological demands of the patient are met.

[1]  Marwan A. Simaan,et al.  A new method for detecting aortic valve dynamics during control of the rotary Left Ventricular Assist Device support , 2014, 2014 American Control Conference.

[2]  Vladimir Vapnik,et al.  Statistical learning theory , 1998 .

[3]  Eisuke Tatsumi,et al.  Development of a novel drive mode to prevent aortic insufficiency during continuous-flow LVAD support by synchronizing rotational speed with heartbeat , 2013, Journal of Artificial Organs.

[4]  Marwan A. Simaan,et al.  A new current-based control model of the combined cardiovascular and Rotary Left Ventricular Assist Device , 2011, Proceedings of the 2011 American Control Conference.

[5]  Lorenzo Bruzzone,et al.  Classification of hyperspectral remote sensing images with support vector machines , 2004, IEEE Transactions on Geoscience and Remote Sensing.

[6]  Nir Uriel,et al.  Prevalence of de novo aortic insufficiency during long-term support with left ventricular assist devices. , 2010, The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation.

[7]  T. Myers,et al.  Continuous flow pumps and total artificial hearts: management issues. , 2003, The Annals of thoracic surgery.

[8]  Karen May-Newman,et al.  Effect of Left Ventricular Assist Device Outflow Conduit Anastomosis Location on Flow Patterns in the Native Aorta , 2006, ASAIO journal.

[9]  A. Kfoury,et al.  A novel non-invasive method to assess aortic valve opening in HeartMate II left ventricular assist device patients using a modified Karhunen-Loève transformation. , 2010, The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation.

[10]  T. Nakatani,et al.  Aortic valve closure for rapidly deteriorated aortic insufficiency after continuous flow left ventricular assist device implantation , 2013, Journal of Artificial Organs.

[11]  M. Simaan,et al.  An engineering analysis of the aortic valve dynamics in patients with rotary Left Ventricular Assist Devices. , 2013, Journal of healthcare engineering.

[12]  Marwan A. Simaan,et al.  Detection of ventricular suction in an implantable rotary blood pump using support vector machines , 2011, 2011 Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[13]  Marwan A. Simaan,et al.  Feedback control of a rotary left ventricular assist device supporting a failing cardiovascular system , 2012, 2012 American Control Conference (ACC).

[14]  David R. Musicant,et al.  Lagrangian Support Vector Machines , 2001, J. Mach. Learn. Res..

[15]  Marwan A. Simaan,et al.  A Suction Detection System for Rotary Blood Pumps Based on the Lagrangian Support Vector Machine Algorithm , 2013, IEEE Journal of Biomedical and Health Informatics.

[16]  Marwan A. Simaan,et al.  Rotary Heart Assist Devices , 2009, Handbook of Automation.

[17]  Yi-Hung Liu,et al.  Face Recognition Using Total Margin-Based Adaptive Fuzzy Support Vector Machines , 2007, IEEE Transactions on Neural Networks.

[18]  Marwan A. Simaan,et al.  Left Ventricular Assist Devices: Engineering Design Considerations , 2011 .

[19]  James O. Mudd,et al.  Fusion of aortic valve commissures in patients supported by a continuous axial flow left ventricular assist device. , 2008, The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation.

[20]  Miyoko Endo,et al.  Less frequent opening of the aortic valve and a continuous flow pump are risk factors for postoperative onset of aortic insufficiency in patients with a left ventricular assist device. , 2011, Circulation journal : official journal of the Japanese Circulation Society.

[21]  S. Russell,et al.  Advanced heart failure treated with continuous-flow left ventricular assist device. , 2009, The New England journal of medicine.

[22]  Marwan A. Simaan,et al.  A Dynamical State Space Representation and Performance Analysis of a Feedback-Controlled Rotary Left Ventricular Assist Device , 2009, IEEE Transactions on Control Systems Technology.

[23]  Sabine Van Huffel,et al.  Preoperative prediction of malignancy of ovarian tumors using least squares support vector machines , 2003, Artif. Intell. Medicine.