Continuous-flow pump model study: the effect on pump performance of pump characteristics and cardiovascular conditions

Abstract

This model study evaluates the effect of pump characteristics and cardiovascular data on hemodynamics in atrio-aortic VAD assistance. The model includes a computational circulatory sub-model and an electrical sub-model representing two rotary blood pumps through their pressure-flow characteristics. The first is close to a pressure generator-PG (average flow sensitivity to pressure variations, -0.047lmmHg(-1)); the second is closer to a flow generator-FG (average flow sensitivity to pressure variations, -0.0097lmmHg(-1)). Interaction with VAD was achieved by means of two interfaces, behaving as impedance transformers. The model was verified by use of literature data and VAD onset conditions were used as a control for the experiments. Tests compared the two pumps, at constant pump speed, in different ventricular and circulatory conditions: maximum ventricular elastance (0.44-0.9mmHgcm(-3)), systemic peripheral resistance (781-1200gcm(-4)s(-1)), ventricular diastolic compliance C p (5-10-50cm(3)mmHg(-1)), systemic arterial compliance (0.9-1.8cm(3)mmHg(-1)). Analyzed variables were: arterial and venous pressures, flows, ventricular volume, external work, and surplus hemodynamic energy (SHE). The PG pump generated the highest SHE under almost all conditions, in particular for higher C p (+50%). PG pump flow is also the most sensitive to E max and C p changes (-26 and -33%, respectively). The FG pump generally guarantees higher external work reduction (54%) and flow less dependent on circulatory and ventricular conditions. The results are evidence of the importance of pump speed regulation with changing ventricular conditions. The computational sub-model will be part of a hydro-numerical model, including autonomic controls, designed to test different VADs.