Regurgitation during the fully supported condition of the percutaneous left ventricular assist device

Abstract

Abstract Objective. A percutaneous left ventricular assist device (PLVAD) can be used as a bridge to heart transplantation or as a temporary support for end-stage heart failure. Transvalvularly placed PLVADs may result in aortic regurgitation due to unstable pump position during fully supported operation, which may diminish the pumping effect of forward flow and predispose to complications. Therefore, accurate characterization of aortic regurgitation is essential for proper modeling of heart-pump interactions and validation of control strategies. Approach. In the present study, an improved aortic valve model was used to analyze the severity of regurgitation produced by different pump position offsets. The link between pump position offset degree and regurgitation is validated in the fixed speed mode, and the influence of pump speed on regurgitation is verified in the variable speed mode, using the mock circulatory loop (MCL) experimental platform. Main results. The greater the pump offset and the more severe the regurgitation, the more carefully the pump speed needs to be managed. To avoid over-pumping, the recommended pump speed in this study should not exceed 30 000 rpm. Significance. The modeling approach provide in this study not only makes it easier to comprehend the impact of regurgitation events on the entire interactive system during mechanical assistance, but it also aids in providing timely alerts and suitable management measures.