Left and Right Pump Output Control in One-Piece Electromechanical Total Artificial Heart

Abstract: Left master alternate (LMA) ejection control based on the left pump fill method was implemented for a one-piece electromechanical total artificial heart (TAH). The TAH consists of left and right pusher-plate-type blood pumps sandwiching a compact electromechanical actuator comprising a direct current (DC) brushless motor and a planetary roller screw. The motor rotation is controlled on the basis of the roller-screw position as detected by a Hall effect sensor and a commutation pulse-counting method. Since the pusher-plate shaft and roller screw are decoupled during filling, both pumps fill passively with the right and left atrial pressure. To obtain response to the right atrial pressure change in the LMA mode, the left fill trigger level as detected by a Hall effect position sensor is adjusted to operate the pump at a higher rate and to drive the right pump at 85–90% of the full stroke level. The invitro evaluation demonstrated that this method can respond to right atrial pressure changes provided that the right pump is operated at less than the full stroke level. When the preload is high and the right pump goes into full stroke operation, the left eject level can be decreased to run the pump at a higher rate and to transfer more blood from the right to the left. In the in vivo evaluation, which lasted 1 week in a 95 kg calf, the left and right atrial pressures were kept within physiological ranges. The LMA mode triggered by the left pump fill can protect the lungs and can also respond to venous return change and therefore is a reliable control method for a one-piece to-tally implantable TAH system.