CARDIOSIM | ProtekDuo

ProtekDuo

Electrical analogue of the cardiovascular system with the RVAD connected "in series" from the right ventricle to the pulmonary artery and "in parallel" from the right atrium to the pulmonary artery, respectively. All the circuit elements have been described in [1,2,3]

To reproduce the behaviour of the TandemHeart^TM pump and the combination of TandemHeart^TM and ProtekDuo^TM cannula as right ventricular assist device (RVAD) the TandemHeartTM pump can be connected both as a right atrial-pulmonary arterial and a right ventricular-pulmonary arterial connection, driven by four different rotational speeds.
Placement of the outflow of the ProtekDuo^TM in the main pulmonary artery (PA) allows a complete bypass of the failing right ventricle improving pulmonary flow, left atrial filling pressures (LAP), and left ventricular (LV) preload. This can also reduce ventricular interdependence and leftward shift of the interventricular septum that occurs in right ventricular failure (RVF).
The heart numerical model, which consists of the left ventricle and atrium (left heart), the right ventricle and atrium (right heart), and the septum, is included in the network configuration assembled for the study. All these elements are described by variable elastance model; elv (erv) represents the left (right) ventricular time-varying elastance; ela (era) is the left (right) atrial time-varying elastance; eVspt (eAspt) represents the time-varying interventricular (interatrial) septum.

1] De Lazzari B, Badagliacca R, Filomena S, Papa S, Vizza CD, Capoccia M and De Lazzari C. CARDIOSIM^©: The First Italian Software Platform for Simulation of the Cardiovascular System and Mechanical Circulatory and Ventilatory Support. Bioengineering 2022, 9, 383: 1-17, https://doi.org/10.3390/bioengineering9080383

2] De Lazzari C, Capoccia M, Marconi S. et al. Concepts, Mathematical Modelling and Applications in Heart Failure. Capoccia M and De Lazzari C Eds. 2023 New York: Nova Science Publishers.

3] De Lazzari B, Badagliacca R, Capoccia M, Maybauer MO and De Lazzari C. The role of TandemHeart^TM combined with ProtekDuo^TM as right ventricular support device: A simulation approach. Computer Methods and Programs in Biomedicine, 2024, 257, 108473, ISSN 0169-2607, https://doi.org/10.1016/j.cmpb.2024.108473.

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Pressure drop-flow rate waveforms of the proximal inflow lumen positioned in the right atrium (A) and the distal outflow lumen positioned in the main pulmonary artery (B).

The waveforms were obtained from data published in " Advanced Circulatory Support, Mechanical Circulatory Support, ProtekDuo, 16/29Fr, 5140-4629 https://www.livanova.com/cannulae/en-gb/advanced-circulatory-support/mechanical-circulatory-support-mcs/protekduo/5140-4629."

The ProtekDuo^TM is a dual-lumen cannula: the proximal inflow lumen is positioned in the right atrium; the distal outflow lumen is positioned in the main pulmonary artery. The inflow (29 Fr) and the outflow (16 Fr) port lumens are connected with the TandemHeart^TM in the numerical model. The equation shown in the upper slide is used to simulate the behavior of the inflow cannula (29-Fr lumen). The equation shown in the lower slide is used to simulate the behavior of the inflow cannula (16-Fr lumen).

In: De Lazzari B, Badagliacca R, Capoccia M, Maybauer MO and De Lazzari C. The role of TandemHeart^TM combined with ProtekDuo^TM as right ventricular support device: A simulation approach. Computer Methods and Programs in Biomedicine, 2024, 257, 108473, ISSN 0169-2607, https://doi.org/10.1016/j.cmpb.2024.108473.

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