An Advanced Physiological Control Algorithm for Left Ventricular Assist Devices
Abstract
:1. Introduction
2. Materials and Methods
2.1. Hemodynamic Characteristics of CVS Model
2.1.1. Blood Flow across the Valves
2.1.2. Functions of Blood Vessel in Chambers
2.2. Blood Flow between Chambers
2.3. LVAD Estimator Model
2.4. Control Design
2.4.1. Control Strategy
- -
- The aortic valve is totally closed.
- -
- The elastance function () is used to determine the cardiac output.
- -
- In each cardiac cycle, is linearly and exponentially varied during end-systole and end-diastole, respectively.
- -
- If the blood flow exceeds the physiological requirement, it is imperative to adjust the estimated value of .
- -
- In order to ensure that the pump flow remains at a constant level, it is necessary to increase the reference flow () in case it falls below the body’s physiological requirements.
2.4.2. Control Algorithm
2.5. Software Simulation Environments Protocols
3. Results
3.1. Results in Rest Scenario
3.2. Results in Exercise Scenario
4. Discussion
5. Conclusions
Funding
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Edelmann, F.; Knosalla, C.; Mörike, K.; Muth, C.; Prien, P.; Störk, S. Chronic Heart Failure. Dtsch. Arztebl. Int. 2018, 115, 124–130. [Google Scholar] [CrossRef] [PubMed]
- Benjamin, E.J.; Blaha, M.J.; Chiuve, S.E.; Cushman, M.; Das, S.R.; Deo, R.; de Ferranti, S.D.; Floyd, J.; Fornage, M.; Gillespie, C.; et al. Heart Disease and Stroke Statistics’2017 Update: A Report from the American Heart Association. Circulation 2017, 135, e146–e603. [Google Scholar] [CrossRef] [PubMed]
- Montalto, A.; Loforte, A.; Musumeci, F.; Krabatsch, T.; Slaughter, M. Mechanical Circulatory Support in End-Stage Heart Failure; Springer International Publishing: Cham, Switzerland, 2017. [Google Scholar] [CrossRef]
- Soucy, K.G.; Giridharan, G.A.; Choi, Y.; Sobieski, M.A.; Monreal, G.; Cheng, A.; Schumer, E.; Slaughter, M.S.; Koenig, S.C. Rotary pump speed modulation for generating pulsatile flow and phasic left ventricular volume unloading in a bovine model of chronic ischemic heart failure. J. Hear. Lung Transplant. 2015, 34, 122–131. [Google Scholar] [CrossRef] [PubMed]
- Mehra, M.R.; Uriel, N.; Naka, Y.; Cleveland, J.C.; Yuzefpolskaya, M.; Salerno, C.T.; Walsh, M.N.; Milano, C.A.; Patel, C.B.; Hutchins, S.W.; et al. A fully magnetically levitated left ventricular assist device-Final report. N. Engl. J. Med. 2019, 380, 1618–1627. [Google Scholar] [CrossRef]
- Levine, A.; Gass, A. Third-Generation LVADs: Has Anything Changed? Cardiol. Rev. 2019, 27, 293–301. [Google Scholar] [CrossRef]
- Hoshi, H.; Shinshi, T.; Takatani, S. Third-generation blood pumps with mechanical noncontact magnetic bearings. Artif. Organs 2006, 30, 324–338. [Google Scholar] [CrossRef] [PubMed]
- Stevens, M.C.; Stephens, A.; AlOmari, A.H.H.; Moscato, F. Physiological Control; Elsevier Inc.: Amsterdam, The Netherlands, 2018. [Google Scholar] [CrossRef]
- Salamonsen, R.F.; Lim, E.; Gaddum, N.; AlOmari, A.-H.H.; Gregory, S.D.; Stevens, M.; Mason, D.G.; Fraser, J.F.; Timms, D.; Karunanithi, M.K.; et al. Theoretical Foundations of a Starling-Like Controller for Rotary Blood Pumps. Artif. Organs 2012, 36, 787–796. [Google Scholar] [CrossRef]
- AlOmari, A.-H.H.; Savkin, A.V.; Stevens, M.; Mason, D.G.; Timms, D.L.; Salamonsen, R.F.; Lovell, N.H. Developments in control systems for rotary left ventricular assist devices for heart failure patients: A review. Physiol. Meas. 2012, 34, R1–R27. [Google Scholar] [CrossRef]
- Bozkurt, S. Physiologic outcome of varying speed rotary blood pump support algorithms: A review study. Australas. Phys. Eng. Sci. Med. 2015, 39, 13–28. [Google Scholar] [CrossRef]
- Wang, Y.; Koenig, S.C.; Wu, Z.; Slaughter, M.S.; Giridharan, G.A. Sensor-based physiologic control strategy for biventricular support with rotary blood pumps. ASAIO J. 2018, 64, 338–350. [Google Scholar] [CrossRef]
- Stephens, A.F.; Stevens, M.C.; Gregory, S.D.; Kleinheyer, M.; Salamonsen, R.F. In Vitro Evaluation of an Immediate Response Starling-Like Controller for Dual Rotary Blood Pumps. Artif. Organs 2017, 41, 911–922. [Google Scholar] [CrossRef] [PubMed]
- Gwak, K.-W.; Ricci, M.; Snyder, S.; Paden, B.E.; Boston, J.R.; Simaan, M.A.; Antaki, J.F. In vitro evaluation of multiobjective hemodynamic control of a heart-assist pump. ASAIO J. 2005, 51, 329–335. [Google Scholar] [CrossRef] [PubMed]
- Ketelhut, M.; Schrödel, F.; Stemmler, S.; Roseveare, J.; Hein, M.; Gesenhues, J.; Albin, T.; Abel, D. Iterative Learning Control of a Left Ventricular Assist Device. IFAC-PapersOnLine 2017, 50, 6684–6690. [Google Scholar] [CrossRef]
- Wu, Y.; Allaire, P.E.; Tao, G.; Adams, M.; Liu, Y.; Wood, H.; Olsen, D.B. A bridge from short-term to long-term left ventricular assist device-Experimental verification of a physiological controller. Artif. Organs 2004, 28, 927–932. [Google Scholar] [CrossRef]
- Bakouri, M. Evaluation of an advanced model reference sliding mode control method for cardiac assist device using a numerical model. IET Syst. Biol. 2018, 12, 68–72. [Google Scholar] [CrossRef] [PubMed]
- Chang, Y.; Gao, B. A global sliding mode controller design for an intra-aorta pump. ASAIO J. 2010, 56, 510–516. [Google Scholar] [CrossRef] [PubMed]
- Bakouri, M.; Alassaf, A.; Alshareef, K.; Abdelsalam, S.; Ismail, H.F.; Ganoun, A.; Alomari, A.H. An Optimal H-Infinity Controller for Left Ventricular Assist Devices Based on a Starling-like Controller: A Simulation Study. Mathematics 2022, 10, 731. [Google Scholar] [CrossRef]
- Huang, F.; Ruan, X.; Fu, X. Pulse-pressure-enhancing controller for better physiologic perfusion of rotary blood pumps based on speed modulation. ASAIO J. 2014, 60, 269–279. [Google Scholar] [CrossRef]
- Bakouri, M.; Alassaf, A.; Alshareef, K.; Smida, A.; AlMohimeed, I.; Alqahtani, A.; Aboamer, M.A.; Alharbi, Y. A Feasible Method to Control Left Ventricular Assist Devices for Heart Failure Patients: A Numerical Study. Mathematics 2022, 10, 2251. [Google Scholar] [CrossRef]
- Bakouri, M.; Alassaf, A.; Alshareef, K.; AlMohimeed, I.; Alqahtani, A.; Aboamer, M.A.; Alonazi, K.A.; Alharbi, Y. In Silico Evaluation of a Physiological Controller for a Rotary Blood Pump Based on a Sensorless Estimator. Appl. Sci. 2022, 12, 11537. [Google Scholar] [CrossRef]
- Lim, E.; Alomari, A.-H.H.; Savkin, A.V.; Dokos, S.; Fraser, J.F.; Timms, D.L.; Mason, D.G.; Lovell, N.H. A method for control of an implantable rotary blood pump for heart failure patients using non-invasive measurements. Artif. Organs 2011, 35, E174–E180. [Google Scholar] [CrossRef] [PubMed]
- AlOmari, A.H.; Savkin, A.V.; Ayre, P.J.; Lim, E.; Mason, D.G.; Salamonsen, R.F.; Fraser, J.F.; Lovell, N.H. Non-invasive estimation and control of inlet pressure in an implantable rotary blood pump for heart failure patients. Physiol. Meas. 2011, 32, 1035–1060. [Google Scholar] [CrossRef] [PubMed]
- Koh, V.; Pauls, J.; Wu, E.; Stevens, M.; Ho, Y.; Lovell, N.; Lim, E. A centralized multiobjective model predictive control for a biventricular assist device: An in vitro evaluation. Biomed. Signal Process. Control 2020, 59, 137–148. [Google Scholar] [CrossRef]
- Koh, V.C.; Ho, Y.K.; Stevens, M.C.; Salamonsen, R.F.; Lovell, N.H.; Lim, E. Synergy of first principles modelling with predictive control for a biventricular assist device: In silico evaluation study. In Proceedings of the 2017 39th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC), Jeju, Republic of Korea, 11–15 July 2017; pp. 1291–1294. [Google Scholar] [CrossRef]
- Ng, B.C.; Salamonsen, R.F.; Gregory, S.D.; Stevens, M.C.; Wu, Y.; Mansouri, M.; Lovell, N.H.; Lim, E. Application of multiobjective neural predictive control to biventricular assistance using dual rotary blood pumps. Biomed. Signal Process. Control 2018, 39, 81–93. [Google Scholar] [CrossRef]
- Bakouri, M.A.; Savkin, A.V.; AH, A.H.A. Non-linear modelling and control of left ventricular assist device. Electron. Lett. 2015, 51, 613–615. [Google Scholar] [CrossRef]
- Son, J.; Du, Y. Model-Free Adaptive Control of the Failing Heart Managed by Mechanical Supporting Devices. IFAC-PapersOnLine 2022, 55, 750–755. [Google Scholar] [CrossRef]
- Azizkhani, M.; Chen, Y. Supervised Adaptive Fuzzy Control of LVAD with Pulsatility Ratio Modulation. In Proceedings of the 2022 IEEE 18th International Conference on Automation Science and Engineering (CASE), Mexico City, Mexico, 20–24 August 2022; pp. 2429–2434. [Google Scholar] [CrossRef]
- Sadatieh, S.; Dehghani, M.; Mohammadi, M.; Boostani, R. Extremum-seeking control of left ventricular assist device to maximize the cardiac output and prevent suction. Chaos Solitons Fractals 2021, 148, 111013. [Google Scholar] [CrossRef]
- Arndt, A.; Nüsser, P.; Lampe, B. Fully autonomous preload-sensitive control of implantable rotary blood pumps. Artif. Organs 2010, 34, 726–735. [Google Scholar] [CrossRef]
- Lim, E.; Dokos, S.; Salamonsen, R.F.; Rosenfeldt, F.L.; Ayre, P.J.; Lovell, N.H. Numerical Optimization Studies of Cardiovascular-Rotary Blood Pump Interaction. Artif. Organs 2012, 36, E110–E124. [Google Scholar] [CrossRef]
- Chiang, H.-K.; Tsai, J.S.H.; Sun, Y.-Y. Extended Ackermann formula for multivariable control systems. Int. J. Syst. Sci. 1990, 21, 2113–2127. [Google Scholar] [CrossRef]
- Gao, W.; Wang, Y.; Homaifa, A. Discrete-time variable structure control systems. IEEE Trans. Ind. Electron. 1995, 42, 117–122. [Google Scholar] [CrossRef]
- Bakouri, M.A.; Salamonsen, R.F.; Savkin, A.V.; AlOmari, A.-H.H.; Lim, E.; Lovell, N.H. A Sliding Mode-Based Starling-Like Controller for Implantable Rotary Blood Pumps. Artif. Organs 2014, 38, 587–593. [Google Scholar] [CrossRef] [PubMed]
- Cysyk, J.; Newswanger, R.; Popjes, E.; Pae, W.; Jhun, C.-S.; Izer, J.; Weiss, W.; Rosenberg, G. Cannula tip with in-tegrated volume sensor for rotary blood pump control: Early-stage development. ASAIO J. 2019, 65, 318–323. [Google Scholar] [CrossRef] [PubMed]
- Horobin, J.T.; Simmonds, M.J.; Nandakumar, D.; Gregory, S.D.; Tansley, G.; Pauls, J.P.; Girnghuber, A.; Balletti, N.; Fraser, J.F. Speed Modulation of the HeartWare HVAD to Assess In Vitro Hemocompatibility of Pulsatile and Continuous Flow Regimes in a Rotary Blood Pump. Artif. Organs 2018, 42, 879–890. [Google Scholar] [CrossRef]
- Meki, M.H.; Wang, Y.; Sethu, P.; Ghazal, M.; El-Baz, A.; Giridharan, G.A. Sensorless Rotational Speed-Based Control System for Continuous Flow Left Ventricular Assist Devices. IEEE Trans. Biomed. Eng. 2020, 67, 1050–1060. [Google Scholar] [CrossRef]
- Gwak, K.W. Application of extremum seeking control to turbodynamic blood pumps. ASAIO J. 2007, 53, 403–409. [Google Scholar] [CrossRef]
- Arndt, A.; Nüsser, P.; Graichen, K.; Müller, J.; Lampe, B. Physiological control of a rotary blood pump with selectable therapeutic options: Control of pulsatility gradient. Artif. Organs 2008, 32, 761–771. [Google Scholar] [CrossRef]
Parameter | HF | Healthy |
---|---|---|
Systemic peripheral resistance (mm Hg × s/mL) | 1.1200 | 0.7501 |
Left ventricle contractility (mm Hg/mL) | 0.7111 | 3.4900 |
Right ventricle contractility (mm Hg/mL) | 0.5299 | 1.7510 |
Total blood volume (mL) | 5798 | 5298 |
Parameters | Healthy | HF + LVAD | |
---|---|---|---|
Exercise | Rest | ||
Aortic pressure (mmHg) | 120 | 77 | 105 |
Left ventricle pressure (mmHg) | 120 | 81 | 97 |
Output flow () (L/min) | 5.5 | 2 | 2.4 |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2023 by the author. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Bakouri, M. An Advanced Physiological Control Algorithm for Left Ventricular Assist Devices. Appl. Syst. Innov. 2023, 6, 97. https://doi.org/10.3390/asi6060097
Bakouri M. An Advanced Physiological Control Algorithm for Left Ventricular Assist Devices. Applied System Innovation. 2023; 6(6):97. https://doi.org/10.3390/asi6060097
Chicago/Turabian StyleBakouri, Mohsen. 2023. "An Advanced Physiological Control Algorithm for Left Ventricular Assist Devices" Applied System Innovation 6, no. 6: 97. https://doi.org/10.3390/asi6060097