Pulsatile Conduit Pressure Gradients in the HeartWare HVAD.

Jain, P; Shehab, S; Stevens, M; Macdonald, P; Jansz, P; Hayward, C

Pulsatile Conduit Pressure Gradients in the HeartWare HVAD.

Jain, P Shehab, S Stevens, M Macdonald, P

Jansz, P Hayward, C

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Publication Type:: Journal Article
Citation:: ASAIO J, 2019, 65 (5), pp. 489 - 494
Issue Date:: 2019-07

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Field	Value	Language
dc.contributor.author	Jain, P	en_US
dc.contributor.author	Shehab, S	en_US
dc.contributor.author	Stevens, M	en_US
dc.contributor.author	Macdonald, P https://orcid.org/0000-0001-5378-2825	en_US
dc.contributor.author	Jansz, P	en_US
dc.contributor.author	Hayward, C	en_US
dc.date.accessioned	2020-04-16T06:46:51Z
dc.date.available	2020-04-16T06:46:51Z
dc.date.issued	2019-07	en_US
dc.identifier.citation	ASAIO J, 2019, 65 (5), pp. 489 - 494	en_US
dc.identifier.uri	http://hdl.handle.net/10453/140037
dc.description.abstract	We evaluated mean, peak, and instantaneous pressure gradients across the outflow conduit in a pulsatile mock circulation loop which incorporated Heartware HVADs for left ventricular (LV) and right ventricular (RV) support. Steady-state 50 Hz measurements of left ventricular assist device (LVAD) flow (Q) and pressures within the proximal and distal outflow conduit were obtained at varying pump speed, LV contractility, hematocrit (HCT), heart rate (HR), and conduit diameter and length. Experiments were conducted using polyvinyl chloride (PVC) tubing and results confirmed in HVAD Gelweave conduit. Conduit diameter was negatively and nonlinearly associated with mean and peak gradient in both the PVC and HVAD conduits. There were no significant differences between the PVC and HVAD conduits in terms of mean Q, systolic dQ/dt, mean conduit gradient, or peak gradient. Across the 10 mm HVAD conduit, mean gradient correlated linearly with mean Q, systolic dQ/dt, HCT, and conduit length (r = 0.91), whereas peak gradient correlated with mean Q, systolic dQ/dt, and conduit length (r = 0.93). A nonlinear model to determine instantaneous gradient was highly predictive (r = 0.83) across a range of pump and circulatory conditions. In summary, hemodynamically significant pressure gradients are observed across the LVAD outflow conduit under physiologic conditions, which may result in diminished pump flow.	en_US
dc.language	eng	en_US
dc.relation.ispartof	ASAIO J	en_US
dc.relation.isbasedon	10.1097/MAT.0000000000000964	en_US
dc.subject.classification	Biomedical Engineering	en_US
dc.title	Pulsatile Conduit Pressure Gradients in the HeartWare HVAD.	en_US
dc.type	Journal Article
utslib.citation.volume	5	en_US
utslib.citation.volume	65	en_US
utslib.location.activity	United States	en_US
utslib.for	0903 Biomedical Engineering	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
utslib.copyright.status	closed_access
pubs.issue	5	en_US
pubs.publication-status	Published	en_US
pubs.volume	65	en_US

Abstract:

We evaluated mean, peak, and instantaneous pressure gradients across the outflow conduit in a pulsatile mock circulation loop which incorporated Heartware HVADs for left ventricular (LV) and right ventricular (RV) support. Steady-state 50 Hz measurements of left ventricular assist device (LVAD) flow (Q) and pressures within the proximal and distal outflow conduit were obtained at varying pump speed, LV contractility, hematocrit (HCT), heart rate (HR), and conduit diameter and length. Experiments were conducted using polyvinyl chloride (PVC) tubing and results confirmed in HVAD Gelweave conduit. Conduit diameter was negatively and nonlinearly associated with mean and peak gradient in both the PVC and HVAD conduits. There were no significant differences between the PVC and HVAD conduits in terms of mean Q, systolic dQ/dt, mean conduit gradient, or peak gradient. Across the 10 mm HVAD conduit, mean gradient correlated linearly with mean Q, systolic dQ/dt, HCT, and conduit length (r = 0.91), whereas peak gradient correlated with mean Q, systolic dQ/dt, and conduit length (r = 0.93). A nonlinear model to determine instantaneous gradient was highly predictive (r = 0.83) across a range of pump and circulatory conditions. In summary, hemodynamically significant pressure gradients are observed across the LVAD outflow conduit under physiologic conditions, which may result in diminished pump flow.

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http://hdl.handle.net/10453/140037