Electrohydraulic Total Artificial Heart Research Articles

Development of an electrohydraulic total artificial heart system: Improvement of pump unit

AbstractAn electrohydraulic total artificial heart (EHTAH) system has been developed. The EHTAH system consists of diaphragm‐type blood pumps, and electrohydraulic actuator, an internal control unit, a transcutaneous energy transfer system (TETS), a transcutaneous optical telemetry system (TOTS), and an internal battery. The reciprocating rotation of the impeller generates oil pressure that drives the blood pumps at alternating intervals. The blood pumps and the actuator were successfully integrated into the pump unit without oil conduits. As a result of miniaturizing the blood pumps and the actuator, the displacement volume and weight of the EHTAH system were decreased to 872 ml and 2492 g, respectively. Furthermore, the maximum flow rate and efficiency increased up to 12 L/min and 15.4%. The pump units and the EHTAH systems were successfully implanted in 36 calves weighing from 55 to 87 kg. In the longest case, a calf with the pump unit survived for 87 days and a calf with the EHTAH system survived for 70 days. The EHTAH system was powered by the TETS, and was powered every day by the internal battery for 40 minutes. These results indicate that the EHTAH system has the potential to become a fully implantable cardiac replacement system. © 2010 Wiley Periodicals, Inc. Electron Comm Jpn, 93(9): 34–46, 2010; Published online in Wiley Online Library (wileyonlinelibrary.com). DOI 10.1002/ecj.10220

Observation of cavitation pits on mechanical heart valve surfaces in an artificial heart used in in vitro testing

Our group has developed an electrohydraulic total artificial heart (EHTAH) with two diaphragm-type blood pumps. Cavitation in a mechanical heart valve (MHV) causes valve surface damage. The objective of this study was to investigate the possibility of estimating the MHV cavitation intensity using the slope of the driving pressure just before valve closure in this artificial heart. Twenty-five and twenty-three-millimeter Medtronic Hall valves were mounted at the inlet and outlet ports, respectively, of both pumps. The EHTAH was connected to the experimental endurance tester developed by our group, and tested under physiological pressure conditions. Cavitation pits could be seen on the inlet valve surface and on the outlet valve surface of the right and left blood pumps. The pits on the inlet valves were more severe than those on the outlet valves in both blood pumps, and the cavitation pits on the inlet valve of the left blood pump were more severe than those on the inlet valve of the right blood pump. The longer the pump running time, the more severe the cavitation pits on the valve surfaces. Cavitation pits were concentrated near the contact area with the valve stop. The major cause of these pits was the squeeze flow between the leaflet and valve stop.

Observation of cavitation pits on a mechanical heart valve surface in an artificial heart used in in vivo testing

The aim of this study was to observe mechanical heart valve (MHV) cavitation pits resulting from in vivo testing of an electrohydraulic total artificial heart (EHTAH). During in vivo testing with three sets of valves (one set used in two animals), the slope of the driving pressure (left and right driving pressure) was used as a factor for investigating cavitation intensity, and the occurrence of cavitation was determined by the observation of cavitation pits on the explanted valve surfaces. Medtronic Hall valves were installed at the inlet and outlet positions of the two blood pumps. The EHTAH was tested using calves weighing 69-80 kg. The cavitation pits on the valve surface of the inlet valves of the left and right blood pumps were examined by scanning electron micrography. The driving pressure slope 5 ms before valve closure exceeded the cavitation threshold during in vitro testing. On both inlet valves, many large pits formed when the driving pressure slope was high and the pump operating time was long. When estimating cavitation intensity during in vivo testing, both a high driving pressure slope and a long operating time are important factors. The cavitation pits observed on the valve surfaces resulting from in vivo testing will eventually lead to leaflet fracture.

Development of an Electrohydraulic Total Artificial Heart System-Improvement of the Pump Unit-

Development of an Electrohydraulic Total Artificial Heart System-Improvement of the Pump Unit-

Mechanism for cavitation of monoleaflet and bileaflet valves in an artificial heart

It is possible that mechanical heart valves mounted in an artificial heart close much faster than those used for clinical valve replacement, resulting in the formation of cavitation bubbles. In this study, the mechanism for mechanical heart cavitation was investigated using the Medtronic Hall monoleaflet valve and the Sorin Bicarbon bileaflet valve mounted at the mitral position in an electrohydraulic total artificial heart. The valve-closing velocity was measured with a charge-coupled device (CCD) laser displacement sensor, and images of mechanical heart valve cavitation were recorded using a high-speed video camera. The valve-closing velocity of the Sorin Bicarbon bileaflet valve was lower than that of the Medtronic Hall monoleaflet valve. Most of the cavitation bubbles generated by the monoleaflet valve were observed near the valve stop; with the Sorin Bicarbon bileaflet valve, cavitation bubbles were concentrated along the leaflet tip. The cavitation density increased as the valve-closing velocity and the valve stop area increased. These results strongly indicate that squeeze flow holds the key to cavitation in the mechanical heart valve. From the perspective of squeeze flow, bileaflet valves with a low valve-closing velocity and a small valve stop area may cause less blood cell damage than monoleaflet valves.

Hydrodynamic Characteristics of Bileaflet Mechanical Heart Valves in an Artificial Heart: Cavitation and Closing Velocity

The aim of this study was to investigate the possibility of using the bileaflet valves in an electrohydraulic total artificial heart (EHTAH). Three kinds of bileaflet valves, namely the ATS valve (ATS Medical Inc., Minneapolis, MN, USA), the St. Jude valve (St. Jude Medical Inc., St. Paul, MN, USA), and the Sorin Bicarbon valve (Sorin Biomedica, Vercelli, Italy), were mounted in the mitral position on an inclined 45 degrees plane in an EHTAH. The pressure waves near the valve surface, the valve-closing velocity, and a high-speed camera were employed to investigate the mechanism for bileaflet valve cavitation. The cavitation bubbles in the bileaflet valves were concentrated along the leaflet tip. The cavitation intensity increased with an increase in the valve-closing velocity. It was established that squeeze flow holds the key to bileaflet valve cavitation. At lower heart rates, the delay time of the asynchronous closure motion between the two leaflets of the Sorin Bicarbon valve was greater than that of the other bileaflet valves. At higher heart rates, no significant difference was observed among the bileaflet valves.

Mechanism for cavitation of monoleaflet and bileaflet valves in an artificial heart

It is possible that mechanical heart valves mounted in an artificial heart close much faster than those used for clinical valve replacement, resulting in the formation of cavitation bubbles. In this study, the mechanism for mechanical heart cavitation was investigated using the Medtronic Hall monoleaflet valve and the Sorin Bicarbon bileaflet valve mounted at the mitral position in an electrohydraulic total artificial heart. The valve-closing velocity was measured with a charge-coupled device (CCD) laser displacement sensor, and images of mechanical heart valve cavitation were recorded using a high-speed video camera. The valve-closing velocity of the Sorin Bicarbon bileaflet valve was lower than that of the Medtronic Hall monoleaflet valve. Most of the cavitation bubbles generated by the monoleaflet valve were observed near the valve stop; with the Sorin Bicarbon bileaflet valve, cavitation bubbles were concentrated along the leaflet tip. The cavitation density increased as the valve-closing velocity and the valve stop area increased. These results strongly indicate that squeeze flow holds the key to cavitation in the mechanical heart valve. From the perspective of squeeze flow, bileaflet valves with a low valve-closing velocity and a small valve stop area may cause less blood cell damage than monoleaflet valves.

Mechanism for cavitation phenomenon in mechanical heart valves

Recently, cavitation on the surface of mechanical heart valve has been studied as a cause of fractures occurring in implanted Mechanical Heart Valves (MHVs). It has been conceived that the MHVs mounted in an artificial heart close much faster than in vivo sue, resulting in cavitation bubbles formation. In this study, six different kinds of monoleaflet and bileaflet valves were mounted in the mitral position in an Electro-Hydraulic Total Artificial Heart (EHTAH), and we investigated the mechanisms for MHV cavitation. The valve closing velocity and a high speed video camera were employed to investigate the mechanism for MHV cavitation. The closing velocity of the bileaflet valves was slower than that of the monoleaflet valves. Cavitation bubbles were concentrated on the edge of the valve stop and along the leaflet tip. It was established that squeeze flow holds the key to MHV cavitation in our study. Cavitation intensity increased with an increase in the valve closing velocity and the valve stop area. With regard to squeeze flow, the bileaflet valve with slow valve-closing velocity and small valve stop areas is better able to prevent blood cell damage than the monoleaflet valves.

Observation and Quantification of Cavitation on a Mechanical Heart Valve with an Electro-Hydraulic Total Artificial Heart

In previous studies, we investigated the cavitation phenomenon in a mechanical heart valve using an electro-hydraulic total artificial heart. With this system, a 50% glycerin solution kept at 37 degrees C was used as the working fluid. We reported that most of the cavitation bubbles were observed near the valve stop and were caused by the squeeze flow. However, in these studies, the effect of the partial pressure of CO(2) on the mechanical heart valve cavitation was neglected. In this study, in order to investigate the effect of the partial pressure of CO(2) on mechanical heart valve cavitation using an electro-hydraulic total artificial heart, we controlled the partial pressure of the CO(2) in vitro. A 25-mm Medtronic Hall valve was installed in the mitral position of an electro-hydraulic total artificial heart. In order to quantify the mechanical heart valve cavitation, we used a high-speed camera. Even though cavitation intensity slightly increased with increases in the PCO(2) at heart rates of 60, 70 and 100 bpm, throughout the experiment, there was no significant difference between the PCO(2) and cavitation intensity.

Estimation of Mechanical Heart Valve Cavitation in an Electro‐hydraulic Total Artificial Heart

The purpose of this study was to establish a method for estimating mechanical in vitro heart valve cavitation in an electro-hydraulic total artificial heart (EHTAH). The variations in the left driving pressure (LDP) slope of the EHTAH were used as an index of the cavitation intensity. The LDP slope was controlled by changing the stroke volume of the EHTAH. The stroke volume was changed from full-filling and full-eject to partial-filling and partial-eject conditions. A 25-mm Medtronic Hall valve was installed in the mitral position of the EHTAH. Cavitation bubbles were concentrated on the valve stop; the major cause of these cavitation bubbles was determined to be squeeze flow. The valve-closing velocity was found to be proportional to increases in the LDP slope and the stroke volume of the left blood pump. The cavitation intensity and the cavitation event rate increased with increases in the stroke volume of the EHTAH. A consistent correlation was observed between the valve-closing velocity and the cavitation intensity. The LDP slope of the EHTAH may play an important role in estimating the mechanical heart valve cavitation intensity.

Mechanisms of Mechanical Heart Valve Cavitation in an Electrohydraulic Total Artificial Heart

Until now, we have estimated cavitation for mechanical heart valves (MHV) mounted in an electrohydraulic total artificial heart (EHTAH) with tap water as a working fluid. However, tap water at room temperature is not a proper substitute for blood at 37 degrees C. We therefore investigated MHV cavitation using a glycerin solution that was identical in viscosity and vapor pressure to blood at body temperature. In this study, six different kinds of monoleaflet and bileaflet valves were mounted in the mitral position in an EHTAH, and we investigated the mechanisms for MHV cavitation. The valve closing velocity, pressure drop measurements, and a high-speed video camera were used to investigate the mechanism for MHV cavitation and to select the best MHV for our EHTAH. The closing velocity of the bileaflet valves was slower than that of the monoleaflet valves. Cavitation bubbles were concentrated on the edge of the valve stop and along the leaflet tip. It was established that squeeze flow holds the key to MHV cavitation in our study. Cavitation intensity increased with an increase in the valve closing velocity and the valve stop area. With regard to squeeze flow, the Björk-Shiley valve, because it is associated with slow squeeze flow, and the bileaflet valve with low valve closing velocity and small valve stop areas are better able to prevent blood cell damage than the monoleaflet valves.

PHYSIOLOGICAL CONTROLLER DESIGN OF THE NCKU ELECTRO-HYDRAULIC TOTAL ARTIFICIAL HEART

This work aims at developing a control logic that can support the electro-hydraulic total artificial heart (EHTAH) operating autonomously in accordance with the cardiac physiology. In the development of the control law, a set of system dynamic equations were used as the platform. A Starling-like cardiac control for a volumetrically-coupled, alternate left and right pumping is developed. In this Starling-like auto-regulation, cardiac output increases in response to the elevation of the blood return pressure. A reference model was constructed with the right ventricle diastolic or venous return mean pressure considered as the input, and the heart rate as well as the desired aortic and pulmonary arterial pressure waveforms generated as the output. Physiologically compatible EHTAH actuation is achieved by regulating the switching and the torque motor speeds subject to the control logic and the reference model constructed. In the pressure tracking control design, the method of neural adaptive model reference control was employed. General and specialized training procedures have been enforced to determine the connection weights associated with the neural controller. The trained neural controller shows a fast response in the pressure tracking control. Two Starling-like control logics, namely, error proportional and gain scheduling were proposed and examined. Both logics can lead to Starling-like blood regulation, though differing in transient behaviors. Gain scheduling logic is found more appealing for it can regulate the cardiac output change in a rapid and monotonically converging manner.

Mechanism for Cavitation in the Mechanical Heart Valve With an Artificial Heart: Nuclei and Viscosity Dependence

Until now, we have estimated cavitation for mechanical heart valves (MHV) mounted in an electrohydraulic total artificial heart (EHTAH) with tap water. However, tap water at room temperature is not a proper substitute for blood at 37 degrees C. We therefore investigated fluid characterization in studies of MHV cavitation associated with the viscosity and nuclei content of a testing fluid. We used the Medtronic Hall valve mounted in the mitral position of the EHTAH. As testing fluids, tap water, distilled water, and glycerin solution were used. The valve-closing velocity, pressure-drop measurements, and a high-speed video camera were employed to determine the cavitation intensity in MHV. Most of the cavitation bubbles were observed at the edge of the valve stop. Our analysis of the results indicates that squeeze flow is the major cause of cavitation in the Medtronic Hall valve. The cavitation intensity increased with increases in the fluid viscosity and the valve-closing velocity. Even if cavitation intensity in glycerin solution was greater, the cavitation occurrence probability was less in glycerin solution than in tap water. Our results suggest that tap water contains particles that cause an increase in the cavitation occurrence probability. We conclude that cavitation intensity is greatly affected by the nuclei concentration in the fluid and the fluid viscosity.

Observation of cavitation bubbles in monoleaflet mechanical heart valves

Recently, cavitation on the surface of mechanical heart valves (MHVs) has been studied as a cause of fractures occurring in implanted MHVs. In the present study, we investigated the mechanism of MHV cavitation associated with the Björk-Shiley valve and the Medtronic Hall valve in an electrohydraulic total artificial heart (EHTAH). The valves were mounted in the mitral position in the EHTAH. The valve closing motion, pressure drop measurements, and cavitation capture were employed to investigate the mechanisms for cavitation in the MHV. There are no differences in valve closing velocity between the two valves, and its value ranged from 0.53 to 1.96 m/s. The magnitude of negative pressure increased with an increase in the heart rate, and the negative pressure in the Medtronic Hall valve was greater than that in the Björk-Shiley valve. Cavitation bubbles were concentrated at the edge of the valve stop; the major cause of these cavitation bubbles was determined to be the squeeze flow. The formation of cavitation bubbles depended on the valve closing velocity and the valve leaflet geometry. From the viewpoint of squeeze flow, the Björk-Shiley valve was less likely to cause blood cell damage than the Medtronic Hall valve in our EHTAH.

Cavitation Phenomenon in Monoleaflet Mechanical Heart Valves with Electrohydraulic Total Artificial Heart

Recently, cavitation on the surface of mechanical heart valves has been studied as a cause of fractures occurring in implanted mechanical heart valves. In this study, to investigate the mechanism of cavitation bubbles associated with monoleaflet mitral valves in an electrohydraulic total artificial heart (EHTAH), and to select the best valves for our EHTAH system, we measured three parameters. First, an image was created of the cavitation bubbles using a high-speed camera. Second, pressure drop in the vicinity of the valve surface was measured using mini pressure sensor. Then, the closing of the valve was observed using a Laser displacement sensor. Most of the cavitation bubbles in the Medtronic Hall valve were observed at the edge of the valve stop. With the Omnicarbon valve, the cavitation bubbles were observed at the edge of the valve and on the inner side of the leaflet. On the other hand, cavitation bubbles were observed only on the inner side of the leaflet in Björk-Shiley valve. Cavitation bubbles concentrated on the edge of the valve stop; the major cause of these cavitation bubbles was determined to be the squeeze flow. The formation of cavitation bubbles depended on the valve closing velocity and the valve leaflet geometry. From a viewpoint of squeeze flow, a low closing velocity and a small size of the valve stop could minimize cavitation.

A Study on the Mechanism for Cavitation in the Mechanical Heart Valves with an Electrohydraulic Total Artificial Heart

It has been conceived that the mechanical heart valves mounted in an artificial heart close much faster than in vivo use, resulting in cavitation bubbles formation. In this study, the mechanisms for cavitation in mechanical heart valves (MHVs) is investigated with monoleaflet and bileaflet valves in the mitral position with an electrohydraulic total artificial heart (EHTAH). The valve-closing velocity and pressure-drop through the valve were done, and a high-speed video camera was employed to investigate the mechanism for MHVs cavitation. The valve-closing velocity and pressure-drop of the bileaflet valves were less than that of the monoleaflet valves. Most of the cavitation bubbles in the monoleaflet valves were observed next to the edge of the valve stop and the inner side of the leaflet. With the bileaflet valves, cavitation bubbles were concentrated along the leaflet tip. Also, the number density of cavitation bubbles in the bileaflet valves was less than that of the monoleaflet valves. The number density of cavitation bubbles increased with an increase in the valve-closing velocity and the valve stop area. It is established that squeeze flow holds the key to cavitation in the mechanical heart valve. In a viewpoint of squeeze flow, the bileaflet valve with slow valve-closing velocity and small valve stop area, is safer to prevent of blood cell damage than the monoleaflet valves.

138 完全埋込み型全人工心臓用経皮エネルギー伝送システムの開発

138 完全埋込み型全人工心臓用経皮エネルギー伝送システムの開発

136 国立循環器病センターにおける電気油圧駆動型全人工心臓の開発現状

136 国立循環器病センターにおける電気油圧駆動型全人工心臓の開発現状

Measurement of the closing behavior of the björk-shiley monoleaflet mechanical heart valve with an electrohydraulic total artificial heart.

When cavitation occurs near a material surface of a mechanical heart valve (MHV), pits on the surface of the MHV and hemolysis are caused. Therefore, it is very important to investigate the possibility of the occurrence of cavitation in an MHV. To study the possibility of cavitation occurrence in a 25 mm Björk-Shiley monoleaflet, we analyzed the closing behavior of these valves. The closing event of these valves in the mitral and aortic positions was simulated in an electrohydraulic total artificial heart with a stroke volume of 100 ml. Tests were conducted under physiologic pressures at heart rates of 50, 60, 70, and 80 beats/min with cardiac outputs of 4.8, 5.9, 7.0, and 8.1 l/min, respectively. The disk-closing behavior was measured by a laser displacement sensor. The closing behaviors were investigated with various cardiac outputs and gravity direction. The maximum velocities of the aortic valve ranged from 0.8 to 0.9 m/s, and for the mitral valve ranged from 1.48 to 1.6 m/s. In aortic position valves, the maximum closing velocities were less than the reported cavitation thresholds, but the maximum closing velocities of the mitral valve were similar to the cavitation threshold. Therefore, we suggest that there should be the possibility of cavitation occurrence in the mitral valve of an electrohydraulic total artificial heart.

The National Cardiovascular Center electrohydraulic total artificial heart and ventricular assist device systems: current status of development.

Electrohydraulic total artificial heart (EHTAH) and electrohydraulic ventricular assist device (EHVAD) systems have been developed in our institute. The EHTAH system comprises a pumping unit consisting of blood pumps and an actuator, as well as an electronic unit consisting of an internal controller, internal and external batteries, and transcutaneous energy transfer (TET) and optical telemetry (TOT) subunits. The actuator, placed outside the pericardial space, reciprocates and delivers hydraulic silicone oil to the alternate blood pumps through a pair of flexible oil conduits. The pumping unit with an external controller was implanted in 10 calves as small as 55 kg. Two animals survived for more than 12 weeks in a good general condition. The assumed cardiac output ranged between 6 and 10 L/min, the power consumption was 12-18 W, and the energy efficiency was estimated to be 9-11%. Initial implantation of subtotal system including electronic units was further conducted in another calf weighing 73 kg. It survived for 3 days with a completely tether free system. The EHVAD system is developed by using the left blood pump and the actuator of the EHTAH, which were packaged in a compact metal casing with a compliance chamber. In vitro testing demonstrated maximum output more than 9 L/min and more than 13% maximum efficiency. The initial animal testing lasted for 25 days. These results indicate that our EHTAH and EHVAD have the potential to be totally implantable systems.