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Bioengineering
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Recent Advances in Cardiac Assist Devices
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Recent Advances in Cardiac Assist Devices

A special issue of Bioengineering (ISSN 2306-5354). This special issue belongs to the section "Nanobiotechnology and Biofabrication".

Deadline for manuscript submissions: 31 October 2024 | Viewed by 4134

Special Issue Editor

Dr. Navin K. Kapur

E-Mail Website
Guest Editor
Molecular Cardiology Research Institute, Tufts Medical Center, Boston, MA, USA
Interests: interventional cardiology; heart failure; invasive hemodynamics; mechanical circulatory support

Special Issue Information

Dear Colleagues,

From rudimentary cardiopulmonary bypass systems to magnetically levitated micro-rotary flow pumps mounted onto catheters with self-expanding elements, we are in the midst of the next major inflection point in bioengineering for cardiac assist devices. In parallel to growth in mechanical engineering, our understanding of both the biologic and physiologic impacts of cardiac assist devices on myocardial recovery and multi-organ perfusion continues to develop. Finally, the promise of closed-loop communication between sensors and actuators driven by alternative intelligence platforms is emerging as a reality. To advance our understanding of this exciting field, this Special Issue of Bioengineering will promote interdisciplinary exchange, facilitate new collaborations, and stimulate expanded applications of innovations in the field of cardiac assist devices. The next major advance in cardiac assist devices is more likely to occur when seemingly disparate fields come together to innovate and disrupt existing paradigms. We invite engineers, scientists, healthcare professionals, and innovators from all disciplines to submit their original reports for consideration.

Dr. Navin K. Kapur
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Bioengineering is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • cardiac assist devices
  • mechanical circulatory support
  • myocardial recovery
  • heart failure
  • ventricular assist devices
  • hemodynamics
  • molecular biology and engineering

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Published Papers (4 papers)

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Research

13 pages, 2643 KiB  
Article
In Vivo Testing of a Second-Generation Prototype Accessory for Single Transapical Left Ventricular Assist Device Implantation
by Florian Meissner, Michelle Costa Galbas, Hendrik Straky, Heiko Vestner, Manuela Schoen, Marius Schimmel, Johanna Reuter, Martin Buechsel, Johannes Dinkelaker, Heidi Cristina Schmitz, Martin Czerny and Wolfgang Bothe
Bioengineering 2024, 11(8), 848; https://doi.org/10.3390/bioengineering11080848 - 19 Aug 2024
Viewed by 491
Abstract
A new accessory was developed to allow implantation of left ventricular assist devices (LVADs) without requiring an anastomosis to the ascending aorta. The accessory combines the LVAD inflow and outflow into a dual-lumen device. Initial prototypes encountered reduced pump performance in vitro, but [...] Read more.
A new accessory was developed to allow implantation of left ventricular assist devices (LVADs) without requiring an anastomosis to the ascending aorta. The accessory combines the LVAD inflow and outflow into a dual-lumen device. Initial prototypes encountered reduced pump performance in vitro, but a second-generation prototype successfully addressed this issue. This feasibility study aimed to demonstrate the anatomic fit, safe implantation, and hemodynamic effectiveness of the LVAD with the accessory. The accessory was implanted in ten female pigs (104 ± 13 kg). Following sternotomy and apical coring under cardiopulmonary bypass, a balloon catheter was retrogradely inserted and exteriorized through the coring site, where it was inflated within the distal third of the outflow graft. It was utilized to pull the accessory’s outflow across the aortic valve. After LVAD attachment, the catheter was removed. Echocardiography revealed no relevant valve regurgitation post-implantation. During ramp testing, pump flow increased from 3.7 ± 1.2 to 5.4 ± 1.2 L/min. Necropsy confirmed correct accessory placement in nine animals. No valve lesions or device thrombosis were observed. The accessory enabled LVAD implantation without compromising pump performance. Future work includes design refinements for implantation without cardiopulmonary bypass and long-term testing in a chronic heart failure model. Full article
(This article belongs to the Special Issue Recent Advances in Cardiac Assist Devices)
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15 pages, 5715 KiB  
Article
Intuitionistic Fuzzy Biofeedback Control of Implanted Dual-Sensor Cardiac Pacemakers
by Hussain Alshahrani, Amnah Alshahrani, Mohamed Esmail Karar and Ebrahim A. Ramadan
Bioengineering 2024, 11(7), 691; https://doi.org/10.3390/bioengineering11070691 - 8 Jul 2024
Viewed by 658
Abstract
Cardiac pacemakers are used for handling bradycardia, which is a cardiac rhythm of usually less than 60 beats per minute. Therapeutic dual-sensor pacemakers aim to preserve or restore the normal electromechanical activity of the cardiac muscle. In this article, a novel intelligent controller [...] Read more.
Cardiac pacemakers are used for handling bradycardia, which is a cardiac rhythm of usually less than 60 beats per minute. Therapeutic dual-sensor pacemakers aim to preserve or restore the normal electromechanical activity of the cardiac muscle. In this article, a novel intelligent controller has been developed for implanted dual-sensor cardiac pacemakers. The developed controller is mainly based on intuitionistic fuzzy logic (IFL). The main advantage of the developed IFL controller is its ability to merge the qualitative expert knowledge of cardiologists in the proposed design of controlled pacemakers. Additionally, the implication of non-membership functions with the uncertainty term plays a key role in the developed fuzzy controller for improving the performance of a cardiac pacemaker over other fuzzy control schemes in previous studies. Moreover, the proposed pacemaker control system is efficient for managing all health-status conditions and constraints during the different daily activities of cardiac patients. Consequently, the healthcare of patients with implanted dual-sensor pacemakers can be efficiently improved intuitively. Full article
(This article belongs to the Special Issue Recent Advances in Cardiac Assist Devices)
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8 pages, 2938 KiB  
Article
Validating the Concept of Mechanical Circulatory Support with a Rotary Blood Pump in the Inferior Vena Cava in an Ovine Fontan Model
by Yves d’Udekem, Joeri Van Puyvelde, Filip Rega, Christoph Nix, Svenja Barth and Bart Meyns
Bioengineering 2024, 11(6), 594; https://doi.org/10.3390/bioengineering11060594 - 11 Jun 2024
Viewed by 844
Abstract
Right-sided mechanical support of the Fontan circulation by existing devices has been compounded by the cross-sectional design of vena cava anastomosis to both pulmonary arteries. Our purpose was to investigate whether increasing inferior vena cava (IVC) flow with a rotary blood pump in [...] Read more.
Right-sided mechanical support of the Fontan circulation by existing devices has been compounded by the cross-sectional design of vena cava anastomosis to both pulmonary arteries. Our purpose was to investigate whether increasing inferior vena cava (IVC) flow with a rotary blood pump in the IVC only in an ovine animal model of Fontan would lead to acceptable superior vena cava (SVC) pressure. To achieve this, a Fontan circulation was established in four female sheep by anastomosing the SVC to the main pulmonary artery (MPA) and by interposing a Dacron graft between the IVC and the MPA. A rotary blood pump was then introduced in the graft, and the effect of incremental flows was observed at increasing flow regimen. Additionally, to stimulate increased pulmonary resistance, the experience was repeated in each animal with the placement of a restrictive band on the MPA distally to the SVC and Dacron graft anastomosis. Circulatory support of IVC flow alone increased the systemic cardiac output significantly, both with and without banding, indicating the feasibility of mechanical support of the Fontan circulation by increasing the flow only in the inferior vena cava. The increase in SVC pressure remained within acceptable limits, indicating the potential effectiveness of this mode of support. The findings suggest that increasing the flow only in the inferior vena cava is a feasible method for mechanical support of the Fontan circulation, potentially leading to an increase in cardiac output with acceptable increases in superior vena cava pressure. Full article
(This article belongs to the Special Issue Recent Advances in Cardiac Assist Devices)
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11 pages, 1534 KiB  
Article
The Self-Expandable Impella CP (ECP) as a Mechanical Resuscitation Device
by Sebastian Billig, Rachad Zayat, Siarhei Yelenski, Christoph Nix, Eveline Bennek-Schoepping, Nadine Hochhausen and Matthias Derwall
Bioengineering 2024, 11(5), 456; https://doi.org/10.3390/bioengineering11050456 - 3 May 2024
Viewed by 1343
Abstract
The survival rate of cardiac arrest (CA) can be improved by utilizing percutaneous left ventricular assist devices (pLVADs) instead of conventional chest compressions. However, existing pLVADs require complex fluoroscopy-guided placement along a guidewire and suffer from limited blood flow due to their cross-sectional [...] Read more.
The survival rate of cardiac arrest (CA) can be improved by utilizing percutaneous left ventricular assist devices (pLVADs) instead of conventional chest compressions. However, existing pLVADs require complex fluoroscopy-guided placement along a guidewire and suffer from limited blood flow due to their cross-sectional area. The recently developed self-expandable Impella CP (ECP) pLVAD addresses these limitations by enabling guidewire-free placement and increasing the pump cross-sectional area. This study evaluates the feasibility of resuscitation using the Impella ECP in a swine CA model. Eleven anesthetized pigs (73.8 ± 1.7 kg) underwent electrically induced CA, were left untreated for 5 min and then received pLVAD insertion and activation. Vasopressors were administered and defibrillations were attempted. Five hours after the return of spontaneous circulation (ROSC), the pLVAD was removed, and animals were monitored for an additional hour. Hemodynamics were assessed and myocardial function was evaluated using echocardiography. Successful guidewire-free pLVAD placement was achieved in all animals. Resuscitation was successful in 75% of cases, with 3.5 ± 2.0 defibrillations and 1.8 ± 0.4 mg norepinephrine used per ROSC. Hemodynamics remained stable post-device removal, with no adverse effects or aortic valve damage observed. The Impella ECP facilitated rapid guidewire-free pLVAD placement in fibrillating hearts, enabling successful resuscitation. These findings support a broader clinical adoption of pLVADs, particularly the Impella ECP, for CA. Full article
(This article belongs to the Special Issue Recent Advances in Cardiac Assist Devices)
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