Completely pulsatile high flow circulatory support with a constant-speed centrifugal blood pump: mechanisms and early clinical observations

Various types of rotary blood pumps (axial flow, centrifugal) have been introduced into clinical use recently. These pumps have different pressure-flow characteristics, and some investigators have noted that a limited pump flow rate and less pulsatility are the problems with the axial flow devices....

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Bibliographic Details
Published in:General thoracic and cardiovascular surgery 2007-04, Vol.55 (4), p.158-162
Main Authors: Yamazaki, Kenji, Saito, Satoshi, Kihara, Shinichiro, Tagusari, Osamu, Kurosawa, Hiromi
Format: Article
Language:English
Subjects:
Adult
Cardiomyopathy, Dilated - therapy
Coronary vessels
Equipment Design
Heart-Assist Devices
Humans
Male
Middle Aged
Pulsatile Flow
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Summary:Various types of rotary blood pumps (axial flow, centrifugal) have been introduced into clinical use recently. These pumps have different pressure-flow characteristics, and some investigators have noted that a limited pump flow rate and less pulsatility are the problems with the axial flow devices. A new implantable centrifugal blood pump was developed that has an extremely flat pressure-flow curve and is able to produce a significantly high pump flow rate of 20 l/min at a low pressure of 10-30mmHg. When the pressure difference between the left ventricle and aorta decreases during systole, an instant high peak flow is achieved, which results in a higher peak pressure in the aorta (systolic pressure). During the diastolic phase, the left ventricle-aorta pressure difference increases to maximum, and the pump flow rate decreases to minimum. Thus, the pump flow rate becomes completely pulsatile, and the high peak flow provides a higher mean pump flow rate. This pump was applied to two end-stage heart failure patients (dilated cardiomyopathy, New York Heart Association (NYHA) class IV, inotrope-dependent). The pump was observed to provide completely pulsatile high flow assistance of 6-9 l/min with a constant pump speed. Both patients are currently in NYHA class I after 1 year on the device with no major adverse events. The new centrifugal blood pump provides completely pulsatile high-flow circulatory support with a constant pump speed, which solves the current clinical problems with rotary blood pumps.
ISSN:1863-6705
1863-6713
DOI:10.1007/s11748-007-0098-6