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- Title
- A NEW DEVELOPMENT OF FEEDBACK CONTROLLER FOR LEFT VENTRICULAR ASSIST DEVICE.
- Creator
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Wang, Yu, Simaan, Marwan, University of Central Florida
- Abstract / Description
-
The rotary Left Ventricular Assist Device (LVAD) is a mechanical pump surgically implanted in patients with end-stage congestive heart failure to help maintain the flow of blood from the sick heart. The rotary type pumps are controlled by varying the impeller speed to control the amount of blood flowing through the LVAD. One important challenge in using these devices is to prevent the occurrence of excessive pumping of blood from the left ventricle (known as suction) that may cause it to...
Show moreThe rotary Left Ventricular Assist Device (LVAD) is a mechanical pump surgically implanted in patients with end-stage congestive heart failure to help maintain the flow of blood from the sick heart. The rotary type pumps are controlled by varying the impeller speed to control the amount of blood flowing through the LVAD. One important challenge in using these devices is to prevent the occurrence of excessive pumping of blood from the left ventricle (known as suction) that may cause it to collapse due to the high pump speed. The development of a proper feedback controller for the pump speed is therefore crucial to meet this challenge. In this thesis, some theoretical and practical issues related to the development of such a controller are discussed. First, a basic nonlinear, time-varying cardiovascular-LVAD circuit model that will be used to develop the controller is reviewed. Using this model, a suction index is tested to detect suction. Finally we propose a feedback controller that uses the pump flow signal to regulate the pump speed based on the suction index and an associated threshold. The objective of this controller is to continuously update the pump speed to adapt to the physiological changes of the patient while at the same time avoiding suction. Simulation results are presented under different conditions of the patient activities. Robustness of the controller to measurement noise is also discussed.
Show less - Date Issued
- 2010
- Identifier
- CFE0003296, ucf:48497
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFE0003296
- Title
- Suction Detection and Feedback Control for the Rotary Left Ventricular Assist Device.
- Creator
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Wang, Yu, Simaan, Marwan, Qu, Zhihua, Haralambous, Michael, Kassab, Alain, Divo, Eduardo, University of Central Florida
- Abstract / Description
-
The Left Ventricular Assist Device (LVAD) is a rotary mechanical pump that is implanted in patients with congestive heart failure to help the left ventricle in pumping blood in the circulatory system. The rotary type pumps are controlled by varying the pump motor current to adjust the amount of blood flowing through the LVAD. One important challenge in using such a device is the desire to provide the patient with as close to a normal lifestyle as possible until a donor heart becomes available...
Show moreThe Left Ventricular Assist Device (LVAD) is a rotary mechanical pump that is implanted in patients with congestive heart failure to help the left ventricle in pumping blood in the circulatory system. The rotary type pumps are controlled by varying the pump motor current to adjust the amount of blood flowing through the LVAD. One important challenge in using such a device is the desire to provide the patient with as close to a normal lifestyle as possible until a donor heart becomes available. The development of an appropriate feedback controller that is capable of automatically adjusting the pump current is therefore a crucial step in meeting this challenge. In addition to being able to adapt to changes in the patient's daily activities, the controller must be able to prevent the occurrence of excessive pumping of blood from the left ventricle (a phenomenon known as ventricular suction) that may cause collapse of the left ventricle and damage to the heart muscle and tissues.In this dissertation, we present a new suction detection system that can precisely classify pump flow patterns, based on a Lagrangian Support Vector Machine (LSVM) model that combines six suction indices extracted from the pump flow signal to make a decision about whether the pump is not in suction, approaching suction, or in suction. The proposed method has been tested using in vivo experimental data based on two different LVAD pumps. The results show that the system can produce superior performance in terms of classification accuracy, stability, learning speed, and good robustness compared to three other existing suction detection methods and the original SVM-based algorithm. The ability of the proposed algorithm to detect suction provides a reliable platform for the development of a feedback control system to control the current of the pump (input variable) while at the same time ensuring that suction is avoided.Based on the proposed suction detector, a new control system for the rotary LVAD was developed to automatically regulate the pump current of the device to avoid ventricular suction. The control system consists of an LSVM suction detector and a feedback controller. The LSVM suction detector is activated first so as to correctly classify the pump status as No Suction (NS) or Suction (S). When the detection is (")No Suction("), the feedback controller is activated so as to automatically adjust the pump current in order that the blood flow requirements of the patient's body at different physiological states are met according to the patient's activity level. When the detection is (")Suction("), the pump current is immediately decreased in order to drive the pump back to a normal No Suction operating condition. The performance of the control system was tested in simulations over a wide range of physiological conditions.
Show less - Date Issued
- 2013
- Identifier
- CFE0005070, ucf:49956
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFE0005070
- Title
- A Multi-Scale CFD Analysis of Patient-Specific Geometries to Tailor LVAD Cannula Implantation Under Pulsatile Flow Conditions: an investigation aimed at reducing stroke incidence in LVADs.
- Creator
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Prather, Ray, Kassab, Alain, Mansy, Hansen, Divo, Eduardo, University of Central Florida
- Abstract / Description
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A Left Ventricular Assist Device (LVAD) is a mechanical pump that provides temporary circulatory support when used as bridge-to-transplantation and relieves workload demand placed on a failing heart allowing for myocardia recovery when used as destination therapy. Stroke is the most devastating complication after ventricular assist device (VAD) implantation, with an incidence of 14-47% over 3-6 months. This complication due to thrombus formation and subsequent transport through the...
Show moreA Left Ventricular Assist Device (LVAD) is a mechanical pump that provides temporary circulatory support when used as bridge-to-transplantation and relieves workload demand placed on a failing heart allowing for myocardia recovery when used as destination therapy. Stroke is the most devastating complication after ventricular assist device (VAD) implantation, with an incidence of 14-47% over 3-6 months. This complication due to thrombus formation and subsequent transport through the vasculature to cerebral vessels continues to limit the widespread implementation of VAD therapy. Patient-specific computational fluid dynamics (CFD) analysis may elucidate ways to reduce this risk.We employed a multi-scale model of the aortic circulation in order to examine the effects on flow conditions resulting from varying the VAD cannula implantation location and angle of incidence of the anastomosis to the ascending aorta based on a patient-specific geometry obtained from CT scans. The multi-scale computation consists of a 0D lumped parameter model (LPM) of the circulation modeled via a 50 degree of freedom (DOF) electrical circuit analogy that includes an LVAD model coupled to a 3D computational fluid dynamics model of the circulation. An in-house adaptive Runge-Kutta method is utilized to solve the 50 DOF LPM, and the Starccm+ CFD code is utilized to solve the flowfield. This 0D-3D coupling for the flow is accomplished iteratively with the 0D LPM providing the pulsatile boundary conditions that drive the 3D CFD time-accurate computations of the flowfield. Investigated angle configurations include cannula implantations at 30(&)deg;, 60(&)deg; and 90(&)deg; to the right lateral wall of the ascending aorta. We also considered placements of the VAD cannula along the ascending aorta in which distances of the VAD anastomosis is varied relative to the take-off of the innominate artery. We implemented a mixed Eulerian-Lagrangian particle-tracking scheme to quantify the number of stroke-inducing particles reaching cerebral vessel outlets and included flow visualization through streamlines to identify regions of strong vorticity and flow stagnation, which can promote thrombus formation. Thrombi were modeled as spheres with perfectly elastic interactions numerically released randomly in time and space at cannula inlet plane. Based on clinical observation of the range of thrombus sizes encountered in such cases, particle diameters of 2.5mm and 3.5mm were investigated in our numerical computations. Pulsatile flow results for aforementioned angles suggest that a 90(&)deg; cannula implementation causes flow impingement on the left lateral aortic wall and appears to be highly thrombogenic due to large momentum losses and zones of large re-circulation and that shallow and intermediate cannula angles promote more regular flow carrying particles towards the lower body potentially reducing stroke risk. Indications from this pulsatile numerical study suggest that up to a 50% reduction in stroke rate can be achieve with tailoring of cannula implantation. Results are consistent with significant reduction in stroke incidence achieved by tailoring cannula implantation as reported in previous steady flow computations carried out by our group. As such, results of this study suggest that a simple surgical maneuver in the process of VAD implantation may significantly improve patient life.
Show less - Date Issued
- 2015
- Identifier
- CFE0005689, ucf:50129
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFE0005689
- Title
- A Bench Top Study of the Optimization of LVAD Cannula Implantation to Reduce Risk of Cerebral Embolism.
- Creator
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Clark, William, Kassab, Alain, Divo, Eduardo, Ilie, Marcel, University of Central Florida
- Abstract / Description
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Physical bench top experiments are performed to validate and complement ongoing computational fluid dynamics (CFD) analyses of ventricular assist device (VAD) circulation. VADs are used in patients whose hearts do not function to their maximum potential due advanced stages of heart disease and, consequently, are unable to adequately supply blood to the systemic circulation. VADs are commonly utilized as a bridge-to-transplantation, meaning that they are implanted in patients while waiting for...
Show morePhysical bench top experiments are performed to validate and complement ongoing computational fluid dynamics (CFD) analyses of ventricular assist device (VAD) circulation. VADs are used in patients whose hearts do not function to their maximum potential due advanced stages of heart disease and, consequently, are unable to adequately supply blood to the systemic circulation. VADs are commonly utilized as a bridge-to-transplantation, meaning that they are implanted in patients while waiting for a heart transplant. In such cases of long term utilization of VADs, it has been reported in the literatures that thrombo-embolic cerebral events occur in 14-47% of patients over the period of 6 to 12 months. This is a result of thrombus forming despite the use of anticoagulants and advances in VAD design. Accepting current rates of thrombo-embolisms, the main objective of the project is to identify and propose an optimal surgical cannula implantation orientation aimed at reducing the rate of thrombi reaching the carotid and vertebral arteries and thus reduce the morbidity and mortality rate associated with the long term use of VADs to patients suffering from advanced heart failure. The main focus of the experiment is on the physical aspect using a synthetic anatomically correct model constructed by rapid prototyping of the human aortic arch and surrounding vessels. Three VAD cannula implantation configurations are studied with and without bypass to the left carotid artery or to the Innominate artery with ligation of the branch vessel at its root. A mixture of water and glycerin serves to match blood viscosity measured with a rotating cone-plate viscometer. The Reynolds number in the ascending aorta is matched in the flow model. A closed loop mock circulatory system is then realized. In order to match the Reynolds number in the ascending aorta and LVAD cannula with that of the CFD model, a volumetric flow rate of 2.7 liters per minute is supplied through the synthetic VAD cannula and 0.9 liter per minute is supplied to the ascending aorta. Flow rates are measured using rotary flow meters and a pressure sensor is used to ensure a mean operating pressure of 100 mmHg is maintained. Synthetic acrylic blood clots are injected at the inlet of the VAD cannula and they are captured and counted at the vertebral and carotid arteries. The sizes of the thrombi simulated are 2, 3.5 and 5 mm which are typical of the range of diameters encountered in practice. Nearly 300 particles are released over 5 separate runs for each diameter, and overall embolization rates as well as individual embolization rates are evaluated along with associated confidence levels. The experimental results show consistency between CFD and experiment. Means comparison of thromboembolization rates predicted by CFD and bench-top results using a Z-score statistic with a 95% confidence level results in 22 of 24 cases being statistically equal. This study provides confidence in the predictive capabilities of the bench-top model as a methodology that can be utilized in upcoming studies utilizing patient-specific aortic bed model.
Show less - Date Issued
- 2012
- Identifier
- CFE0004365, ucf:49412
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFE0004365
- Title
- COMPUTATIONAL FLUID DYNAMICS INVESTIGATION OF THE ORIENTATION OF A PEDIATRIC LEFT VENTRICLE ASSIST DEVICE CANNULA TO REDUCE STROKE EVENTS.
- Creator
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Guimond, Stephen, Kassab, Alain, University of Central Florida
- Abstract / Description
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Ventricle Assist Devices (VADs), which are typically either axial or centrifugal flow pumps implanted on the aortic arch, have been used to support patients who are awaiting cardiac transplantation. Success of the apparatus in the short term has led to long term use. Despite anticoagulation measures, blood clots (thrombi) have been known to form in the device itself or inside of the heart. The Ventricle Assist Devices supply blood flow via a conduit (cannula) implanted on the ascending aorta....
Show moreVentricle Assist Devices (VADs), which are typically either axial or centrifugal flow pumps implanted on the aortic arch, have been used to support patients who are awaiting cardiac transplantation. Success of the apparatus in the short term has led to long term use. Despite anticoagulation measures, blood clots (thrombi) have been known to form in the device itself or inside of the heart. The Ventricle Assist Devices supply blood flow via a conduit (cannula) implanted on the ascending aorta. Currently, the implantation angle of the VAD cannula is not taken into consideration. Since the VADs supply a significant amount of blood flow to the aorta, the implantation angle can greatly affect the trajectory of the formed thrombi as well as the cardiac flow field inside of the aortic arch. This study aims to vary the implantation angle of a pediatric Left Ventricle Assist Device (LVAD) through a series of computational fluid dynamics (CFD) software simulations focusing on the aortic arch and its branching arteries of a 20 kg pediatric patient in order to reduce the occurrence of stroke.
Show less - Date Issued
- 2012
- Identifier
- CFH0004305, ucf:45044
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFH0004305
- Title
- Hybrid Multi-Objective Optimization of Left Ventricular Assist Device Outflow Graft Anastomosis Orientation to Minimize Stroke Rate.
- Creator
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Lozinski, Blake, Kassab, Alain, Mansy, Hansen, DeCampli, William, University of Central Florida
- Abstract / Description
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A Left Ventricular Assist Device (LVAD) is a mechanical pump that is utilized as a bridge to transplantation for patients with a Heart Failure (HF) condition. More recently, LVADs have been also used as destination therapy and have provided an increase in the quality of life for patients with HF. However, despite improvements in VAD design and anticoagulation treatment, there remains a significant problem with VAD therapy, namely drive line infection and thromboembolic events leading to...
Show moreA Left Ventricular Assist Device (LVAD) is a mechanical pump that is utilized as a bridge to transplantation for patients with a Heart Failure (HF) condition. More recently, LVADs have been also used as destination therapy and have provided an increase in the quality of life for patients with HF. However, despite improvements in VAD design and anticoagulation treatment, there remains a significant problem with VAD therapy, namely drive line infection and thromboembolic events leading to stroke. This thesis focuses on a surgical maneuver to address the second of these issues, guided by previous steady flow hemodynamic studies that have shown the potential of tailoring the VAD outflow graft (VAD-OG) implantation in providing up to 50% reduction in embolization rates. In the current study, multi-scale pulsatile hemodynamics of the VAD bed is modeled and integrated in a fully automated multi-objective shape optimization scheme in which the VAD-OG anastomosis along the Ascending Aorta (AA) is optimized to minimize the objective function which include thromboembolic events to the cerebral vessels and wall shear stress (WSS). The model is driven by a time dependent pressure and flow boundary conditions located at the boundaries of the 3D domain through a 50 degree of freedom 0D lumped parameter model (LPM). The model includes a time dependent multi-scale Computational Fluid Dynamics (CFD) analysis of a patient specific geometry. Blood rheology is modeled as using the non-Newtonian Carreua-Yasuda model, while the hemodynamics are that of a laminar and constant density fluid. The pulsatile hemodynamics are resolved using the commercial CFD solver StarCCM+ while a Lagrangian particle tracking scheme is used to track constant density particles modeling thromobi released from the cannula to determine embolization rated of thrombi. The results show that cannula anastomosis orientation plays a large role when minimizing the objective function for patient derived aortic bed geometry used in this study. The scheme determined the optimal location of the cannula is located at 5.5 cm from the aortic root, cannula angle at 90 degrees and coronal angle at 8 degrees along the AA with a peak surface average WSS of 55.97 dy/cm2 and stroke percentile of 12.51%. A Pareto front was generated showing the range of 9.7% to 44.08% for stroke and WSS of 55.97 to 81.47 dy/cm2 ranged over 22 implantation configurations for the specific case studied. These results will further assist in the treatment planning for clinicians when implementing a LVAD.
Show less - Date Issued
- 2019
- Identifier
- CFE0007833, ucf:52827
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFE0007833
