Electrohydraulic Vascular Compression Device (e‐VaC) with Integrated Sensing and Controls. Issue 4 (13th November 2022)

• Record Type: Journal Article
• Authors: Pirozzi, Ileana; Kight, Ali; Liang, XinYi; Han, Amy Kyungwon; Ennis, Daniel B.; Hiesinger, William; Dual, Seraina A.; Cutkosky, Mark R.
• Is Part Of: Advanced materials technologies. Volume 8:Issue 4(2023)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2022-11-13
• Subjects: continuous sensing -- electrohydraulic actuator -- mechanical cardiac support -- right ventricular failure; Materials science -- Periodicals; Technological innovations -- Periodicals; Materials science; Technological innovations; Periodicals; 620.1105
• DOI: 10.1002/admt.202201196
• Languages: English
• ISSNs: 2365-709X

Abstract

Abstract: Right ventricular (RV) failure remains a significant clinical burden particularly during the perioperative period surrounding major cardiac surgeries, such as implantation of left ventricular assist devices (LVADs), bypass procedures or valvular surgeries. Device solutions designed to support the function of the RV do not keep up with the pace of development of left‐sided solutions, leaving the RV vulnerable to acute failure in the challenging hemodynamic environments of the perioperative setting. This work describes the design of a biomimetic, soft, conformable sleeve that can be prophylactically implanted on the pulmonary artery to support RV ventricular function during major cardiac surgeries, through afterload reduction and augmentation of flow. Leveraging electrohydraulic principles, a technology is proposed that is non‐blood contacting and obviates the necessity for drivelines by virtue of being electrically powered. In addition, the integration of an adjacent is demonstrate, continuous pressure sensing module to support physiologically adaptive control schemes based on a real‐time biological signal. In vitro experiments conducted in a pulsatile flow‐loop replicating physiological flow and pressure conditions show a reduction of mean pulmonary arterial pressure of 8 mmHg (25% reduction), a reduction in peak systolic arterial pressure of up to 10 mmHg (20% reduction), and a concomitant 19% increase in diastolic pulmonary flow. Computational simulations further predict substantial augmentation of cardiac output as a result of reduced RV ventricular stress and RV dilatation. Abstract : e‐VaC is an electrohydrualic vascular compression device with integrated sensing and adaptive physiological control schemes. The device is intended for perioperative protection of the right ventricle by providing ventricular unloading through the reduction of pulmonary arterial systolic pressures. This effect is achieved by carefully timing vascular counterpulsation of the e‐VaC device around the pulmonary artery. The low‐power requirements of the device pave the way for untethered actuation and full implantability.