在虚拟模拟模型中评估双心室支持用离心泵的性能。

Evaluation of centrifugal blood pump performances for biventricular support in the virtual simulation model.

机构信息

Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA.

R1 Engineering, Euclid, Ohio, USA.

出版信息

Artif Organs. 2022 Aug;46(8):1544-1554. doi: 10.1111/aor.14220. Epub 2022 Mar 10.

DOI:10.1111/aor.14220

PMID:35230724

Abstract

BACKGROUND

Despite the advances in the left ventricular assist device (LVAD), there are still situations that require a biventricular assist device (BVAD) system. The purpose of this study was to explore and compare the system performance interactions with the HeartMate3 (HM3) and HeartWare (HVAD) in a BVAD configuration using the virtual mock loop (VML) simulation tool.

METHODS

The VML simulation tool is an in silico implementation of a lumped parameter model of the cardiovascular system with mechanical circulatory support. Patients with ejection fractions of 60%, 20%, and 15% were simulated in VML, and the HVAD and HM3 in a BVAD with ventricular cannulation were applied to simulated conditions. Pump speeds that restored baseline normal hemodynamics were determined. To determine the optimal speeds for BVAD, the left and right arterial pressures (LAP, RAP) were plotted.

RESULTS

In the HVAD, LAP and RAP are balanced at 11 mm Hg with LVAD 3500 rpm, right ventricular assist device (RVAD) 2200 rpm; at 13 mm Hg with LVAD 3000 rpm, RVAD 1700 rpm; and at 14 mm Hg with LVAD 2500 rpm, RVAD 1300 rpm. For the HM3, at 8 mm Hg with LVAD 7000 rpm, RVAD 5000 rpm; at 9 mm Hg with LVAD 6000 rpm, RVAD 4300 rpm; and at 9.5 mm Hg with LVAD 5000 rpm, RVAD 3500 rpm.

CONCLUSION

The RVAD/LVAD speed ratios required for atrial balance were approximately 0.6 for the HVAD and 0.7 for the HM3. However, the HVAD required RVAD speeds below its range of operation.

摘要

背景

尽管左心室辅助装置（LVAD）取得了进步，但仍有一些情况需要双心室辅助装置（BVAD）系统。本研究旨在使用虚拟模拟回路（VML）仿真工具探讨和比较 HeartMate3（HM3）和 HeartWare（HVAD）在 BVAD 配置中的系统性能相互作用。

方法

VML 仿真工具是心血管系统的集中参数模型的计算机模拟，具有机械循环支持。在 VML 中模拟射血分数为 60%、20%和 15%的患者，并将 HVAD 和 HM3 应用于心室插管的 BVAD。确定恢复基线正常血液动力学的泵速。为了确定 BVAD 的最佳速度，绘制左、右动脉压（LAP、RAP）。

结果

在 HVAD 中，LVAD 3500rpm、RVAD 2200rpm 时 LAP 和 RAP 平衡为 11mmHg；LVAD 3000rpm、RVAD 1700rpm 时 LAP 和 RAP 平衡为 13mmHg；LVAD 2500rpm、RVAD 1300rpm 时 LAP 和 RAP 平衡为 14mmHg。对于 HM3，LVAD 7000rpm、RVAD 5000rpm 时 LAP 为 8mmHg；LVAD 6000rpm、RVAD 4300rpm 时 LAP 为 9mmHg；LVAD 5000rpm、RVAD 3500rpm 时 LAP 为 9.5mmHg。