Native Hemodynamic Measurement as Feedback Control for Mechanical Cardiac Support

Abstract Temporary Mechanical Circulatory SupportMCSdevices have been an effective means of temporary support in patients for two indicationsacute myocardial infarctionMIwith or without cardiogenic shockCSand acute decompensated heart failureHFThese ailments strike the elderly the hardest and are simultaneously more prevalent as age progressesCardiogenic shock after MI is more common in elderly patients than in the youngand HF has increasing prevalence with agehave HFfor overhave HFIn these patientsa shortterm MCS device is a catheter delivered pump that can be placed in the LVand pump blood across the aortic valveto help maintain forward flow while unloading the failing heartThe key metric for optimizing the use of these devices includes a combination of pressureand volume measurementWhile pressure is already commonly measured on deviceMCS devices on the market today cannot estimate the total Cardiac Output of the hearta key component of Cardiac Power OutputCPOCO x mean aortic pressurewhich is now well accepted as the single most important correlate of mortality in cardiogenic shockOptimization of ongoing treatment as well as when to wean the patient from the MCS device to transition them to recoveryor a more permanent devicecurrently lacks a real timeaccurate measure of COnecessary to calculate CPOWe propose integrating a proven LV volume measurementCardioVolAdmittance TechnologiesAustinTXcapable of determining CO directly onto the MCS deviceallowing the device to actively change pump speedand therefore effect CPOto respond to changing patient conditionIn this phaseeffortBridgeSource Medical will demonstrate how CardioVol can be redeveloped for application on existing MCS device platforms Project Narrative Temporary Mechanical Circulatory SupportMCSdevices have a goal of assisting the failing heart to bridge a patient to recoveryor to a more durable ventricular pumpHowevera key metric of optimal hemodynamic stabilizationthe native cardiac outputCOis not measured on these increasingly popular devices