To address the challenge of unloading the left ventricle during pediatric mechanical circulatory support using next-generation rotary blood pumps, a novel inflow cannula was developed. This unique inflow cannula for pediatric, continuous-flow, left ventricular assist devices (VADs) with a parabolic-shaped inlet entrance was evaluated alongside a bevel-tip and fenestrated-tip cannula via an ex vivo, isolated-heart experimental setup. Performance was characterized using two clinical scenarios of over-pumping and hypovolemia, created by varying pump speed and filling preload pressure, respectively, at ideal and off-axis cannula placement to assess ventricular unloading and positional sensitivity. Quantitative and qualitative assessments were performed on the resultant hemodynamics and intra-ventricular boroscopic images to classify conditions of nonsuction, partial, gradual or severe entrainment, and ventricular collapse. The parabolic-tip cannula was found to be significantly less sensitive to placement position (p < 0.001) than the bevel-tip cannula under all conditions, while not statistically different from the fenestrated cannula. Visual analysis of the parabolic-tip cannula showed complete resistance to entrainment, whereas the fenestrated-tip had partial entrainment in 90% and 87% of the over-pumping and hypovolemic studies, respectively. We conclude that future pediatric VAD designs may benefit from incorporating the parabolic-tip inflow cannula design to maximize unloading of the left ventricle in ideal and nonoptimal conditions.
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http://dx.doi.org/10.1097/MAT.0000000000000411 | DOI Listing |
Indian J Ophthalmol
December 2024
Department of Oculoplasty, Disha Eye Hospitals Pvt Ltd, Kolkata, West Bengal, India.
JTCVS Open
October 2024
Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio.
Objective: A less-invasive left atrial assist device (LAADx) is a novel and implantable, extracardiac blood pump concept, intended for the treatment of diastolic heart failure, represented by heart failure with preserved ejection fraction.
Methods: A mixed-flow pump was used as the working LAADx model. Its performance was evaluated at 3 speeds, using an in vitro pulsatile mock circulatory loop, with a pneumatic pump that can simulate diastolic heart failure conditions by adjusting the diastolic drive pressure.
Comput Methods Programs Biomed
December 2024
National Research Council, Institute of Clinical Physiology (IFC-CNR), 00185 Rome, Italy; Faculty of Medicine, Teaching University Geomedi, 0114 Tbilisi, Georgia. Electronic address:
Background And Objective: Right ventricular failure increases short-term mortality in the setting of acute myocardial infarction, cardiogenic shock, advanced left-sided heart failure and pulmonary arterial hypertension. Percutaneous and surgically implanted right ventricular assist devices (RVAD) have been investigated in different clinical settings. The use of the ProtekDuo™ is currently a promising approach due to its features such as groin-free approach leading to early mobilisation, easy percutaneous deployment, compatibility with different pumps and oxygenators, and adaptability to different configurations.
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November 2024
Department of Cardiology and Vascular Medicine, University Hospital Frankfurt, Goethe-University Frankfurt, ZIM-Med. Klinik 3-Kardiologie, Angiologie, Frankfurt am Main, Germany.
Perfusion
September 2024
Department of Surgery, Division of Cardiothoracic Surgery, Washington University School of Medicine, Barnes-Jewish Hospital, St Louis, MO, USA.
Introduction: The Protek Duo (PtD) dual lumen, single cannula was developed as a percutaneous system for temporary mechanical support, inserted through the internal jugular vein (IJ) for both atrial inflow and pulmonary artery outflow. Outcomes of PtD compared to alternative Peripheral Right Ventricular Assist Device (pRVAD) methods are limited.
Methods: A retrospective analysis was conducted of pRVAD recipients from January 2017 - February 2022 ( = 111).
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