Rotary Blood Pump Control Strategy for Preventing Left Ventricular Suction

The risk for left ventricular (LV) suction while maintaining adequate perfusion over a range of physiologic conditions during continuous flow LV assist device (LVAD) support is a significant clinical concern. To address this challenge, we developed a suction prevention and physiologic control (SPPC) algorithm for use with axial and centrifugal LVADs. The SPPC algorithm uses two gain-scheduled, proportional-integral controllers that maintain a differential pump speed (&Dgr;RPM) above a user-defined threshold to prevent LV suction, while maintaining an average reference differential pressure (&Dgr;P) between the LV and aorta to provide physiologic perfusion. Efficacy and robustness of the proposed algorithm were evaluated in silico during simulated rest and exercise test conditions for (1) &Dgr;P/&Dgr;RPM excessive setpoint (ES); (2) rapid eightfold increase in pulmonary vascular resistance (PVR); and (3) ES and PVR. Hemodynamic waveforms (LV pressure and volume; aortic pressure and flow) were simulated and analyzed to identify suction event(s), quantify total flow output (pump + cardiac output), and characterize the performance of the SPPC algorithm. The results demonstrated that the proposed SPPC algorithm prevented LV suction while maintaining physiologic perfusion for all simulated test conditions, and warrants further investigation in vivo.

[1]  Nigel H. Lovell,et al.  Noninvasive Detection of Suction in an implantable Rotary Blood Pump Using Neural Networks , 2008, Int. J. Comput. Intell. Appl..

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

[3]  M Komeda,et al.  Physical model-based indirect measurements of blood pressure and flow using a centrifugal pump. , 2000, Artificial organs.

[4]  M Fu,et al.  Computer simulation of sensorless fuzzy control of a rotary blood pump to assure normal physiology. , 2000, ASAIO journal.

[5]  Mikhail Skliar,et al.  Physiological control of blood pumps using intrinsic pump parameters: a computer simulation study. , 2006, Artificial organs.

[6]  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.

[7]  S Takatani,et al.  Detection of suction and regurgitation of the implantable centrifugal pump based on the motor current waveform analysis and its application to optimization of pump flow. , 1999, Artificial organs.

[8]  Georg Wieselthaler,et al.  Development of a suction detection system for axial blood pumps. , 2004, Artificial organs.

[9]  Yorgos Goletsis,et al.  A Gaussian Mixture Model to detect suction events in rotary blood pumps , 2012, 2012 IEEE 12th International Conference on Bioinformatics & Bioengineering (BIBE).

[10]  J R Boston,et al.  Controller for an Axial Flow Blood Pump. , 1996, Artificial organs.

[11]  Nigel H Lovell,et al.  Identification and classification of physiologically significant pumping states in an implantable rotary blood pump. , 2006, Artificial organs.

[12]  Mikhail Skliar,et al.  Modeling and Control of a Brushless DC Axial Flow Ventricular Assist Device , 2002, ASAIO journal.

[13]  Guruprasad A Giridharan,et al.  Fault Detection in Rotary Blood Pumps Using Motor Speed Response , 2013, ASAIO journal.

[14]  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.

[15]  Steven C. Koenig,et al.  Flow Modulation Algorithms for Continuous Flow Left Ventricular Assist Devices to Increase Vascular Pulsatility: A Computer Simulation Study , 2011 .

[16]  G. Giridharan,et al.  Predicted Hemodynamic Benefits Of Counterpulsation Therapy Using A Superficial Surgical Approach , 2006, ASAIO journal.

[17]  Pragasen Pillay,et al.  Modeling, simulation, and analysis of permanent-magnet motor drives. II. The brushless DC motor drive , 1989 .

[18]  J. R. Boston,et al.  Modeling and identification of an axial flow blood pump , 1997, Proceedings of the 1997 American Control Conference (Cat. No.97CH36041).

[19]  L Xu,et al.  Computer Modeling of Interactions of an Electric Motor, Circulatory System, and Rotary Blood Pump , 2000, ASAIO journal.

[20]  K Araki,et al.  Detection of total assist and sucking points based on pulsatility of a continuous flow artificial heart: in vitro evaluation. , 1998, ASAIO journal.

[21]  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.

[22]  Mikhail Skliar,et al.  Nonlinear controller for ventricular assist devices. , 2002, Artificial organs.

[23]  G. Giridharan,et al.  Control strategy for maintaining physiological perfusion with rotary blood pumps. , 2003, Artificial organs.

[24]  D B Olsen.  Sixth International Symposium for Rotary Blood Pumps. , 1999, Artificial organs.

[25]  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).

[26]  D. Mason,et al.  Response of rotary blood pumps to changes in preload and afterload at a fixed speed setting are unphysiological when compared with the natural heart. , 2011, Artificial organs.

[27]  Georg Wieselthaler,et al.  Advanced suction detection for an axial flow pump. , 2006, Artificial organs.

[28]  K Araki,et al.  Sensorless controlling method for a continuous flow left ventricular assist device. , 2000, Artificial organs.

[29]  Guruprasad A. Giridharan,et al.  Physiological control of blood pumps without implantable sensors , 2003, Proceedings of the 2003 American Control Conference, 2003..

[30]  Marwan A. Simaan,et al.  A discriminant-analysis-based suction detection system for rotary blood pumps , 2006, 2006 International Conference of the IEEE Engineering in Medicine and Biology Society.

[31]  James F. Antaki,et al.  A Control System for Rotary Blood Pumps Based on Suction Detection , 2009, IEEE Transactions on Biomedical Engineering.

[32]  J F Antaki,et al.  Dynamic systemic vascular resistance in a sheep supported with a Nimbus AxiPump. , 1994, ASAIO journal.

[33]  George M Pantalos,et al.  Intraoperative evaluation of the HeartMate II flow estimator. , 2009, The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation.