Physiological heart pump control

• US 20030045772A1
• Filed: 08/15/2002
• Published: 03/06/2003
• Est. Priority Date: 08/16/2001
• Status: Active Grant

• Current Assignee: Apex Medical Corporation
• Original Assignee: Apex Medical Corporation
• Inventors: Bullister, Edward Theodore, Reich, Sanford
• Granted Patent: US 6,623,420 B2
• Time in Patent Office: Days
• US Class Current: 600/18
• CPC Class Codes: A61M 2205/04 implanted
• CPC Class Codes: A61M 2205/33 Controlling, regulating or measuring
• CPC Class Codes: A61M 2205/3334 Measuring or controlling the flow rate
• CPC Class Codes: A61M 2205/3344 Measuring or controlling pressure at the body treatment site
• CPC Class Codes: A61M 2205/502 User interfaces, e.g. screens or keyboards
• CPC Class Codes: A61M 2205/8206 battery-operated
• CPC Class Codes: A61M 2210/125 Heart
• CPC Class Codes: A61M 60/148 in line with a blood vessel using resection or like techniques, e.g. permanent endovascular heart assist devices
• CPC Class Codes: A61M 60/178 drawing blood from a ventricle and returning the blood to the arterial system via a cannula external to the ventricle, e.g. left or right ventricular assist devices
• CPC Class Codes: A61M 60/216 including a rotating member acting on the blood, e.g. impeller
• CPC Class Codes: A61M 60/411 generated by an electromotor
• CPC Class Codes: A61M 60/531 using blood pressure data, e.g. from blood pressure sensors
• CPC Class Codes: A61M 60/546 of blood flow, e.g. by adapting rotor speed
• CPC Class Codes: A61M 60/554 of blood pressure

Abstract

A blood pump is joined in parallel flow between the left ventricle and aorta of a patient'"'"'s heart. The pump includes an inlet pressure sensor and cooperating controller for measuring inlet pressure to the pump to control operation thereof. The controller adjusts speed of the pump in a closed loop control using feedback of the measured inlet pressure to conform operation of the pump with the natural cycle of the heart.

Claims

1. A method of controlling a blood pump joined in parallel flow between a left ventricle and aorta of a patient'"'"'s heart comprising:

measuring inlet pressure of blood flow to said pump from said left ventricle;

comparing said measured inlet pressure with a set value thereof to determine a difference therebetween; and

adjusting speed of said pump in a closed control loop using feedback of said measured inlet pressure to minimize said pressure difference.

2. A method according to claim 1 further comprising limiting said measured inlet pressure to a preselected first range having a minimum value for preventing collapse of said left ventricle.

3. A method according to claim 2 wherein said first range includes a maximum value of said inlet pressure for preventing overburdening of the patent'"'"'s right heart.

4. A method according to claim 3 further comprising:

measuring outlet pressure of said blood flow from said pump to said aorta; and

adjusting speed of said pump in an outer closed loop control using feedback of said measured outlet pressure for maintaining said outlet pressure in a preselected second range, with said feedback of said measured inlet pressure being used in a cooperating inner closed loop control for maintaining said inlet pressure in said first range.

5. A method according to claim 4 wherein said outer loop control adjusts said inlet pressure within said first range for maintaining said outlet pressure within said second range.

6. A method according to claim 5 wherein said inlet pressure is measured over a period of at least one full heartbeat cycle, and consists of the minimum value during said period.

7. A method according to claim 6 wherein said outer loop control has a slower response time than said inner loop control.

8. A method according to claim 6 further comprising correcting said measured inlet pressure to conform with pressure inside left ventricle.

9. A method according to claim 6 further comprising correcting said measured outlet pressure to conform with pressure inside said aorta.

10. A method according to claim 6 further comprising:

measuring atmospheric reference pressure at skin of the patient; and

correcting said measured inlet and outlet pressures to gauge pressure using said reference pressure.

11. A method according to claim 6 further comprising:

specifying a resting heart rate for the patient;

measuring heart rate of the patient'"'"'s heart; and

increasing speed of said pump in a second level of control to increase said outlet pressure for measured heart rate greater than said resting heart rate.

12. A method according to claim 11 further comprising:

suspending said second range of outlet pressure when said second level control increases said pump speed; and

replacing said second range with a different preselected third range of said outlet pressure.

13. A method according to claim 12 wherein said second level control increases said outlet pressure from said pump by adjusting said inlet pressure.

14. A method according to claim 12 wherein:

said second range includes preselected maximum and minimum values of said outlet pressure;

said third range includes a different preselected maximum value of said outlet pressure, a preselected maximum percent increase of said outlet pressure above said outlet pressure at said resting heart rate, and a preselected maximum increase in said heart rate; and

said outlet pressure is increased in response to increase in said heart rate as derived from said third range.

15. A method according to claim 12 wherein said heart rate is measured by measuring periodic pulses in said inlet pressure corresponding with beating of said heart.

16. A method according to claim 12 further comprising:

measuring speed of said pump;

determining pressure differential between said measured outlet and inlet pressures;

determining flowrate through said pump using predetermined performance curves for said pump based on said measured speed and pressure differentials; and

determining pumping power for said pump as the product of said pressure differential and said flowrate determined therefrom.

17. A method according to claim 16 further comprising adjusting said speed of said pump in a third level of control of said inlet pressure to control pumping power of said pump.

18. A method according to claim 17 further comprising:

determining pumping power for said left ventricle; and

adjusting pumping power of said pump to correspondingly share pumping load between said pump and said left ventricle.

19. A method according to claim 12 further comprising monitoring said inlet and outlet pressures, and performance of said pump to diagnose abnormalities therewith.

20. A system for assisting blood pumping through a left ventricle of a patient'"'"'s heart comprising:

a blood pump joined in parallel flow between the left ventricle and an aorta inside said patient;

an inlet pressure sensor for measuring inlet pressure of blood flow to said pump from said left ventricle;

a controller operatively joined to said inlet pressure sensor, and to said pump for controlling operation thereof, and including;

means for comparing said measured inlet pressure with a set value thereof to determine a difference therebetween; and

means for adjusting speed of said pump in a closed loop control using feedback of said measured inlet pressure to minimize said pressure difference.

21. A system according to claim 20 wherein said controller further comprises means for limiting said measured inlet pressure to a preselected first range having a minimum value for preventing collapse of said left ventricle.

22. A system according to claim 21 further comprising:

an outlet pressure sensor operatively joined to said controller for measuring outlet pressure of said blood flow from said pump to said aorta; and

said controller further includes an outer closed loop control for adjusting speed of said pump using feedback of said measured outlet pressure for maintaining said outlet pressure in a preselected second range, with feedback of said measured inlet pressure being used in a cooperating inner closed loop control for maintaining said inlet pressure in said first range.

23. A system according to claim 22 wherein said outer loop control is further configured to adjust said inlet pressure within said first range for maintaining said outlet pressure within said second range.

24. A system according to claim 23 wherein said controller is further configured for measuring said inlet pressure over a period of at least one full heartbeat cycle, and said inlet pressure consists of the minimum value thereof during said period.

25. A system according to claim 24 further comprising:

a reference pressure sensor disposed adjacent to skin of said patient for measuring atmospheric pressure thereat; and

said controller is further configured for correcting said measured inlet and outlet pressures to gauge pressure using said reference pressure.

26. A system according to claim 25 further comprising:

means for measuring heart rate of the patient'"'"'s heart; and

said controller further includes a second level of control for increasing speed of said pump to increase said outlet pressure for measured heart rates greater than a specified resting heart rate.

27. A system according to claim 26 wherein said controller is further configured for suspending said second range of outlet pressure when said second level control increases said pump speed;

and

replacing said second range with a different preselected third range of said outlet pressure.

28. A system according to claim 27 wherein said second control level in said controller is configured for increasing said outlet pressure from said pump by adjusting said inlet pressure.

29. A system according to claim 28 wherein:

said second range includes preselected maximum and minimum values of said outlet pressure;

said third range includes a different preselected maximum value of said outlet pressure, a preselected maximum percent increase of said outlet pressure above said outlet pressure at said resting heart rate, and a preselected maximum increase in said heart rate; and

said outlet pressure is increased in response to increase in said heart rate as derived from said third range.

30. A system according to claim 28 wherein said heart rate measuring means are effective for measuring periodic pulses in said inlet pressure corresponding with beating of said heart.

31. A system according to claim 28 further comprising:

means for measuring speed of said pump; and

said controller is further configured for determining pressure differential between said measured outlet and inlet pressures;

said controller is further configured for determining flowrate through said pump using predetermined performance curves for said pump based on said measured speed and pressure differential; and

said controller is further configured for determining pumping power for said pump as the product of said pressure differential and flowrate determined therefrom.

32. A system according to claim 31 wherein said controller includes a third level of control of said inlet pressure for adjusting speed of said pump to control pumping power of said pump.

33. A system according to claim 32 wherein said controller is further configured for:

determining pumping power for said left ventricle; and

adjusting said pumping power of said pump to correspondingly share pumping load between said pump and said left ventricle.