Skip to main content

01.12.2014 | Brief Communication

Influence of a novel electrocardiogram-synchronized rotational-speed-change system of an implantable continuous-flow left ventricular assist device (EVAHEART) on hemolytic performance

verfasst von: Satoru Kishimoto, Kazuma Date, Mamoru Arakawa, Yoshiaki Takewa, Takashi Nishimura, Tomonori Tsukiya, Toshihide Mizuno, Nobumasa Katagiri, Yukihide Kakuta, Daisuke Ogawa, Motonobu Nishimura, Eisuke Tatsumi

Erschienen in: Journal of Artificial Organs | Ausgabe 4/2014

Einloggen, um Zugang zu erhalten

Abstract

We developed a novel controller for a continuous-flow left ventricular assist device (EVAHEART) that can change the pump’s rotational speed (RS) in synchronization with a patient’s myocardial electrocardiogram (ECG) with the aim of facilitating cardiac recovery. We previously presented various applications of this system in animal models, but there remained a concern that the repeated acceleration and deceleration of the impeller may induce additional hemolysis. In this study, we evaluated the blood trauma and motor power consumption induced by our system in a mock circulation. We evaluated our system with a 60-bpm pulse frequency and a variance between the high and low RSs of 500 rpm (EVA-P; n = 4). The continuous modes of EVAHEART (EVA-C; n = 4) and ROTAFLOW (n = 4) were used as controls. The pumps were examined at a mean flow rate of 5.0 ± 0.2 L/min against a mean pressure head of 100 ± 3 mmHg for a 4-h period. As a result, the normalized indexes of the hemolysis levels of EVA-P and EVA-C were 0.0023 ± 0.0019 and 0.0023 ± 0.0025, respectively, and their difference was not significant. The estimated mean motor power consumptions of EVA-C and EVA-P were 6.24 ± 0.33 and 7.19 ± 0.93 W, respectively. When a novel ECG-synchronized RS-change system was applied to EVAHEART, the periodic RS change with a 500-rpm RS variance did not affect the hemolysis at a 60-bpm pulse frequency.
Literatur
1.
Zurück zum Zitat Ando M, Nishimura T, Takewa Y, Yamazaki K, Kyo S, Ono M, et al. Electrocardiogram-synchronized rotational speed change mode in rotary pumps could improve pulsatility. Artif Organs. 2011;35:941–7.PubMedCrossRef Ando M, Nishimura T, Takewa Y, Yamazaki K, Kyo S, Ono M, et al. Electrocardiogram-synchronized rotational speed change mode in rotary pumps could improve pulsatility. Artif Organs. 2011;35:941–7.PubMedCrossRef
2.
Zurück zum Zitat Ando M, Takewa Y, Nishimura T, Yamazaki K, Kyo S, Ono M, et al. A novel counterpulsation mode of rotary left ventricular assist device can enhance myocardial perfusion. J Artif Organs. 2011;14:185–91.PubMedCrossRef Ando M, Takewa Y, Nishimura T, Yamazaki K, Kyo S, Ono M, et al. A novel counterpulsation mode of rotary left ventricular assist device can enhance myocardial perfusion. J Artif Organs. 2011;14:185–91.PubMedCrossRef
3.
Zurück zum Zitat Kishimoto Y, Takewa Y, Arakawa M, Umeki A, Ando M, Nishimura T, et al. Development of a novel drive mode to prevent aortic insufficiency during continuous-flow LVAD support by synchronizing rotational speed with heartbeat. J Artif Organs. 2013;16:129–37.PubMedCrossRef Kishimoto Y, Takewa Y, Arakawa M, Umeki A, Ando M, Nishimura T, et al. Development of a novel drive mode to prevent aortic insufficiency during continuous-flow LVAD support by synchronizing rotational speed with heartbeat. J Artif Organs. 2013;16:129–37.PubMedCrossRef
4.
Zurück zum Zitat Umeki A, Nishimura T, Ando M, Takewa Y, Yamazaki K, Kyo S, et al. Change of coronary flow by continuous-flow left ventricular assist device with cardiac beat synchronizing system (native heart load control system) in acute ischemic heart failure model. Circ J. 2013;77:995–1000.PubMedCrossRef Umeki A, Nishimura T, Ando M, Takewa Y, Yamazaki K, Kyo S, et al. Change of coronary flow by continuous-flow left ventricular assist device with cardiac beat synchronizing system (native heart load control system) in acute ischemic heart failure model. Circ J. 2013;77:995–1000.PubMedCrossRef
5.
Zurück zum Zitat Umeki A, Nishimura T, Ando M, Takewa Y, Yamazaki K, Kyo S, et al. Alteration of LV end-diastolic volume by controlling the power of the continuous-flow LVAD, so it is synchronized with cardiac beat: development of a native heart load control system (NHLCS). J Artif Organs. 2012;15:128–33.PubMedCrossRef Umeki A, Nishimura T, Ando M, Takewa Y, Yamazaki K, Kyo S, et al. Alteration of LV end-diastolic volume by controlling the power of the continuous-flow LVAD, so it is synchronized with cardiac beat: development of a native heart load control system (NHLCS). J Artif Organs. 2012;15:128–33.PubMedCrossRef
6.
Zurück zum Zitat Arakawa M, Nishimura T, Takewa Y, Umeki A, Ando M, Adachi H, et al. Alternation of left ventricular load by a continuous-flow left ventricular assist device with a native heart load control system in a chronic heart failure model. J Thorac Cardiovasc Surg. 2014. doi:10.1016/j.jtcvs.2013.12.049. (Epub ahead of print). Arakawa M, Nishimura T, Takewa Y, Umeki A, Ando M, Adachi H, et al. Alternation of left ventricular load by a continuous-flow left ventricular assist device with a native heart load control system in a chronic heart failure model. J Thorac Cardiovasc Surg. 2014. doi:10.​1016/​j.​jtcvs.​2013.​12.​049. (Epub ahead of print).
7.
Zurück zum Zitat Ando M, Nishimura T, Takawa Y, Ogawa D, Yamazaki K, Kashiwa K, et al. A novel counterpulse drive mode of continuous-flow left ventricular assist device can minimize intracircuit backward flow during pump weaning. J Artif Organs. 2011;14:74–9.PubMedCrossRef Ando M, Nishimura T, Takawa Y, Ogawa D, Yamazaki K, Kashiwa K, et al. A novel counterpulse drive mode of continuous-flow left ventricular assist device can minimize intracircuit backward flow during pump weaning. J Artif Organs. 2011;14:74–9.PubMedCrossRef
8.
Zurück zum Zitat Ando M, Nishimura T, Takewa Y, Kyo S, Ono M, Taenaka Y, et al. Creating an ideal “off-test mode” for rotary left ventricular assist devices: establishing a safe and appropriate weaning protocol after myocardial recovery. J Thorac Cardiovasc Surg. 2012;143:1176–82.PubMedCrossRef Ando M, Nishimura T, Takewa Y, Kyo S, Ono M, Taenaka Y, et al. Creating an ideal “off-test mode” for rotary left ventricular assist devices: establishing a safe and appropriate weaning protocol after myocardial recovery. J Thorac Cardiovasc Surg. 2012;143:1176–82.PubMedCrossRef
9.
Zurück zum Zitat ASTM. ASTM F1841-91. Standard practice for assessment of hemolysis in continuous flow blood pumps. 2005. ASTM. ASTM F1841-91. Standard practice for assessment of hemolysis in continuous flow blood pumps. 2005.
10.
Zurück zum Zitat Sobieski MA, Giridharan GA, Ising M, Koenig SC, Slaughter MS. Blood trauma testing of CentriMag and RotaFlow devices: a pilot study. Artif Organs. 2012;36:677–82.PubMedCrossRef Sobieski MA, Giridharan GA, Ising M, Koenig SC, Slaughter MS. Blood trauma testing of CentriMag and RotaFlow devices: a pilot study. Artif Organs. 2012;36:677–82.PubMedCrossRef
11.
Zurück zum Zitat Araki K, Taenaka Y, Masuzawa T, Wakisaka Y, Nakatani T, Akagi H, et al. In vitro performance in centrifugal blood pumps. Jpn J Artif Organs. 1994;23:898–903. Araki K, Taenaka Y, Masuzawa T, Wakisaka Y, Nakatani T, Akagi H, et al. In vitro performance in centrifugal blood pumps. Jpn J Artif Organs. 1994;23:898–903.
12.
Zurück zum Zitat Tayama E, Nakazawa T, Takami Y, Ohtsubo S, Ohbayashi Y, Andrade AJ, et al. The hemolysis test of Gyro C1E3 pump in pulsatile mode. Artif Organs. 1997;21:657–9. Tayama E, Nakazawa T, Takami Y, Ohtsubo S, Ohbayashi Y, Andrade AJ, et al. The hemolysis test of Gyro C1E3 pump in pulsatile mode. Artif Organs. 1997;21:657–9.
13.
Zurück zum Zitat Tayama E, Niimi Y, Takami Y, Ohashi Y, Ohtsuka G, Glueck JA, et al. Hemolysis test of a centrifugal pump in a pulsatile mode: the effect of pulse rate and RPM variance. Artif Organs. 1997;21:1284–7.PubMedCrossRef Tayama E, Niimi Y, Takami Y, Ohashi Y, Ohtsuka G, Glueck JA, et al. Hemolysis test of a centrifugal pump in a pulsatile mode: the effect of pulse rate and RPM variance. Artif Organs. 1997;21:1284–7.PubMedCrossRef
14.
Zurück zum Zitat Kono S, Nishimura K, Yamada T, Oonishi T, Tsukiya T, Akamatsu T, et al. In vivo and in vitro evaluation of the pulsatile mode of a magnetically suspended centrifugal pump. ASAIO J. 1997;43:M580–4.PubMedCrossRef Kono S, Nishimura K, Yamada T, Oonishi T, Tsukiya T, Akamatsu T, et al. In vivo and in vitro evaluation of the pulsatile mode of a magnetically suspended centrifugal pump. ASAIO J. 1997;43:M580–4.PubMedCrossRef
15.
Zurück zum Zitat Yamazaki K, Kihara S, Akimoto T, Tagusari O, et al. EVAHEART: an implantable centrifugal blood pump for long-term circulatory support. Jpn J Thorac Cardiovasc Surg. 2002;50:461–5.PubMedCrossRef Yamazaki K, Kihara S, Akimoto T, Tagusari O, et al. EVAHEART: an implantable centrifugal blood pump for long-term circulatory support. Jpn J Thorac Cardiovasc Surg. 2002;50:461–5.PubMedCrossRef
Metadaten
Titel
Influence of a novel electrocardiogram-synchronized rotational-speed-change system of an implantable continuous-flow left ventricular assist device (EVAHEART) on hemolytic performance
verfasst von
Satoru Kishimoto
Kazuma Date
Mamoru Arakawa
Yoshiaki Takewa
Takashi Nishimura
Tomonori Tsukiya
Toshihide Mizuno
Nobumasa Katagiri
Yukihide Kakuta
Daisuke Ogawa
Motonobu Nishimura
Eisuke Tatsumi
Publikationsdatum
01.12.2014
Verlag
Springer Japan
Erschienen in
Journal of Artificial Organs / Ausgabe 4/2014
Print ISSN: 1434-7229
Elektronische ISSN: 1619-0904
DOI
https://doi.org/10.1007/s10047-014-0787-8

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.