This paper presents a novel mock circulation for the evaluation of ventricular assist devices (VADs), which is based on a hardware-in-the-loop concept. A numerical model of the human blood circulation runs in real time and computes instantaneous pressure, volume, and flow rate values. The VAD to be tested is connected to a numerical-hydraulic interface, which allows the interaction between the VAD and the numerical model of the circulation. The numerical-hydraulic interface consists of two pressure-controlled reservoirs, which apply the computed pressure values from the model to the VAD, and a flow probe to feed the resulting VAD flow rate back to the model. Experimental results are provided to show the proper interaction between a numerical model of the circulation and a mixed-flow blood pump.
Turbodynamic left ventricular assist devices (LVADs) provide a continuous flow depending on the speed at which the pump is set, and do not adapt to the changing requirements of the patient. The limited adaptation of the pump flow (PF) to the amount of venous return can lead to ventricular suction or overload. Physiologic control may compensate such situations by an automatic adaptation of the PF to the volume status of the left ventricle. We evaluated two physiologic control algorithms in an acute study with eight healthy pigs. Both controllers imitate the Frank–Starling law of the heart and are based on a measurement of the left ventricular volume (LVV) or pressure (LVP), respectively. After implantation of a modified Deltastream DP2 blood pump as an LVAD, we tested the responses of the physiologic controllers to hemodynamic changes and compared them with the response of the constant speed (CS) mode. Both physiologic controllers adapted the pump speed (PS) such that the flow was more sensitive to preload and less sensitive to afterload, as compared with the CS mode. As a result, the risk for suction was strongly reduced. Five suction events were observed in the CS mode, one with the volume-based controller and none with the pressure-based controller. The results suggest that both physiologic controllers have the potential to reduce the number of adverse events when used in the clinical setting.