Document Detail

Hybrid Model Analysis of Intra-Aortic Balloon Pump Performance as a Function of Ventricular and Circulatory Parameters.
MedLine Citation:
PMID:  21726242     Owner:  NLM     Status:  Publisher    
We investigated the effects of the intra-aortic balloon pump (IABP) on endocardial viability ratio (EVR), cardiac output (CO), end-systolic (V(es) ) and end-diastolic (V(ed) ) ventricular volumes, total coronary blood flow (TCBF), and ventricular energetics (external work [EW], pressure-volume area [PVA]) under different ventricular (E(max) and diastolic stiffness) and circulatory (arterial compliance) parameters. We derived a hybrid model from a computational model, which is based on merging computational and hydraulic submodels. The lumped parameter computational submodel consists of left and right hearts and systemic, pulmonary, and coronary circulations. The hydraulic submodel includes part of the systemic arterial circulation, essentially a silicone rubber tube representing the aorta, which contains a 40-mL IAB. EVR, CO, V(es) , and V(ed) , TCBF and ventricular energetics (EW, PVA) were analyzed against the ranges of left ventricular E(max) (0.3-0.5-1 mm Hg/cm(3) ) and diastolic stiffness V(stiffness) (≈0.08 and ≈0.3 mm Hg/cm(3) , obtained by changing diastolic stiffness constant) and systemic arterial compliance (1.8-2.5 cm(3) /mm Hg). All experiments were performed comparing the selected variables before and during IABP assistance. Increasing E(maxl) from 0.5 to 2 mm Hg/cm(3) resulted in IABP assistance producing lower percentage changes in the selected variables. The changes in ventricular diastolic stiffness strongly influence both absolute value of EVR and its variations during IABP (71 and 65% for lower and higher arterial compliance, respectively). V(ed) and V(es) changes are rather small but higher for lower E(max) and higher V(stiffness) . Lower E(max) and higher V(stiffness) resulted in higher TCBF and CO during IABP assistance (∼35 and 10%, respectively). The use of this hybrid model allows for testing real devices in realistic, stable, and repeatable circulatory conditions. Specifically, the presented results show that IABP performance is dependent, at least in part, on left ventricular filling, ejection characteristics, and arterial compliance. It is possible in this way to simulate patient-specific conditions and predict the IABP performance at different values of the circulatory or ventricular parameters. Further work is required to study the conditions for heart recovery modeling, baroreceptor controls, and physiological feedbacks.
Gianfranco Ferrari; Ashraf W Khir; Libera Fresiello; Arianna Di Molfetta; Maciej Kozarski
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-7-5
Journal Detail:
Title:  Artificial organs     Volume:  -     ISSN:  1525-1594     ISO Abbreviation:  -     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-7-5     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802778     Medline TA:  Artif Organs     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011, Copyright the Authors. Artificial Organs © 2011, International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.
Section of Rome, Institute of Clinical Physiology, National Council for Research Faculty of Medicine, Tor Vergata University, Rome, Italy Institute for Bioengineering, Brunel University, London, UK Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Science, Warsaw, Poland.
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