Design of Ventricular Assist Device

Basic Components of VAD

1. Blood pump
2. Controller
3. Power source

Two Categories of VAD’s Pump

1. Pulsatile flow : rythmic propagation of
blood flow
2. Continuous flow
Design of Ventricular Assist Device
First Generation VADs
- Displacement blood pumps
- External control system triggers pumping by a
pusher plate or diaphragm mechanism
- Pneumatic console used to drive pump, but now
have been replaced by implantable electric system
- This mechanism provides pulsatile stroke volume
- But there’s problem with weight, size, driveline
infection and thromboembolism.
- e.g. Abiomed BVS®5000, Thoratec, LionHeart
Design of Ventricular Assist Device
LionHeart™ VAD
- Implantable
- Consist of internal components : blood pump, system controller,
rechargeable batteries, compliance chamber, internal power coil
- Also there are external components : power pack, power
transmitter, telemetry wand, charger, battery
- No percutaneous leads :
- reduction in risk of infection
- improved mobility
- enhanced quality of life
- Pump consist of :
- Titanium case with motor
- Seam-free polyurethane blood sac
- Pusher plate
- Unidirectional inlet/outlet mechanical heart valve
Design of Ventricular Assist Device
Design of Ventricular Assist Device

- Principle operation :
- - equipment powered using trancutaneous energy transmission
(TET) i.e. wireless power transmission.
- - external DC power converted to AC allowing TET.
- - external transformer coil will placed over implanted
transformer coil.
Design of Ventricular Assist Device
Design of Ventricular Assist Device
- - implanted power coil produce current to run the motor.
- - motor actuates roller screw and pusher plate.
- - motor will drive the roller screw mechanism.
- - linear motion of screw will results in linear motion of pusher
plate.
- - pusher plate will compress blood sac.
- - compressed blood sac will eject blood from the pump.
- - when pusher plate releases, blood will fill the pump.
- - LionHeart capable to produce 3-7 L/min of output.

- - controller housed in titanium case.

- - continuous monitoring of EDV using Hall Effect sensor for
control system.
- - pump rate automatically adjusted to match the rate of blood
filling the sac.
Design of Ventricular Assist Device
- - gas-filled compliance chamber ensure constant air pressure
inside the pump.
- - otherwise it could cause fatigue to motor components.

Novacor® LVA System

- - electromechanical vented VAD.
- - controller and battery located externally.
- - pump design is dual-plate pusher.
- - percutaneous lead connecting pump with external component.
- - the system can be operated in fixed-pulse rate, synchronous
or automatic mode.
- - inflow conduit designed to reduce thromboembolic
complications.
- - vibration damping in pump driving unit.
Design of Ventricular Assist Device
Design of Ventricular Assist Device
Second Generation VADs
- Of rotary pump type i.e. axial flow impeller pumps and
centrifugal/radial flow pump.
- Provide continuous, non-pulsatile flow.
- Electromagnetic mechanism consist of rotor and impeller blades
- Advantage of rotary pump over pulsatile flow :
- - small size
- - fewer moving part
- - elimination of compliance chamber or external vent tube
- - absence of valves
- - quiet operation
- - fewer infections and thromboembolic complications
- e.g DeBakey VAD, FlowMaker, HeartMate II
Design of Ventricular Assist Device
DeBakey VAD®
- Axial flow blood pump.
- The pump composed of :
- - titanium pump housing
- - inlet cannula
- - rotating inducer impeller
- - stationary flow straightener
- - percutaneous cable assembly with controller connector
- Impeller has six blades rotated by electromagnetic force.
- Pump driven by DC motor stator contained in stator housing.
- Ultrasonic flow probe placed on outflow graft.
- Controller module has audible and visual alarms with LCD to
display messages.
Design of Ventricular Assist Device
Design of Ventricular Assist Device
HeartMate II
- Axial flow blood pump.
- Consist of blood pump, percutaneous lead, external power
source and system driver.
- The pump unit has blood immersed mechanical bearings.
- External power source connected by abdominal percutaneous
electrical lead.
- Designed for thrombosis and haemolysis reduction using
computational fluid dynamics and laser flow visualization.
- Smooth and textured design for blood contacting surfaces to
eliminate thrombus at inlet and outlet stator.
- Manual or auto mode for rotation speed control.
- For auto mode, motor speed control based on characteristics of
pump’s head pressure, pump flow and current consumption.
Design of Ventricular Assist Device
Design of Ventricular Assist Device
Third Generation VADs
- Replacement of mechanical bearings of 2nd generation by
hydrodynamics bearing and/or full magnetic suspension pumps
thus allow higher durability and reliability.
- In hydrodynamic bearing, rotor partially supported by a film of
blood that counteract mechanical loads on pump rotor.
- Magnetic suspension(levitation) allow large clearances around
impeller and permits optimised flow.
- Longer life expectancy (10-15 yrs) since there is no friction
effect at contact bearings.
- No contact between impeller and static part, thus it is a silent
device.
- Sensor linked to magnetic bearing provide info on flow rate and
pump performance.
- e.g. INCOR® LVAD, MicroVAD, MagneVAD, EVAHEART
Design of Ventricular Assist Device
INCOR® LVAD
- Axial flow blood pump.
- Free floating active magnetic bearing stabilize impeller in axial
direction.
- Percutaneous driveline to controller and power pack.
- Integrated sensor system to measure pressure of head.
- Automatic anti-suction algorithm based on grade of pulsatility of
blood flow across pump.

- VentrAssist LVAD
- Centrifugal flow pump.
- Contact-free hydrodynamicaly suspended impeller.
- Integrated rare earth magnet motor.
- Pump encased in biocompatible titanium alloy shell
Design of Ventricular Assist Device
Classification of VADs
1. Pulsatile flow
2. Continuous flow (or rotary pump) :
- axial flow
- centrifugal flow
- magnetic bearing supported
- blood immersed bearing supported
- hybrid magnetic/blood bearings

Examples of VAD design will be shown :

Design of Ventricular Assist Device
Baxtor/Novacor Pulsatile Pumping Mechanism
Design of Ventricular Assist Device
- Electromagnetic actuator closes rapidly.
- Stores energy by deforming a compliant flexure drives the pump.
- Deformed flexure compresses the flexible blood sac to move the
blood.
Mechanism
- Pump sac filled with blood and solenoid is unlatched.
- Solenoid closed rapidly at start of pump ejection.
- Beam spring defelected through pump pusher plates.
- Force exerted on surfaces of blood in pump sac.
Design of Ventricular Assist Device
Design of Ventricular Assist Device
Nimbus Rotary LVAD
- With blood immersed bearing.
- Such bearings has high shear rates*
- Bearings also might cause blood damage.
- Thrombus might be formed around the bearing.
Magnetically Levitated Pump
- Magnetic bearings with large gaps replace blood immersed bearing.
- Impeller supported by passive permanent magnet toward inlet.
- Active conical bearing support towards outlet of the pump.

*gradient of velocity
Design of Ventricular Assist Device
Design of Ventricular Assist Device
Design of Ventricular Assist Device
Medtronic Centrifugal Pump
Design of Ventricular Assist Device
- Impeller driven to rotate by external motor and power console.
- Impeller’s rotation produces vortexing effect establishing suction in
inlet cannula.
- Blood enters the pump and ejected tangentially.