In vitro pulsatility analysis of axial-flow and centrifugal-flow left ventricular assist devices

J Biomech Eng. 2013 Mar 1;135(3):34505. doi: 10.1115/1.4023525.

Abstract

Recently, continuous-flow ventricular assist devices (CF-VADs) have supplanted older, pulsatile-flow pumps, for treating patients with advanced heart failure. Despite the excellent results of the newer generation devices, the effects of long-term loss of pulsatility remain unknown. The aim of this study is to compare the ability of both axial and centrifugal continuous-flow pumps to intrinsically modify pulsatility when placed under physiologically diverse conditions. Four VADs, two axial- and two centrifugal-flow, were evaluated on a mock circulatory flow system. Each VAD was operated at a constant impeller speed over three hypothetical cardiac conditions: normo-tensive, hypertensive, and hypotensive. Pulsatility index (PI) was compared for each device under each condition. Centrifugal-flow devices had a higher PI than that of axial-flow pumps. Under normo-tension, flow PI was 0.98 ± 0.03 and 1.50 ± 0.02 for the axial and centrifugal groups, respectively (p < 0.01). Under hypertension, flow PI was 1.90 ± 0.16 and 4.21 ± 0.29 for the axial and centrifugal pumps, respectively (p = 0.01). Under hypotension, PI was 0.73 ± 0.02 and 0.78 ± 0.02 for the axial and centrifugal groups, respectively (p = 0.13). All tested CF-VADs were capable of maintaining some pulsatile-flow when connected in parallel with our mock ventricle. We conclude that centrifugal-flow devices outperform the axial pumps from the basis of PI under tested conditions.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Animals
  • Blood Pressure
  • Centrifugation*
  • Heart Ventricles*
  • Heart-Assist Devices*
  • Hydrodynamics*
  • Hypertension / physiopathology
  • Swine