Ren Yiliang, Wang Shaojun, Gao Yu, Li Zijian, Zhang Yao, Wang Fangqun
School of Electrical and Information Engineering, Jiangsu University, Zhenjiang, Jiangsu 212013, P. R. China.
School of Medical Imaging, North Sichuan Medical College, Nanchong, Sichuan 637000, P. R. China.
Sheng Wu Yi Xue Gong Cheng Xue Za Zhi. 2022 Apr 25;39(2):329-338. doi: 10.7507/1001-5515.202109043.
The implantation of biventricular assist device (BiVAD) is more challenging than that of left ventricular assist device for the interaction in the process of multiple input and output. Besides, ventricular assist device (VAD) often runs in constant speed (CS) mode in clinical use and thus BiVAD also faces the problems of low pulsation and imbalance of blood volume between systemic circulation and pulmonary circulation. In this paper, a delay assist mode for a VAD by shortening the support time of VAD was put forward. Then, the effect of the delay mode on cardiac output, pulsation and the function of the aortic valve was observed by numerical method and the rules of hemodynamics were revealed. The research showed that compared with VAD supported in CS mode, the VAD using delay mode in systolic and diastolic period proposed in this paper could meet the demand of cardiac output perfusion and restore the function of the arterial valves. The open ratio of aortic valve (AV) and pulmonary valve (PV) increased with the time set in delay mode, and the blood through the AV/PV helped to balance the left and the right cardiac volume. Besides, delay mode also improved the pulsation index of arterial blood flow, which is conducive to the recovery of the ventricular pulse function of patients.
双心室辅助装置(BiVAD)的植入比左心室辅助装置更具挑战性,因为在多输入输出过程中存在相互作用。此外,心室辅助装置(VAD)在临床使用中常以恒速(CS)模式运行,因此BiVAD还面临搏动性低以及体循环和肺循环之间血容量失衡的问题。本文提出了一种通过缩短VAD支持时间的VAD延迟辅助模式。然后,通过数值方法观察延迟模式对心输出量、搏动以及主动脉瓣功能的影响,并揭示血流动力学规律。研究表明,与CS模式支持的VAD相比,本文提出的在收缩期和舒张期采用延迟模式的VAD能够满足心输出量灌注需求并恢复动脉瓣功能。主动脉瓣(AV)和肺动脉瓣(PV)的开放率随延迟模式设定时间增加,通过AV/PV的血液有助于平衡左右心腔容积。此外,延迟模式还提高了动脉血流的搏动指数,有利于患者心室搏动功能的恢复。