A novel pulsatile blood pump design for cardiothoracic surgery: Proof-of-concept in a mock circulation

Artif Organs. 2023 Mar;47(3):512-525. doi: 10.1111/aor.14436. Epub 2022 Nov 12.

Abstract

Background: Pulsatile perfusion during extracorporeal circulation is a promising concept to improve perfusion of critical organs. Clinical benefits are limited by the amount of pulsatile energy provided by standard pumps. The present study investigated the properties of a novel positive displacement blood pump in a mock circulation.

Methods: The pump was attached to an aortic model with a human-like geometry and compliance as a pseudo patient. Hemodynamic data were recorded while the pump settings were adjusted systematically.

Results: Using a regular oxygenator, maximum flow was 2.6 L/min at a pressure of 27 mm Hg and a frequency (F) of 90 bpm. Pulse pressure (PP; 28.9 mm Hg) and surplus hemodynamic energy (SHE; 26.1% of mean arterial pressure) were highest at F = 40 bpm. Flow and pressure profiles appeared sinusoid. Using a low-resistance membrane ventilator to assess the impact of back pressure, maximum flow was 4.0 L/min at a pressure of 58.6 mm Hg and F = 40 bpm. At F = 40 bpm, PP was 58.7 mm Hg with an SHE of 33.4%. SHE decreased with increasing flow, heart rate, and systolic percentage but surpassed 10% with reasonable settings.

Conclusions: The present prototype achieved sufficient flow and pressure ranges only in the presence of a low-resistance membrane ventilator. It delivered supraphysiologic levels of pulse pressure and SHE. Further modifications are planned to establish this concept for adult pulsatile perfusion.

Keywords: blood pump; extracorporeal circulation; pulsatile perfusion; surplus hemodynamic energy.

MeSH terms

  • Adult
  • Blood Pressure
  • Extracorporeal Circulation*
  • Hemodynamics* / physiology
  • Humans
  • Perfusion
  • Pulsatile Flow / physiology