Improving hemocompatibility in ventricular assist device therapy using physiological control strategies

• Applicant: Professor Dr.-Ing. Steffen Leonhardt
• Subject Area: Hydraulic and Turbo Engines and Piston Engines ; Biomedical Systems Technology
• Term: from 2019 to 2024
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 409796053

• Final Report Year: 2024

Final Report Abstract

The use of continuous-flow left ventricular assist devices (LVADs) has become a standard treatment for patients suffering from end-stage heart failure. However, the rapid rotation of the impeller in these devices exposes red blood cells to unphysiologically high shear rates. This causes damage to the cells known as hemolysis. The ultimate goal of the project He- VAD was to investigate, whether the objective of minimizing hemolysis can be incorporated into LVAD control strategies. The Sputnik1 axial-flow LVAD was primarily investigated within this project. However, the developed methodology can be applied to other continuous-flow LVADs as well. An automated version of the hemolysis test benches according to the ASTM- F1841 standard was developed and used to perform hemolysis experiments under various relevant LVAD operating conditions. A dynamic model of LVAD-induced hemolysis of axialflow LVADs was developed and unknown parameters were identified from experimental data. Subsequently, the hemolysis model was combined with a model of the LVAD-supported cardiovascular system. By investigating the estimated hemolysis for various constant LVAD speeds under various conditions of the cardiovascular system, it was concluded that the speed of the Sputnik1 LVAD should be selected possibly low for hemolysis-minimizing control strategies. Furthermore, a dynamic hemolysis test bench was developed, which also takes into account that LVAD patients typically still have remaining heart activity. The test bench was already assessed for hemocompatibility and will be used in future studies to evaluate LVADs under more relevant operating conditions. The (partial) results have been published in 8 scientific journals and 6 conferences.

Publications

• A Mathematical Model for Estimating Physiological Parameters of Blood Flow through Rotary Blood Pumps. Biomedical Engineering, 54(3), 163-168.
  Telyshev, D. V.
  
• Evaluation of Left Ventricular Assist Device Electrical Current as a Predictor of Left Ventricular Recovery. MDPI AG.
  Telyshev, Dmitry; Pugovkin, Alexander; Ephimov, Ivan; Markov, Aleksandr; Leonhardt, Steffen; Walter, Marian; Karimov, Jamshid & Selishchev, Sergey
  
• Computational fluid dynamics simulation of hemolysis at different levels of circulatory support in the left ventricular assist device Sputnik. Journal of Physics: Conference Series, 2091(1), 012021.
  Romanova, A. & Telyshev, D.
  
• Correlation between Myocardial Function and Electric Current Pulsatility of the Sputnik Left Ventricular Assist Device: In-Vitro Study. Applied Sciences, 11(8), 3359.
  Telyshev, Dmitry V.; Pugovkin, Alexander A.; Ephimov, Ivan A.; Markov, Aleksandr; Leonhardt, Steffen; Walter, Marian; Karimov, Jamshid H. & Selishchev, Sergey V.
  
• Effects of the Design of a Rotary Blood Pump on Hemocompatibility. Biomedical Engineering, 54(5), 327-332.
  Denisov, M. V.; Walter, M.; Leonhard, S. & Telyshev, D. V.
  
• Electrodynamics of Axial-Flow Rotary Blood Pumps. IEEE Access, 9, 164700-164711.
  Nesterenko, Igor V.; Pugovkin, Alexander A.; Leonhardt, Steffen; Walter, Marian; Borchers, Patrick; Markov, Aleksandr; Karimov, Jamshid H.; Selishchev, Sergey V. & Telyshev, Dmitry V.
  
• Flow profile generation for a left ventricular assist device using iterative learning control. Current Directions in Biomedical Engineering, 7(2), 279-282.
  Borchers, Patrick; Walter, Marian; Leonhardt, Steffen; Telyshev, Dmitry & Pugovkin, Alexander
  
• Automated Test Loop To Assess Pump-Induced Hemolysis Under Pulsatile Operating Conditions. In: Abstracts submitted to 48th ESAO Congress [Internet]. Krems, Austria: The International Journal of Artificial Organs; 2022. p. 773. (9; vol. 45).
  Borchers P., Leonhardt S. & Walter M.
  
• Comparison of the Hemocompatibility of an Axial and a Centrifugal Left Ventricular Assist Device in an In Vitro Test Circuit. Journal of Clinical Medicine, 11(12), 3431.
  Borchers, Patrick; Winnersbach, Patrick; Kraemer, Sandra; Beckers, Christian; Buhl, Eva; Leonhardt, Steffen; Rossaint, Rolf; Walter, Marian; Breuer, Thomas & Bleilevens, Christian
  
• Hemolytic Performance in Two Generations of the Sputnik Left Ventricular Assist Device: A Combined Numerical and Experimental Study. Journal of Functional Biomaterials, 13(1), 7.
  Romanova, Alexandra N.; Pugovkin, Alexander A.; Denisov, Maxim V.; Ephimov, Ivan A.; Gusev, Dmitry V.; Walter, Marian; Groth, Thomas; Bockeria, Olga L.; Le, Tatyana G.; Satyukova, Anna S.; Selishchev, Sergey V. & Telyshev, Dmitry V.
  
• Resistivity-based Determination of Pump-induced Hemolysis in Whole Blood. In: Proceedings of the international student scientific conference POSTER 2022 [Internet]. Prag, Czech Republic; 2022. p. 35–38
  Borchers P.
  
• Studies of the Hemocompatibility of the Sputnik Ventricular Assist Device in Constant and Pulse-Modulated Operating Modes. Biomedical Engineering, 56(4), 256-259.
  Romanova, A. N.; Pugovkin, A. A. & Telyshev, D. V.
  
• An Optical Sensor for Continuous Hemolysis Measurement. ESAO Conference, 2024, Aachen, Germany
  Borchers P., Leonhardt S. & Walter M.
  
• Modeling and Control of an Automated Hemolysis Test Bench. IFAC-PapersOnLine, 58(24), 61-65.
  Borchers, Patrick; Leonhardt, Steffen & Walter, Marian
  
• Pump‐Induced Hemolysis of Speed Modulated Axial‐Flow Left Ventricular Assist Devices. Artificial Organs, 49(6), 988-996.
  Borchers, Patrick; Österlein, Kück Ailín; Leonhardt, Steffen & Walter, Marian