Performance and Robustness of Physiological Controllers With Integrated Pressure Sensors on Inflow Cannula.

The control of left ventricular assist devices (LVADs) requires sensors and/or estimators to account for the physiological state of the patient and apply advanced controllers. Sensor characteristics are a challenge when using implantable pressure sensors because they influence the quality of physiological control and the robustness of the controlled system. The objective of this work is to investigate the performance and robustness of LVAD controllers that operate based on LVAD integrated pressure sensors.

Performance and Reliable Operation of Physiological Controllers Under Various Cardiovascular Models: In Silico and In Vitro Study.

The evaluation of control schemes for left ventricular assist devices (LVADs) requires the utilization of an appropriate model of the human cardiovascular system. Given that different patients and experimental data yield varying performance of the cardiovascular models (CVMs) and their respective parameters, it becomes crucial to assess the reliable operation of controllers. This study aims to assess the performance and reliability of various LVAD controllers using two state-of-the-art CVMs, with a specific focus on the impact of interpatient variability.

Continuous Monitoring of Blood Pressure and Vascular Hemodynamic Properties With Miniature Extravascular Hall-Based Magnetic Sensor.

Continuous measurement of vascular and hemodynamic parameters could improve monitoring of disease progression and enable timely clinical decision making and therapy surveillance in patients suffering from cardiovascular diseases. However, no reliable extravascular implantable sensor technology is currently available. Here, we report the design, characterization, and validation of an extravascular, magnetic flux sensing device capable of capturing the waveforms of the arterial wall diameter, arterial circumferential strain, and arterial pressure without restricting the arterial wall.

In-vitro investigation of endothelial monolayer retention on an inflow VAD cannula inside a beating heart phantom.

Ventricular assist devices (VADs) provide an alternative solution to heart transplantation for patients with end-stage heart failure. Insufficient hemocompatibility of VAD components can result in severe adverse events, such as thromboembolic stroke, and readmissions. To enhance VAD hemocompatibility, and avoid thrombus formation, surface modification techniques and endothelialization strategies are employed.

Building an interdisciplinary program of cardiovascular research at the Swiss Federal Institute of Technology- the ETHeart story.

In this backstory, researchers from Swiss Federal Institute of Technology (ETH Zurich) who initiated an interdisciplinary program to generate innovative solutions for different cardiovascular diseases, such as myocardial infarction, valvular replacement, and movement-based rehabilitation therapy, discuss the benefits and challenges of interdisciplinary research.

Physiologic Data-Driven Iterative Learning Control for Left Ventricular Assist Devices.

Continuous flow ventricular assist devices (cfVADs) constitute a viable and increasingly used therapy for end-stage heart failure patients. However, they are still operating at a fixed-speed mode that precludes physiological cfVAD response and it is often related to adverse events of cfVAD therapy. To ameliorate this, various physiological controllers have been proposed, however, the majority of these controllers do not account for the lack of pulsatility in the cfVAD operation, which is supposed to be beneficial for the physiological function of the cardiovascular system.

Pressure and Bernoulli-Based Flow Measurement via a Tapered Inflow VAD Cannula.

Objective: Currently available ventricular assist devices provide continuous flow and do not adapt to the changing needs of patients. Physiological control algorithms have been proposed that adapt the pump speed based on the left ventricular pressure. However, so far, no clinically used pump can acquire this pressure.

Cardiac Output Estimation: Online Implementation for Left Ventricular Assist Device Support.

Objective: We present a novel pipeline that consists of various algorithms for the estimation of the cardiac output (CO) during ventricular assist devices (VADs) support using a single pump inlet pressure (PIP) sensor as well as pump intrinsic signals.

Methods: A machine learning (ML) model was constructed for the prediction of the aortic valve opening status. When a closed aortic valve is detected, the estimated CO equals the estimated pump flow.

Continuous Heart Volume Monitoring by Fully Implantable Soft Strain Sensor.

Cardiothoracic open-heart surgery has revolutionized the treatment of cardiovascular disease, the leading cause of death worldwide. After the surgery, hemodynamic and volume management can be complicated, for example in case of vasoplegia after endocarditis. Timely treatment is crucial for outcomes.

Control of ventricular unloading using an electrocardiogram-synchronized pulsatile ventricular assist device under high stroke ratios.

Pulsatile ventricular assist devices (pVADs) yield a blood flow that imitates the pulsatile flow of the heart and, therefore, could diminish the adverse events related to the continuous flow provided by the ventricular assist devices that are commonly used. However, their intrinsic characteristics of larger size and higher weight set a burden to their implantation, that along with the frequent mechanical failures and thrombosis events, reduce the usage of pVADs in the clinical environment. In this study, we investigated the possibility to reduce the pump size by using high pump stroke ratios while maintaining the ability to control the hemodynamics of the cardiovascular system (CVS).