A cavalpulmonary assist device utilising impedance pumping enhanced by peristaltic effect.

Abstract

Background: Fontan procedure, the standard surgical palliation to treat children with single ventricular defects, causes systemic complications over years due to lack of pumping at cavopulmonary junction. A device developed specifically for cavopulmonary support is thus considered, while current commercial ventricular assist devices (VAD) induce high shear rates to blood, and have issues with paediatric suitability.

Aim: To demonstrate the feasibility of a small, valveless, non-invasive to blood and pulsatile rotary pump, which integrates impedance and peristaltic effects.

Methods: A prototype pump was designed and fabricated in-house without any effort to optimise its specification. It was then tested in vitro, in terms of effect of pumping frequency, background pressure differences and pump size on output performance.

Results: Net flow rate (NFR) and maximum pressure head delivery are both reasonably linearly dependent on pumping frequency within normal physiological range. Positive linearity is also observed between NFR and the extent of asymmetric pumping. The device regulates NFR in favourable pressure head difference and overcomes significant adverse pressure head difference. Additionally, performance is shown to be insensitive to device size.

Conclusions: The feasibility of the novel rotary pump integrating impedance and peristaltic effects is demonstrated to perform in normal physiological conditions without any optimisation effort. It provides promising results for possible future paediatric cavopulmonary support and warrants further investigation of miniaturisation and possible haemolysis.