One pulsatile heart pump size does not fit all patients

Abstract

One of the main principles of personalized medicine is to adapt health care to the specific needs of our patients. Based on this principle, medical devices should be tailored to the specific characteristics of the patients and doctors should choose medical devices for patients according to their size. Both pulsatile and continuous flow ventricular assist device help patients with heart failure. Every left ventricular assist device usually contains a pump that a cardiac surgeon connects to the apex of the heart. Pulsatile ventricular assist device systems using volume displacement pulsatile pumps are designed and mainly used for children patients. The first generation ventricular assist devices systems for adult patients relied on volume displacement pumps with one constant stroke volume for all sizes of patients. The concept of one size of the medical device for all patients goes against the principle of personalized medicine. A cardiovascular model in Modelica has confirmed that a pump with one constant pump stroke volume of 65 ml can generate uncontrolled flow and pressure curves oscillating over the normotensive zone for small patients and under the normotensive zone for large patients. The one pulsatile pump size for all patients may cause harm due to non-physiological flow and pressure condition in circulations.