Left Ventricular Blood Pumping Device for HFpEF Diastolic Support
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Solution Overview
Problem
Current treatments for heart failure with preserved ejection fraction (HFpEF) are inadequate, as no pharmacological treatment has been shown to reduce morbidity and mortality in randomized clinical trials, and existing devices pose risks such as right ventricular volume overloading and secondary pulmonary hypertension.
Innovation Solution
A system and method employing a blood pumping device implanted in the left ventricle, configured for sequential activation during diastole to assist the left ventricle in filling with blood and deactivation during systole, controlled by a controller that synchronizes the device's operation with the cardiac cycle.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If a blood pumping device operates continuously to prevent backflow during systole, then backflow prevention is improved, but ventricular compression during diastole worsens
Solution Approach 1:
The pump operates periodically rather than continuously, with distinct operational phases: high-speed operation during systole to prevent backflow, and low-speed operation during diastole to minimize ventricular compression. This periodic action resolves the contradiction by timing pump activity to match cardiac cycle phases.
Solution Approach 2:
The pump speed is dynamically adjusted based on the cardiac cycle phase. The controller varies the pump speed between high (during systole) and low (during diastole), making the system adaptive to physiological conditions rather than operating at a fixed speed.
2Reliability
If a pump is attached to the mitral valve to prevent backflow, then backflow control is improved, but device complexity and surgical complexity worsen
Solution Approach 1:
The pump is extracted from the mitral valve attachment configuration and repositioned to implantation within the left ventricle. This eliminates the need for complex mitral valve sewing cuff attachment and allows for simpler surgical procedures while maintaining backflow prevention functionality through internal ventricular placement.
3Quantity of substance
If a wide bore pump is used to ensure adequate blood flow, then flow capacity is improved, but percutaneous delivery capability worsens
Solution Approach 1:
The pump design transitions from a wide-bore configuration that requires surgical implantation to a narrower profile that enables percutaneous delivery through vascular access. This dimensional change in the pump architecture allows delivery through catheter-based approaches while maintaining adequate flow capacity through optimized impeller design and rotational speed.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
The system effectively assists the left ventricle in filling during diastole, potentially reducing secondary pulmonary hypertension and improving patient outcomes by addressing the pathophysiological heterogeneity of HFpEF.
Implementation Method 1
The blood pumping device generally comprises an impeller and ideally is an axial flow pump. In use, the blood pumping device is anchored to a wall of the left ventricle and positioned such that upon activation the pressure in the top of the left ventricle adjacent the mitral valve is reduced sufficiently to assist the drawing of blood into the left ventricle from the right atrium.
Data Source
AI summary
A system to treat heart failure with preserved ejection fraction (HFpEF) is described. The system comprises a blood pumping device configured for implantation in a left ventricle of a heart of a subject, an anchoring assembly for anchoring the blood pumping device to a wall of the left ventricle, and a controller configured to modify the output parameters of the blood pumping device so as to activate and deactivate the blood pumping device in a pattern synergistic with a cardiac cycle of the subject comprising activation during ventricular diastole and deactivation during ventricular systole.