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Modeling and non-invasive control of implantable blood pumps for heart failure patients

Number of pages: 104 File Format: word File Code: 32049
Year: 2013 University Degree: Master's degree Category: Paramedical
Tags/Keywords: Blood pumps - Heart failure patients - Implantable blood pumps - Left ventricular assist equipment - Left ventricular systolic failure - LVAD - Modeling - Non-invasive control - Suction phenomenon - the heart
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  • Summary of Modeling and non-invasive control of implantable blood pumps for heart failure patients

    Master's Thesis in Instrument Engineering and Automation in Oil Industries

    Abstract

    Non-invasive modeling and control of implantable blood pumps in the body for heart failure patients

    Left ventricular assist devices (LVAD) are mechanical pumps that are surgically placed in the body of patients who are in the dangerous and final stages of congestive heart failure and help to continue the blood flow from the patient's heart as normal. Rotary type pumps control the amount of blood flowing through the LVAD by controlling the variable speed of the pump vanes. One of the important challenges in using this equipment is avoiding excessive pumping of blood from the left ventricle (which is known as the suction phenomenon), which causes damage to the heart due to the high speed of the pump. One of the innovations of this control system is the speed control to avoid being in this range.

    In this thesis, first, the combined circuit of the time-varying non-linear model, LVAD with the cardiovascular system will be investigated. Using this model, the suction index is tested to detect the suction mode. In the end, a control system based on fuzzy logic and predictive model will be presented that adjusts the pump flow signal to adjust the pump speed based on the suction characteristic and the corresponding threshold. The purpose of this control method is to update and adapt the speed of the pump rotation to match the physiological changes of the patient in the shortest time and without the occurrence of suction phenomenon.

    Simulation results will be presented for different conditions and different activity levels of the patient, and the power of the controller in reducing noise effects will also be discussed.

    General

     

    According to the evaluation of the World Health Organization and the statistics obtained by this organization, about one third of the common diseases around the world are dedicated to heart diseases. An important issue is the upward trend of these diseases, especially in the field of "left ventricular systolic failure", which is considered one of the most important and acute types of heart diseases [1]. The complication of this disease is the improper pumping of blood and, as a result, insufficient amount of blood reaching the organs and organs of the body.

    Although drug treatments have a significant effect on improving the quality of life of patients with systolic heart failure, it is not possible to reduce the high death rate of these patients until this type of treatment is used for the long term. As a result, heart transplant surgery will be the only safe and acceptable method to treat serious cases of congestive heart failure. Generally, patients with congestive heart failure must wait for a long time (about a year or even more) to receive a suitable heart for transplantation, and it is obvious that during this time, there is a possibility of worsening their disease and more disruption in blood pumping by the heart. Therefore, left ventricular assist devices (LVADs) can help the patient's weak heart as a bridge to the surgical stage and provide favorable conditions for the patient until the surgery [2]. style="direction: rtl;">

    Left ventricular assist devices (LVADs) can be divided into two main categories based on the blood pumping pattern and method:

    Positive displacement LVADs (pulsatile) and turbodynamic LVADs (rotary). The first generation of these devices are pulsatile LVADs, which have a functional behavior similar to the heartbeat and produce normal blood flow in the same way. Rotary LVADs, as the newer generation of these devices, produce continuous blood flow instead of pulsatile flow. In addition, rotary LVADs allow us to connect to the heart and arteries and to implant under the skin, which is usually implanted in the chest cavity or its extra space.In addition, rotary LVADs allow us to connect to the heart and artery and implant under the skin, which are usually implanted in the chest cavity or its extra space [1]. Today, rotary LVADs are used more widely in clinical treatments due to their smaller size, less weight, more survival and stability [3] and their higher efficiency compared to their usual pulsating type.

    Rotary LVAD is a mechanical pump that is surgically placed in the patient's body from the left ventricle to the aorta and between them, in order to provide sufficient blood flow, which the patient's heart alone can provide. It is not to bring it, but to help [2]. Rotary pumps control the amount of passing blood by changing their rotation speed. Due to the automatic control of the rotation speed of these pumps, which is adjusted according to the physiological needs of the patient, it is possible for the patient to be away from the relevant doctor, hospital and special care, and to have an acceptable level of health until the heart transplant surgery. rtl;">MODELLING AND NON-INVASIVE CONTROL OF IMPLANTABLE LVADS FOR FAILURE PATIENT

     

    BY

     

    HAMED KOLLARI

     

     

    The rotary Left Ventricular Assist Device (LVAD) is a mechanical pump surgically implanted in patients with end-stage congestive heart failure to help maintain the flow of blood from the sick heart. The rotary type pumps are controlled by varying the impeller speed to control the amount of blood flowing through the LVAD. One important challenge in using these devices is to prevent the occurrence of excessive pumping of blood from the left ventricle (known as suction) that may cause it to collapse due to the high pump speed. The development of a proper feedback controller for the pump speed is therefore crucial to meet this challenge.

    In this thesis, some theoretical and practical issues related to the development of such a controller are discussed. First, a basic nonlinear, time-varying cardiovascular-LVAD circuit model that will be used to develop the controller is reviewed. Using this model, a suction index is tested to detect suction. Finally, we propose a feedback controller that uses the pump flow signal to regulate the pump speed based on the suction index and an associated threshold. The objective of this controller is to continuously update the pump speed to adapt to the physiological changes of the patient while at the same time avoiding suction. Simulation results are presented under different conditions of the patient's activities. Robustness of the controller to measure noise is also discussed.

  • Contents & References of Modeling and non-invasive control of implantable blood pumps for heart failure patients

    List:

    Introduction. 1

    1-1- Overview 1

    1-2- Left ventricular assist devices (LVADs) 2

    1-3-        Important phenomena in LVADs 3

    1-4-       History and evolution of suction phenomenon detection. 4

    1-5-       The history and evolution of the design of the relevant controllers. 5

    1-6-        The process of reviewing the contents. 7

    The heart system and its related model. 9

    2-1-       Heart and circulatory system. 10

    2-1-1- Heart 10

    2-1-2- Blood circulation system. 12

    2-2- Cardiac cycle. 15

    2-2-1- Examining some main concepts. 15

    2-2-2- cardiac cycle. 18

    2-3-       Heart model. 23

    2-3-1- Circuit model of the heart. 23

    2-3-2- State equations. 28

    2-3-3- Simulation results. 31

    2-4-       Heart-pump model. 34

    4-2-1- Heart model- LVAD. 35

    4-2-2- State equations. 38

    4-2-3- open-loop simulation 41

    Problem of detection of suction mode in LVAD. 48

    3-1-       Suction view in LVAD. 50

    3-2-       Analysis of suction indicators using the flow through the pump. 54

    3-3-       Simulation with heart-LVAD model. 60

    Fuzzy-MPC integrated controller design for heart-LVAD system 63

    4-1-       Structure of predictive model controllers. 64

    4-2- Fuzzy-MPC integrated controller design 66

    4-2-1- Model Predictive Controller 67

    4-2-2- SI Calculator 68

    4-2-3- Fuzzy Controller 68

    4-3-        Simulation. 73

    4-3-1-Simulation for the sick heart 73

    4-4-       Checking the amount of resistance of the controller 78

    5-        Conclusion and future goals 83

    5-1-        Conclusion. 83

    5-1-1- Heart and heart model - LVAD. 84

    5-1-2- Suction mode detector. 84

    5-1-3- predictive-fuzzy model controller. 84

    5-1-4- Simulations 85

    5-1-5- Limitations 85

    5-2-       Future goals 86

     

    Source:

     

     

    [1] Gu, M. and Qin, Y., “Development of left ventricular assist devices,” International Journal of Cardiovascular Disease, 36(2): 69-71, 2009.

    [2] http://www.americanheart.org/presenter.jhtml?identifier=4599

    [3] Slaughter, M. S., Rogers, J.G., et al, “Advanced heart failure treated with continuous-flow left ventricular assist device,” The new England journal of medicine, Nov. 17, 2009.

    [4] Vollkron, M., Schima, H., Huber, L., Benkowski, R., Morello, G., et al, “Development of a suction detection system for axial blood pumps,” Artificial Organs, 28(8): 709-716, 2004.

    [5] Vollkron, M., Schima, H., Huber, L., Benkowski, R., Morello, G., et al, "Advanced suction detection for an axial flow pump," Artificial Organs, 30(9): 665-670, 2006.

    [6] Voigt, O., Benkowski, R.J. and Morello, G.F., “Suction detection for the micromed debakey left ventricular assist device,” ASAIO Journal, 51(4): 321-328, 2005.

    [7] Ferreira, A., Chen, S., Simaan, M.A., Boston, J.R. and Antaki, J.F., "A discriminant-analysis-based suction detection system for rotary blood pump," Proceedings of the IEEE EMBC, New York, USA, 5382-5385, 2006.

    [8] Mason, D.G., Hilton, A.K. and Salamonsen, R.F., "Reliable suction detection for patients with rotary blood pumps," ASAIO Journal, 54(4): 359-366, 2008.

    [9] Wu, Y., Allaire, P., Tao, G., Wood, H., Olsen, D. and Tribble, C., "An advanced physiological controller design for a left ventricular assist device to prevent left ventricular collapse,” Artificial Organs, 27(10): 926-930, 2003.

     

    [10] Vollkon, M., Schima, H., Huber, L., Benkowski, R., Morello, G., et al, “Development of a reliable automatic speed control system for rotary blood pumps,” The Journal of Heart and Lung Transplantation, 24(11): 1878-1885, 2005.

    [11] Chen, S., “Baroreflex-based Physiological Control of a Left Ventricular Assist Device,” University of Pittsburgh, 2006.

    [12] Chen, S.,, Ferreira, A., Simaan, M.A., Boston, J.R. and Antaki, J.F., "Feedback control of an LVAD supporting a failing cardiovascular system regulated by a baroreflex," Proceedings of the 45th IEEE CDC, San Diego, CA, USA, Dec. 13-15: 655-660, 2006.

    [13] Ferreira, A., "A rule-based controller based on suction detection for rotary blood pumps," PhD. Thesis, University of Pittsburgh, Pittsburgh, PA, 2007.

    [14] Ferreira, A., Boston, J.R., and Antaki, J.F., “A control system for rotary blood pumps based on suction detection,” IEEE Transactions on Biomedical Engineering, 56(3): 656-665, 2009.

    [15] Simaan, M.A., Ferreira, A., Chen, S., Antaki, J.F. and Galati, D.G., "A Dynamical State Space Representation and Performance Analysis of a Feedback-Controlled Rotary Left Ventricular Assist Device," IEEE Transactions on Control Systems Technology, 11(7): 15-28, 2009.

     

    [16] http://www.zgxl.net/sljk/imgbody/xinzang.htm

    [17] http://en.wikipedia.org/wiki/File:Heart_systole.svg

    [18] http://en.wikipedia.org/wiki/File:Heart_diastole.png

    [19] http://www.hudong.com/wiki

     

    [20] Suga, H., Sagawa, K., “Instantaneous pressure-volume relationships and their ratio in the excised, supported canine. left ventricle,” Circulation Research, 35(1): 117-126, 1974.

    [21] Stergiopulos, N., Meister, J. and Westerhof, N., “Determinants of stroke volume and systolic and diastolic aortic pressure,” American Journal of Physiology, 270(6): 2050-2059, 1996.

    [22] Simaan, M.A., “Modeling and control of rotary heart assist device,” Handbook of Automation, Ed S. Norf, Springer Verlag, 1409-1422, 2009.

    [23] Schima, H., Trubel, W., Moritz, A., et al, “Noninvasive monitoring of rotary blood pumps: necessity, possibilities, and limitations,” Artificial Organs, 16(2): 195-202, 1992. [24] Yuhki, A., Hatoh, E., Nogawa, M., Miura, M., Shimazaki, Y. and Takatani, S., "Detection of suction and regurgitation of the implantable centrifugal pump based on the motor current waveform analysis and its application to optimization of pump flow," Artificial Organs, 23(6): 532-537, 1999.

     

    [25] Morello, G.F., “Blood pump system and method of operation,” US Patent: 0215050, 2004.

    [26] Karantonis, D.M., Lovell, N.H., Ayre, P.J., Mason, D.G. and Cloherty, S.L., "Identification and classification of physiologically significant pumping states in an implantable rotary blood pump," Artificial Organs, 30(9): 671-679, 2006.

    [27] K., M., "Central venous pressure and pulmonary capillary wedge pressure monitoring," Indian Journal of anesthesia, 46(4): 298-303, 2002.

    [28] Klabunde, R.E., “Cardiovascular physiology concepts,” Lippincott Williams & Wilkins, 2005

    [29] http://www.doctorsky.cn/surgery/20081029/51524.html

     

     

    [30] George Faragallah*, Yu Wang*, Eduardo Divo+, and Marwan. A. Simaan*, Fellow, IEEE, "A New Current-Based Control Model of the Combined Cardiovascular and Rotary Left Ventricular Assist Device" 2011 American Control Conference/ June 29 - July 01, 2011.

     

    [31] Abdul-Hakeem H. AlOmari "Non-Invasive Modeling And Control of Implantable Blood Pumps For Heart Failure Patients" The University of New South Wales (UNSW), Sydney, Australia/ March 2011.

Modeling and non-invasive control of implantable blood pumps for heart failure patients
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