A Novel Hybrid Membrane VAD as First Step Toward Hemocompatible Blood Propulsion.

Heart failure is a raising cause of mortality. Heart transplantation and ventricular assist device (VAD) support represent the only available lifelines for end stage disease. In the context of donor organ shortage, the future role of VAD as destination therapy is emerging. Yet, major drawbacks are connected to the long-term implantation of current devices. Poor VAD hemocompatibility exposes the patient to life-threatening events, including haemorrhagic syndromes and thrombosis. Here, we introduce a new concept of artificial support, the Hybrid Membrane VAD, as a first-of-its-kind pump prototype enabling physiological blood propulsion through the cyclic actuation of a hyperelastic membrane, enabling the protection from the thrombogenic interaction between blood and the implant materials. The centre of the luminal membrane surface displays a rationally-developed surface topography interfering with flow to support a living endothelium. The precast cell layer survives to a range of dynamically changing pump actuating conditions i.e., actuation frequency from 1 to 4 Hz, stroke volume from 12 to 30 mL, and support duration up to 313 min, which are tested both in vitro and in vivo, ensuring the full retention of tissue integrity and connectivity under challenging conditions. In summary, the presented results constitute a proof of principle for the Hybrid Membrane VAD concept and represent the basis for its future development towards clinical validation.

High-frequency operation of pulsatile ventricular assist devices: A computational study on circular and elliptically shaped pumps.

Pulsatile positive displacement pumps as ventricular assist devices were gradually replaced by rotary devices due to their large volume and high adverse event rates. Nevertheless, pulsatile ventricular assist devices might be beneficial with regard to gastrointestinal bleeding and cardiac recovery. Therefore, aim of this study was to investigate the flow field in new pulsatile ventricular assist devices concepts with an increased pump frequency, which would allow lower stroke volumes to reduce the pump size. We developed a novel elliptically shaped pulsatile ventricular assist devices, which we compared to a design based on a circular shape. The pump size was adjusted to deliver similar flow rates at pump frequencies of 80, 160, and 240 bpm. Through a computational fluid dynamics study, we investigated flow patterns, residence times, and wall shear stresses for different frequencies and pump sizes. A pump size reduction by almost 50% is possible when using a threefold pump frequency. We show that flow patterns inside the circular pump are frequency dependent, while they remain similar for the elliptic pump. With slightly increased wall shear stresses for higher frequencies, maximum wall shear stresses on the pump housing are higher for the circular design (42.2 Pa vs 18.4 Pa). The calculated blood residence times within the pump decrease significantly with increasing pump rates. A smaller pump size leads to a slight increase of wall shear stresses and a significant improvement of residence times. Hence, high-frequency operation of pulsatile ventricular assist devices, especially in combination with an elliptical shape, might be a feasible mean to reduce the size, without any expectable disadvantages in terms of hemocompatibility.