Pressure and Bernoulli-Based Flow Measurement via a Tapered Inflow VAD Cannula.

ABSTRACT

OBJECTIVE: Currently available ventricular assist devices provide continuous flow and do not adapt to the changing needs of patients. Physiological control algorithms have been proposed that adapt the pump speed based on the left ventricular pressure. However, so far, no clinically used pump can acquire this pressure. Therefore, for the validation of physiological control concepts in vivo, a system that can continuously and accurately provide the left ventricular pressure signal is needed. METHODS: We demonstrate the integration of two pressure sensors into a tapered inflow cannula compatible with the HeartMate 3 (HM3) ventricular assist device. Selective laser melting was used to incorporate functional elements with a small footprint and therefore retain the geometry, function and implantability of the original cannula. The system was tested on a hybrid mock circulation system. Static and simulated physiological flow and pressure profiles were used to evaluate the combined pressure and flow sensing capabilities of the modified cannula. RESULTS: The cannula prototypes enabled continuous pressure measurements at two points of their inner wall in the range of -100 and 200 mmHg. The developed, Bernoulli-based, two sensor model improved the accuracy of the measured simulated left ventricular pressure by eliminating the influence of flow inside the cannula. This method reduced the flow induced pressure uncertainty from up to 7.6 mmHg in single sensor measurements to 0.3 mmHg. Additionally, the two-sensor system and model enable the measurement of the blood flow through the pump with an accuracy of -0.14 ± 0.04 L/min, without dedicated flow sensors.