Ventricular-vascular interaction is very complex, because pulsatile pressures depend on vascular properties and three cardiac parametersheart rate,

ventricular compliance and contractility. There is a growing interest in modeling the interaction of the vasculature and continuous-flow pumps to optimize the design, control, and pharmacological support of a continuous-flow total artificial heart. The lack of pulsatility that makes the interaction easier to model, however, also introduces a new constraint: continuous-flow pumps depend only on two parameterspump speed and an internal resistance. The purpose of this work is to predict flows and pressures in terms of vascular and pump properties. The vasculature was characterized by parameters for arterial and venous compliances, as well as systemic and pulmonary resistances. Through linearization and simplification, we were able to develop simple algebraic formulas predicting total flow, systemic arterial and venous pressure, pulmonary arterial and venous pressure, as well as pump power. With fewer parameters than a ventricle, a pump does not have enough flexibility to adjust the limited set of pump parameters to independently control pressures while maintaining normal blood volume and vascular resistances. Our algebraic solution, however, suggests that pump and vascular parameter values can be adjusted to optimize hemodynamic homeostasis.

Prediction of Optimal Continuous-Flow Total Artificial Heart and Vascular Parameters to Maintain Hemodynamic Homeostasis
Michael T. McDowall1, Paige A. Adair1, Sarah F. Knezek1, Egemen Tuzun2, and Christopher M. Quick1 1Michael E. DeBakey Institute, Texas A&M University, 2Texas Institute for Pre-clinical Studies, Texas A&M University

Introduction
Previous Total Artificial Heart (TAH) implants have failed for unknown reasons Past artificial hearts have only been modeled numerically, our model is analytical Analytical solution is an accurate approximation of the behavior of the closed loop cardiovascular system There is a growing interest in modeling the interaction of continuous flow pumps and the vasculature to optimize the construction of a total artificial heart The purpose of this work is to predict Q, Pa and Pv, and pump power in terms of vascular and pump properties With fewer parameters than a ventricle, a pump does not have enough flexibility to adjust the limited set of pump parameters to independently control pressures while maintaining normal blood volume and vascular resistances Our algebraic solution, however, suggests that pump and vascular parameter values can be adjusted to optimize hemodynamic homeostasis

Methods
Standard Minimal Model
We started with the standard minimal closed loop cardiovascular model in which linear equations are given for pressures, volumes, and flows in terms of cardiovascular parameters We reorganized these equations in terms of the TAH parameters R and Qo

Results
This model indicates that a ventricle has a differential sensitivity to arterial and venous pressure, and the continuous flow pump does not. As a result, a ventricle, coupled with cardiovascular system has the flexibility to independently set venous and arterial pressure and CO. TAH, with one less degree of freedom, can only be tuned to set two out of the four. The algebraic solution describes the best pump parameters to optimize the systemic pressure, cardiac output, venous pressure, and pump power.
Pressure-Flow curves of 3 common TAH's at speed 10,000
160 140 120 100 80 60

Jarvik 2000 HeartMate II Micromed DeBakey

Equations
1.

40 20 0 0 1 2 3 4 5

HR HR CO = HR * V0 + * PV * Pa Emin Emax

3.

HR 1 = E (max/ min) R

2.

1 1 QLVAD = Q0 + * Pv - * Pa R R

4.

E max = E min

lungs

The given equation for CO (eq.1) is similar to the QLVAD equation (eq.2): -HR*V0 correlates to Q0 in equation 2. Comparison of the PV and Pa terms from equations 1 and 2 allows you to equate the coefficients as seen in equation 3. From this we can assume that Emax = Emin as seen in equation 4.

Conclusion
TAH pumps do not have the capability of maintaining normal blood volume and resistances, as well as independently setting pressures like a normal heart is capable of doing. Using the algebraic solutions, pump and vascular parameter values can be found in order to optimize hemodynamic homeostasis.

Pulmonary Circulation

Cost Function
Psv - Psv ' 2 Psa - Psa ' 2 CO - CO ' 2 2 CostFunction = a[ ] + b[ ] + c[ ] + d[CO *(Psa - Psv ) - CO '*(Psa '- Psv ')] Psv ' Psa ' CO '

TAH

References
Preload sensitivity of the Jarvik 2000 and HeartMate II left ventricular assist devices. -Khalil HA, Cohn WE, Metcalfe RW, Frazier OH. -ASAIO J. 2008 May-Jun; 54(3):245-8.

Systemic Circulation

Organs and tissues

The purpose of the cost equation is to combine and weight the four parameters, creating an order of importance. This is necessary due to the loss of a degree of freedom in the TAH compared to an actual heart, allowing only 2 of the 4 parameters to be optimized.