WO2006047620A2 - Method for making a blood pump and pumping blood - Google Patents

Method for making a blood pump and pumping blood Download PDF

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Publication number
WO2006047620A2
WO2006047620A2 PCT/US2005/038635 US2005038635W WO2006047620A2 WO 2006047620 A2 WO2006047620 A2 WO 2006047620A2 US 2005038635 W US2005038635 W US 2005038635W WO 2006047620 A2 WO2006047620 A2 WO 2006047620A2
Authority
WO
WIPO (PCT)
Prior art keywords
bladder
blood
pumping chamber
blood flow
initial
Prior art date
Application number
PCT/US2005/038635
Other languages
French (fr)
Other versions
WO2006047620B1 (en
WO2006047620A3 (en
Inventor
Arthur Palmer
Original Assignee
Arthur Palmer
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Arthur Palmer filed Critical Arthur Palmer
Publication of WO2006047620A2 publication Critical patent/WO2006047620A2/en
Publication of WO2006047620A3 publication Critical patent/WO2006047620A3/en
Publication of WO2006047620B1 publication Critical patent/WO2006047620B1/en
Priority to US11/788,668 priority Critical patent/US7803105B2/en
Priority to US12/846,405 priority patent/US8500621B2/en

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M60/00Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
    • A61M60/10Location thereof with respect to the patient's body
    • A61M60/122Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body
    • A61M60/126Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body implantable via, into, inside, in line, branching on, or around a blood vessel
    • A61M60/148Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body implantable via, into, inside, in line, branching on, or around a blood vessel in line with a blood vessel using resection or like techniques, e.g. permanent endovascular heart assist devices
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M60/00Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
    • A61M60/40Details relating to driving
    • A61M60/424Details relating to driving for positive displacement blood pumps
    • A61M60/427Details relating to driving for positive displacement blood pumps the force acting on the blood contacting member being hydraulic or pneumatic
    • A61M60/43Details relating to driving for positive displacement blood pumps the force acting on the blood contacting member being hydraulic or pneumatic using vacuum at the blood pump, e.g. to accelerate filling
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M60/00Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
    • A61M60/80Constructional details other than related to driving
    • A61M60/835Constructional details other than related to driving of positive displacement blood pumps
    • A61M60/837Aspects of flexible displacement members, e.g. shapes or materials
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M60/00Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
    • A61M60/80Constructional details other than related to driving
    • A61M60/855Constructional details other than related to driving of implantable pumps or pumping devices
    • A61M60/89Valves
    • A61M60/894Passive valves, i.e. valves actuated by the blood
    • GPHYSICS
    • G06COMPUTING; CALCULATING OR COUNTING
    • G06FELECTRIC DIGITAL DATA PROCESSING
    • G06F30/00Computer-aided design [CAD]
    • G06F30/20Design optimisation, verification or simulation
    • GPHYSICS
    • G16INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16HHEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H50/00ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics
    • G16H50/50ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for simulation or modelling of medical disorders
    • GPHYSICS
    • G16INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16ZINFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS, NOT OTHERWISE PROVIDED FOR
    • G16Z99/00Subject matter not provided for in other main groups of this subclass
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2205/00General characteristics of the apparatus
    • A61M2205/33Controlling, regulating or measuring
    • A61M2205/3331Pressure; Flow
    • A61M2205/3334Measuring or controlling the flow rate
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M60/00Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
    • A61M60/10Location thereof with respect to the patient's body
    • A61M60/122Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body
    • A61M60/196Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body replacing the entire heart, e.g. total artificial hearts [TAH]
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M60/00Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
    • A61M60/50Details relating to control
    • A61M60/508Electronic control means, e.g. for feedback regulation
    • A61M60/562Electronic control means, e.g. for feedback regulation for making blood flow pulsatile in blood pumps that do not intrinsically create pulsatile flow
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M60/00Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
    • A61M60/80Constructional details other than related to driving
    • A61M60/855Constructional details other than related to driving of implantable pumps or pumping devices
    • A61M60/89Valves
    • A61M60/894Passive valves, i.e. valves actuated by the blood
    • A61M60/896Passive valves, i.e. valves actuated by the blood having flexible or resilient parts, e.g. flap valves
    • GPHYSICS
    • G06COMPUTING; CALCULATING OR COUNTING
    • G06FELECTRIC DIGITAL DATA PROCESSING
    • G06F2111/00Details relating to CAD techniques
    • G06F2111/10Numerical modelling

Definitions

  • the subject application relates generally to fluid pumps, and more particularly to blood pumps, cardiac assist devices, methods for making blood pumps and blood pumping methods.
  • the natural heart functions in a fashion similar to a positive displacement pump.
  • Each of the two pumping chambers in the natural heart has two check valves (an inlet and an outlet valve).
  • the walls of the natural heart are made of contractile muscle that provide the power to pump the blood.
  • Each pumping cycle consists of a filling or diastolic phase of the pumping cycle and an ejection or systolic phase of the pumping cycle.
  • the muscle fibers making up the walls of the heart relax allowing the chamber they surround to fill with blood.
  • the muscle making up the walls of the heart contracts ejecting a portion of the blood from the chamber.
  • the muscle making up the walls of the heart does not all relax simultaneously during the filling phase and does not all contract simultaneously during the ejection phase of the heart's pumping cycle. Portions relax sequentially during the filing phase and they contract sequentially during the ejection phase in such a way to direct or "milk" the blood through the heart in flow that is generally laminar.
  • This pump- is designed to milk the blood through the apparatus, by progressively expanding the bladder in the direction of fluid flow and progressively contracting the bladder, also in the direction of flow.
  • the pumping chamber has an inlet and an outlet, each of which is equipped with a one-way flow check valve. The elastic expansion and contraction of the bladder reduces the formation of blood clots (thrombosis) in the pump.
  • a problem with some prior art blood pumps relates to the pattern of blood flow through the pump, i.e., the flow pattern.
  • Significant turbulence occurs in the pumping chamber during the pumping cycle. There is little that can be done to control the characteristics of blood flow through the pumping chamber. There are areas of high velocity and other areas of slow flow. These slow flow areas also contribute to thrombosis. Turbulence leads to energy loss and inefficiency of the pump. Excessive turbulence can also damage the blood cells.
  • my prior patent addresses this issue, further improvements are needed in creating a flow pattern that resembles that of a natural heart. Also, there is a need for a process of designing the pump components, particularly the bladder, to achieve the desired flow pattern.
  • the present disclosure builds on my prior patent, U.S. Patent No. 6,579,223, entitled Blood Pump.
  • the object of the invention is to provide for improved flow through the pump, for harnessing the inertial forces of the pumped fluid and for improved washing of the areas of the pump susceptible to thrombosis (clotting) thereby decreasing thrombosis in these susceptible areas.
  • a process is provided for the design and construction of the pump.
  • diaphragm type pumps draw the fluid being pumped through an intake port into a pumping chamber. They have little or no ability to guide the flow of fluid through the pumping chamber. Once the pumping chamber has filled, the fluid in the chamber must slow or stop. In the ensuing ejection phase of the pumping cycle, the fluid is accelerated toward the discharge port, which in at least some pumps, is in a direction that is opposite the direction of the intake flow. Flow momentum is lost, and considerable turbulence is created.
  • available designs may vary in construction and geometry, they generally function as just described.
  • One aspect of the present invention is to guide and direct the flow of blood through the pumping chamber by reason of the action of an expansile bladder on the blood flow.
  • a continuous circular or spiral fluid path is obtained that more effectively washes the inlet and discharge ports as well as the walls of the pumping chamber with the pumped fluid, i.e., blood.
  • Good washing of all areas of the bladder will decrease the tendency for blood clotting.
  • the blood is initially drawn into the pumping chamber through the inlet port. As the blood flows into the pumping chamber it washes the discharge port. As various areas of the bladder sequentially expand and contract, the blood is guided through the pumping chamber washing the chamber walls. Prior to being ejected out of the discharge port, the blood washes past the inlet port. It is expected that the flow of blood directed across the inlet and discharge ports and the washing action associated with this flow will decrease clotting in these areas.
  • the inertia of the blood will contribute to the action of the bladder and the path of the blood flow through the device.
  • a smoother laminar flow through the pumping chamber afforded by the expansible bladder will improve the efficiency of the pump and decrease energy requirements.
  • a process for designing, constructing and operating the pump, especially the bladder comprises essentially two parts.
  • the first part is to select a desired flow pattern and using sophisticated mathematical modeling techniques work backwards, so to speak, to arrive at the bladder function necessary to achieve that flow pattern.
  • the second part of the method is to design a bladder and pump operating system to achieve the desired bladder function, and then to use the same mathematical modeling techniques to predict the resulting flow pattern.
  • the design may be refined by repeating the foregoing steps. More specifically, in the first part of the method, an initial pumping chamber configuration is selected or created, preferably with a circular or spiral shaped pumping chamber.
  • a desired flow pattern, streamlines and other characteristics of blood flow through the device is designed guided by blood flow in a natural heart.
  • An initial computer model of flow pattern will be developed using the mathematical techniques such as computational fluid dynamics and immersed boundary methods. This rigorous mathematical approach will provide the information to design the housing and bladder.
  • the initial computer model will be used to determine the position of variovis points of the bladder, as a function of time, throughout the pumping cycle. To induce laminar flow along these streamlines it may also be helpful to modify the shape of the bladder and pumping chamber.
  • a pump including a bladder, housing and pump operating system are designed.
  • the pump is designed to operate such that each point or element of the bladder will move substantially in accordance with the initial computer model.
  • the bladder and operating system for driving the bladder preferably will function similar to that of a natural heart.
  • the various elements of the bladder wall will not all expand simultaneously (or at the same rate) during the filling phase and will not all contract simultaneously (or at the same rate) during the ejection phase of the pumping cycle.
  • Portions of the bladders will expand sequentially during the filing phase and contract sequentially during the ejection phase in such a way to direct or "milk" the blood through the pumping chamber in a generally laminar flow pattern.
  • the physical characteristics that the bladder will require at each point will be determined from the initial computer model (thickness, elasticity, viscoelasticity, fatigue strength and others). Appropriate materials will be selected for the bladder. In order to achieve the required characteristics at each point on the bladder, the thickness and composition of the bladder may vary, polymers or other materials may need to be combined in various areas by layering, forming bands or struts, electrospinning or other means. Preferably, the bladder is formed with directional elastic properties in the bladder wall that simulate heart muscles. It is further contemplated that the bladder operating system, including housing surrounding the bladder and means for driving the bladder will be adapted as necessary to achieve the designed sequential expansion and contraction of the bladder.
  • the bladder and pump operating system design are then tested, preferably by generating a computer model of the apparatus and generating simulated fluid flow using the same mathematical techniques described above, but now in the sequence of having a given pump design and generating the flow pattern therefrom.
  • Problems in bladder and operating system design may mandate reversion back to previous steps with further modification of the size or shape of the housing, or shape or composition of the bladder, or means for driving the bladder. More than one simultaneous flow pathway through the bladder may be required. During this phase, progression from a two-dimensional to a three-dimensional model will occur.
  • a prototype will be constructed based on the computer model. This will be bench tested followed by animal and human testing. Further refinement of the shell and bladder design will be made following prototype testing to simulate flow in natural hearts, eliminate stagnation points, provide laminar flow, wash ports, conserve energy, and reduce the potential for thrombosis.
  • FIG. 1 diagrammatically illustrates a preferred method of pumping blood.
  • Fig. 2 is a flow diagram showing a preferred method for designing the pump.
  • Figs. IA-I F illustrate a pump apparatus 10 constructed generally in accordance with my earlier patent, U.S. Patent No. 6,579,223.
  • Pump 10 comprises an expansile bladder 12 within a shell or housing 14.
  • the bladder and housing in this embodiment are generally round for ease in illustrating the concept, and may be easier to begin with in the initial designs. Nevertheless, other shapes can be used and may be preferable, such as conical or heart-shaped bladders.
  • the bladder has an inlet port 16 and a discharge port 18.
  • the inlet and discharge ports are preferably adjacent to one another, but may be spaced apart.
  • An inlet check valve 20 and an outlet check valve 22 insure one-way flow through the bladder.
  • the bladder is connected to the shell or housing at the inlet and outlet.
  • a volume or space 24 is defined between the bladder 12 and housing 14.
  • a bladder driving fluid is adapted to be cyclically introduced into and removed from the space 24 through port 26.
  • a pumping chamber 28 is defined within bladder 12.
  • Various devices known in the art are commercially available for introducing and removing the driving fluid from the space 24, for example, a vacuum pump as described in U.S. Patent No. 6,579,223.
  • pressure regulating means may be provided in the space 24 between the bladder and housing to regulate the pressure applied to various portions or segments of the bladder as a function of time during the pumping cycle, and thereby affect the desired sequence and rate of expansion and contraction of each segment of the elastic bladder.
  • a pressure regulating means is shown in Fig. 6 of U.S.
  • Patent Nos. 6,579,223 and others are known in the art. Still further, a driving means (not shown) may be utilized for mechanically or hydraulically driving selected portions of the bladder and assisting in controlling the direction, magnitude, rate and timing of movement of various portions of the bladder to achieve the designed dynamic bladder pumping cycle shown in Figs. IA-I J.
  • the neutral or relaxed condition of the bladder is a fully contracted position, as shown in Figs. IA and IJ.
  • the bladder By decreasing the pressure of the actuating fluid the bladder is elastically expanded to draw blood into the pumping chamber.
  • the bladder retracts by reason of the elastic recoil of the bladder to eject blood from the pumping chamber.
  • the ejection may also be augmented by positive pressure.
  • Figs. IA through IF a method for pumping blood is diagrammatically illustrated wherein the blood is guided and directed through the pumping chamber by the expansile bladder.
  • a fluid path through pump 10 more effectively washes the inlet 16 and discharge ports 18 and pumping chamber walls with the pumped fluid.
  • the blood is initially drawn into the pumping chamber through the inlet port 16.
  • Fig. IA As the blood flows into the pumping chamber through the inlet port, it washes the discharge port, as shown by arrows 30 and flow lines in Figs. IB - IE.
  • the blood is guided through the pumping chamber and washes past the inlet port 16 prior to being ejected out of the discharge port 18, as shown by arrows 32 and flow lines in Figs. IF - II. It is expected that the flow of blood directed across the inlet and discharge ports and the washing action associated with this flow will decrease clotting in these areas. Also, by appropriately directing the flow of the blood through the device and optimizing the angle of the inlet and the discharge port, the inertia of the blood will contribute to the action of the bladder and the path of the blood flow through the device. The smoother laminar flow through the pumping chamber afforded by the expansible bladder will improve the efficiency of the pump and decrease energy requirements.
  • pump 10 in Fig. 1 is merely to illustrate the pumping method, and should not be construed as limiting.
  • the housing or shell 14 of the pump is shown as generally cylindrical, but spiral, conical or other shapes may be used.
  • the particular means for expanding and contracting the bladder is not important as long as a smooth, laminar blood flow, guided and directed as explained above, is achieved.
  • a second aspect of the invention is a method for designing the bladder and pump operating system. It is an object of the invention to create a blood flow pattern similar to that of the natural heart, as described above.
  • the design and composition of the bladder, housing and pump operating system are important factors in achieving the desired blood flow pattern.
  • the bladder and operating system design process comprises a number of steps, which are shown in Fig. 2.
  • the first step 101 is to select an initial housing and bladder shape, as shown for example in Fig. 1.
  • the desired streamlines and other characteristics of blood flow through the device that is, the blood flow pattern, will be designed 103 based generally on blood flow in a natural heart.
  • a computer model of the blood flow pattern is developed 105.
  • the computer model can be generated by any technique, for example by use of the mathematical techniques of computational fluid dynamics. Newer techniques, such as "Immersed Boundary Method” may be used. See, Peskin, Charles S., “The Immersed Boundary Method” Acta Nume ⁇ ca (2002) pp. 1-39.
  • the Immersed Boundary Method is adaptable to computer simulation of the fluid-structure interaction. It is called for because in accordance herewith the size and shape of the pumping chamber is constantly changing throughout the pumping cycle, which in turn changes flow dynamics, which in turn affects bladder shape.
  • a computer model will simulate the desired flow pattern.
  • the computer model will be used to determine the position of various portions or elements of the bladder, as a function of time, throughout the pumping cycle. It may be necessary to refine or modify the initial design as shown at query 107, and repeat or revise steps 103, 105 and 107 until one is satisfied with the initial pump design and computer model.
  • the first part of the method thus uses a computer model in reverse, that is, the desired flow pattern is used to determine the structure, shape and function of the pump.
  • the second part of the method uses information provided by the first part to design a prototype bladder and pump operating system, and then utilizes a computer model to predict the flow pattern in the prototype.
  • the initial computer model is used to determine the physical characteristics (e.g., thickness, elasticity, viscoelasticity, fatigue strength) of each element of the bladder wall 109 required for the given flow pattern.
  • Appropriate materials will be selected for each element or portion of the bladder, hi order to achieve the required characteristics of each element of the bladder, the thickness and material composition of the bladder may vary. Polymers or other materials can be combined in various areas by layering, forming bands or struts (as described in U.S. Patent 6,579,223), electrospinning or other means.
  • Electrospinning techniques may be used to design a continuous, unitary elastic bladder comprised of composite materials, where the composition and physical, viscoelastic and dynamic properties of the bladder vary from point to point in accordance with the computer model. See e.g., Boland, Eugene D. et al, "ElectiOspinning of Biopolymers (Natural and Synthetic) for Tissue Engineering Scaffolds" Polymer Preprints 2003, 44(2) at pp. 92-93; and U.S. patent publication No. 2003/0168756. Electrospinning techniques can be used to create directional elastic properties in the bladder that mimic the architecture and function of heart muscles. Indeed, it is preferred to simulate multiple muscle layers.
  • the pump operating system is designed, in cooperation with the bladder, to control the direction, magnitude, rate and timing of movement of each of the various portions of the bladder to achieve the designed dynamic bladder pumping cycle. More specifically, based on the computer model, the operating system causes portions of the bladder to expand sequentially during the filing phase and contract sequentially during the ejection phase in such a way to direct or "milk" the blood through the pumping chamber.
  • the pump operating system includes a device, e.g., a vacuum pump, for introducing and removing the driving fluid from the space 24 between the bladder and housing, and may optionally include pressure regulating means for regulating the pressure applied to various portions or segments of the bladder as a function of time during the pumping cycle, and/or a driving means for mechanically or hydraulically assisting in controlling the direction, magnitude, rate and timing of movement of various portions of the bladder to achieve the designed dynamic bladder pumping cycle.
  • a device e.g., a vacuum pump
  • pressure regulating means for regulating the pressure applied to various portions or segments of the bladder as a function of time during the pumping cycle
  • a driving means for mechanically or hydraulically assisting in controlling the direction, magnitude, rate and timing of movement of various portions of the bladder to achieve the designed dynamic bladder pumping cycle.
  • the particular devices utilized are within the skill of this highly specialized art, and are unimportant to the present invention as long as they substantially achieve the object of providing the desired movement of the bladder wall, which in turn provides the desired
  • the bladder and pump operating system are then tested 113, preferably by generating a computer model of the apparatus and generating simulated fluid flow 111.
  • the flow pattern of the model is examined 115 to determine whether the design criteria are being met, including whether the flow is laminar, whether inertia of the blood is maintained, whether the discharge port is effectively washed by incoming flow, whether the exit port is washed by flow being ejected from the pump, whether areas of flow stagnation are avoided, whether zones of turbulent flow are avoided.
  • Problems in bladder design may mandate reversion back to previous steps with further modification 117 of the size or shape of the housing, or shape or composition of the bladder, or design of the pump operating system. During this phase, progression from a two-dimensional to a three-dimensional model will occur.
  • the design 117, computer modeling 111, testing 113 and evaluation 115 steps are modified or repeated until an acceptable flow pattern is achieved.
  • a prototype will then be constructed 119 based on the computer model.
  • the prototype will be bench tested followed by animal and human testing 121.
  • Test results will be evaluated 123.
  • Further refinement of the bladder pump operating system 117 will be made following prototype testing to simulate flow in natural hearts, eliminate stagnation points, provide laminar flow, wash ports, conserve energy, and reduce the potential for thrombosis.
  • the forgoing steps of computer modeling 111, testing 113 and evaluation 115, and prototype refinement 119, testing 121 and evaluation 123 are repeated as necessary to achieve the desired flow characteristics.

Abstract

A method of making a blood pump comprises selecting a desired flow pattern in a pumping chamber defined by an extensible bladder wherein the flow pattern is based gnerally on blood flow in a natural heart, using an initial computer model of the desired flow pattern to determine the material composition and dynamic operation conditions of each portion of the bladder, designing a bladder and pump operating system, computer modeling the actual design, testing and refining the design, and constructing a prototype based thereon. The desired flow pattern includes guiding and directing the flow of blood through the pumping chamber by reason of the action of an expansile bladder on the blood flow. A continuous circular or spiral fluid path is obtained that more effectively washes all areas of the bladder including the inlet and discharge ports with blood to reduce thrombosis.

Description

METHOD FOR MAKING A BLOOD PUMP AND PUMPING BLOOD
Reference
This application claims priority from U.S. Provisional Patent Application Serial No. 60/621 ,920 filed October 25, 2004, which is hereby incorporated by reference.
Technical Field
The subject application relates generally to fluid pumps, and more particularly to blood pumps, cardiac assist devices, methods for making blood pumps and blood pumping methods.
Background Art
The natural heart functions in a fashion similar to a positive displacement pump. Each of the two pumping chambers in the natural heart has two check valves (an inlet and an outlet valve). The walls of the natural heart are made of contractile muscle that provide the power to pump the blood. Each pumping cycle consists of a filling or diastolic phase of the pumping cycle and an ejection or systolic phase of the pumping cycle. During the filling phase, the muscle fibers making up the walls of the heart relax allowing the chamber they surround to fill with blood. During the ejection phase of the cycle the muscle making up the walls of the heart contracts ejecting a portion of the blood from the chamber. The muscle making up the walls of the heart does not all relax simultaneously during the filling phase and does not all contract simultaneously during the ejection phase of the heart's pumping cycle. Portions relax sequentially during the filing phase and they contract sequentially during the ejection phase in such a way to direct or "milk" the blood through the heart in flow that is generally laminar.
Mechanical blood pumps have been developed for use as artificial hearts to replace or assist the natural heart. Present blood pumps fall into two general categories. One category uses a rotary impeller and includes centrifugal pumps and axial flow pumps. The other category is pulsatile pumps that provide a flow pattern that more resembles that of the natural heart. My earlier patent, U.S. Patent No. 6,579,223, discloses a pump with desirable pulsatile flow. This pump comprises a housing, an extensible bladder within the housing, a driving fluid between the bladder and the housing, and device such as a vacuum pump to cyclically decrease and increase the pressure of the driving fluid to expand and contract the elastic bladder. This pump- is designed to milk the blood through the apparatus, by progressively expanding the bladder in the direction of fluid flow and progressively contracting the bladder, also in the direction of flow. The pumping chamber has an inlet and an outlet, each of which is equipped with a one-way flow check valve. The elastic expansion and contraction of the bladder reduces the formation of blood clots (thrombosis) in the pump.
A problem with some prior art blood pumps relates to the pattern of blood flow through the pump, i.e., the flow pattern. Significant turbulence occurs in the pumping chamber during the pumping cycle. There is little that can be done to control the characteristics of blood flow through the pumping chamber. There are areas of high velocity and other areas of slow flow. These slow flow areas also contribute to thrombosis. Turbulence leads to energy loss and inefficiency of the pump. Excessive turbulence can also damage the blood cells. Although my prior patent addresses this issue, further improvements are needed in creating a flow pattern that resembles that of a natural heart. Also, there is a need for a process of designing the pump components, particularly the bladder, to achieve the desired flow pattern.
Disclosure of Invention
The present disclosure builds on my prior patent, U.S. Patent No. 6,579,223, entitled Blood Pump. The object of the invention is to provide for improved flow through the pump, for harnessing the inertial forces of the pumped fluid and for improved washing of the areas of the pump susceptible to thrombosis (clotting) thereby decreasing thrombosis in these susceptible areas. In addition a process is provided for the design and construction of the pump. Although this disclosure focuses primarily on pumping blood, it is contemplated that principles herein are applicable to other fluids.
Presently available diaphragm type pumps draw the fluid being pumped through an intake port into a pumping chamber. They have little or no ability to guide the flow of fluid through the pumping chamber. Once the pumping chamber has filled, the fluid in the chamber must slow or stop. In the ensuing ejection phase of the pumping cycle, the fluid is accelerated toward the discharge port, which in at least some pumps, is in a direction that is opposite the direction of the intake flow. Flow momentum is lost, and considerable turbulence is created. Although available designs may vary in construction and geometry, they generally function as just described. One aspect of the present invention is to guide and direct the flow of blood through the pumping chamber by reason of the action of an expansile bladder on the blood flow. A continuous circular or spiral fluid path is obtained that more effectively washes the inlet and discharge ports as well as the walls of the pumping chamber with the pumped fluid, i.e., blood. Good washing of all areas of the bladder will decrease the tendency for blood clotting. The blood is initially drawn into the pumping chamber through the inlet port. As the blood flows into the pumping chamber it washes the discharge port. As various areas of the bladder sequentially expand and contract, the blood is guided through the pumping chamber washing the chamber walls. Prior to being ejected out of the discharge port, the blood washes past the inlet port. It is expected that the flow of blood directed across the inlet and discharge ports and the washing action associated with this flow will decrease clotting in these areas. Also, by appropriately directing the flow of the blood through the device and optimizing the angle of the inlet and the discharge port, the inertia of the blood will contribute to the action of the bladder and the path of the blood flow through the device. A smoother laminar flow through the pumping chamber afforded by the expansible bladder will improve the efficiency of the pump and decrease energy requirements.
A process for designing, constructing and operating the pump, especially the bladder, comprises essentially two parts. The first part is to select a desired flow pattern and using sophisticated mathematical modeling techniques work backwards, so to speak, to arrive at the bladder function necessary to achieve that flow pattern. The second part of the method is to design a bladder and pump operating system to achieve the desired bladder function, and then to use the same mathematical modeling techniques to predict the resulting flow pattern. The design may be refined by repeating the foregoing steps. More specifically, in the first part of the method, an initial pumping chamber configuration is selected or created, preferably with a circular or spiral shaped pumping chamber. A desired flow pattern, streamlines and other characteristics of blood flow through the device is designed guided by blood flow in a natural heart. An initial computer model of flow pattern will be developed using the mathematical techniques such as computational fluid dynamics and immersed boundary methods. This rigorous mathematical approach will provide the information to design the housing and bladder. The initial computer model will be used to determine the position of variovis points of the bladder, as a function of time, throughout the pumping cycle. To induce laminar flow along these streamlines it may also be helpful to modify the shape of the bladder and pumping chamber.
In the second part of the method, a pump including a bladder, housing and pump operating system are designed. The pump is designed to operate such that each point or element of the bladder will move substantially in accordance with the initial computer model. To achieve this functionality, the bladder and operating system for driving the bladder preferably will function similar to that of a natural heart. The various elements of the bladder wall will not all expand simultaneously (or at the same rate) during the filling phase and will not all contract simultaneously (or at the same rate) during the ejection phase of the pumping cycle. Portions of the bladders will expand sequentially during the filing phase and contract sequentially during the ejection phase in such a way to direct or "milk" the blood through the pumping chamber in a generally laminar flow pattern. The physical characteristics that the bladder will require at each point will be determined from the initial computer model (thickness, elasticity, viscoelasticity, fatigue strength and others). Appropriate materials will be selected for the bladder. In order to achieve the required characteristics at each point on the bladder, the thickness and composition of the bladder may vary, polymers or other materials may need to be combined in various areas by layering, forming bands or struts, electrospinning or other means. Preferably, the bladder is formed with directional elastic properties in the bladder wall that simulate heart muscles. It is further contemplated that the bladder operating system, including housing surrounding the bladder and means for driving the bladder will be adapted as necessary to achieve the designed sequential expansion and contraction of the bladder. The bladder and pump operating system design are then tested, preferably by generating a computer model of the apparatus and generating simulated fluid flow using the same mathematical techniques described above, but now in the sequence of having a given pump design and generating the flow pattern therefrom. Problems in bladder and operating system design may mandate reversion back to previous steps with further modification of the size or shape of the housing, or shape or composition of the bladder, or means for driving the bladder. More than one simultaneous flow pathway through the bladder may be required. During this phase, progression from a two-dimensional to a three-dimensional model will occur.
A prototype will be constructed based on the computer model. This will be bench tested followed by animal and human testing. Further refinement of the shell and bladder design will be made following prototype testing to simulate flow in natural hearts, eliminate stagnation points, provide laminar flow, wash ports, conserve energy, and reduce the potential for thrombosis.
Brief Description of Drawings Fig. 1 diagrammatically illustrates a preferred method of pumping blood.
Fig. 2 is a flow diagram showing a preferred method for designing the pump.
Best Mode for Carrying Out The Invention
The following is a detailed description of certain embodiments of the invention presently deemed by the inventor to be the best mode of carrying out his invention. The invention as defined by the appended claims is not limited to these embodiments, and additional embodiments of the claimed inventive concept will undoubtedly be apparent to those skilled in the art.
Referring to the drawings, Figs. IA-I F illustrate a pump apparatus 10 constructed generally in accordance with my earlier patent, U.S. Patent No. 6,579,223. Pump 10 comprises an expansile bladder 12 within a shell or housing 14. The bladder and housing in this embodiment are generally round for ease in illustrating the concept, and may be easier to begin with in the initial designs. Nevertheless, other shapes can be used and may be preferable, such as conical or heart-shaped bladders. The bladder has an inlet port 16 and a discharge port 18. The inlet and discharge ports are preferably adjacent to one another, but may be spaced apart. An inlet check valve 20 and an outlet check valve 22 insure one-way flow through the bladder. The bladder is connected to the shell or housing at the inlet and outlet. A volume or space 24 is defined between the bladder 12 and housing 14. A bladder driving fluid is adapted to be cyclically introduced into and removed from the space 24 through port 26. A pumping chamber 28 is defined within bladder 12. Various devices known in the art are commercially available for introducing and removing the driving fluid from the space 24, for example, a vacuum pump as described in U.S. Patent No. 6,579,223. Further, pressure regulating means (omitted from the drawings for clarity) may be provided in the space 24 between the bladder and housing to regulate the pressure applied to various portions or segments of the bladder as a function of time during the pumping cycle, and thereby affect the desired sequence and rate of expansion and contraction of each segment of the elastic bladder. One example of a pressure regulating means is shown in Fig. 6 of U.S. Patent Nos. 6,579,223 and others are known in the art. Still further, a driving means (not shown) may be utilized for mechanically or hydraulically driving selected portions of the bladder and assisting in controlling the direction, magnitude, rate and timing of movement of various portions of the bladder to achieve the designed dynamic bladder pumping cycle shown in Figs. IA-I J.
Preferably, the neutral or relaxed condition of the bladder is a fully contracted position, as shown in Figs. IA and IJ. By decreasing the pressure of the actuating fluid the bladder is elastically expanded to draw blood into the pumping chamber. By releasing the vacuum, the bladder retracts by reason of the elastic recoil of the bladder to eject blood from the pumping chamber. The ejection may also be augmented by positive pressure.
Referring now to Figs. IA through IF, a method for pumping blood is diagrammatically illustrated wherein the blood is guided and directed through the pumping chamber by the expansile bladder. A fluid path through pump 10 more effectively washes the inlet 16 and discharge ports 18 and pumping chamber walls with the pumped fluid. The blood is initially drawn into the pumping chamber through the inlet port 16. Fig. IA. As the blood flows into the pumping chamber through the inlet port, it washes the discharge port, as shown by arrows 30 and flow lines in Figs. IB - IE. As various areas of the bladder 12 sequentially expand and contract, the blood is guided through the pumping chamber and washes past the inlet port 16 prior to being ejected out of the discharge port 18, as shown by arrows 32 and flow lines in Figs. IF - II. It is expected that the flow of blood directed across the inlet and discharge ports and the washing action associated with this flow will decrease clotting in these areas. Also, by appropriately directing the flow of the blood through the device and optimizing the angle of the inlet and the discharge port, the inertia of the blood will contribute to the action of the bladder and the path of the blood flow through the device. The smoother laminar flow through the pumping chamber afforded by the expansible bladder will improve the efficiency of the pump and decrease energy requirements.
The specific configuration of pump 10 in Fig. 1 is merely to illustrate the pumping method, and should not be construed as limiting. For example, the housing or shell 14 of the pump is shown as generally cylindrical, but spiral, conical or other shapes may be used. Further, the particular means for expanding and contracting the bladder is not important as long as a smooth, laminar blood flow, guided and directed as explained above, is achieved.
A second aspect of the invention is a method for designing the bladder and pump operating system. It is an object of the invention to create a blood flow pattern similar to that of the natural heart, as described above. The design and composition of the bladder, housing and pump operating system are important factors in achieving the desired blood flow pattern. The bladder and operating system design process comprises a number of steps, which are shown in Fig. 2. The first step 101 is to select an initial housing and bladder shape, as shown for example in Fig. 1. Next, the desired streamlines and other characteristics of blood flow through the device, that is, the blood flow pattern, will be designed 103 based generally on blood flow in a natural heart.
A computer model of the blood flow pattern is developed 105. The computer model can be generated by any technique, for example by use of the mathematical techniques of computational fluid dynamics. Newer techniques, such as "Immersed Boundary Method" may be used. See, Peskin, Charles S., "The Immersed Boundary Method" Acta Numeήca (2002) pp. 1-39. The Immersed Boundary Method is adaptable to computer simulation of the fluid-structure interaction. It is called for because in accordance herewith the size and shape of the pumping chamber is constantly changing throughout the pumping cycle, which in turn changes flow dynamics, which in turn affects bladder shape. A computer model will simulate the desired flow pattern. The computer model will be used to determine the position of various portions or elements of the bladder, as a function of time, throughout the pumping cycle. It may be necessary to refine or modify the initial design as shown at query 107, and repeat or revise steps 103, 105 and 107 until one is satisfied with the initial pump design and computer model. The first part of the method thus uses a computer model in reverse, that is, the desired flow pattern is used to determine the structure, shape and function of the pump. The second part of the method uses information provided by the first part to design a prototype bladder and pump operating system, and then utilizes a computer model to predict the flow pattern in the prototype. The initial computer model is used to determine the physical characteristics (e.g., thickness, elasticity, viscoelasticity, fatigue strength) of each element of the bladder wall 109 required for the given flow pattern. Appropriate materials will be selected for each element or portion of the bladder, hi order to achieve the required characteristics of each element of the bladder, the thickness and material composition of the bladder may vary. Polymers or other materials can be combined in various areas by layering, forming bands or struts (as described in U.S. Patent 6,579,223), electrospinning or other means. Electrospinning techniques, for example, may be used to design a continuous, unitary elastic bladder comprised of composite materials, where the composition and physical, viscoelastic and dynamic properties of the bladder vary from point to point in accordance with the computer model. See e.g., Boland, Eugene D. et al, "ElectiOspinning of Biopolymers (Natural and Synthetic) for Tissue Engineering Scaffolds" Polymer Preprints 2003, 44(2) at pp. 92-93; and U.S. patent publication No. 2003/0168756. Electrospinning techniques can be used to create directional elastic properties in the bladder that mimic the architecture and function of heart muscles. Indeed, it is preferred to simulate multiple muscle layers.
The pump operating system is designed, in cooperation with the bladder, to control the direction, magnitude, rate and timing of movement of each of the various portions of the bladder to achieve the designed dynamic bladder pumping cycle. More specifically, based on the computer model, the operating system causes portions of the bladder to expand sequentially during the filing phase and contract sequentially during the ejection phase in such a way to direct or "milk" the blood through the pumping chamber. The pump operating system includes a device, e.g., a vacuum pump, for introducing and removing the driving fluid from the space 24 between the bladder and housing, and may optionally include pressure regulating means for regulating the pressure applied to various portions or segments of the bladder as a function of time during the pumping cycle, and/or a driving means for mechanically or hydraulically assisting in controlling the direction, magnitude, rate and timing of movement of various portions of the bladder to achieve the designed dynamic bladder pumping cycle. The particular devices utilized are within the skill of this highly specialized art, and are unimportant to the present invention as long as they substantially achieve the object of providing the desired movement of the bladder wall, which in turn provides the desired blood flow pattern.
The bladder and pump operating system are then tested 113, preferably by generating a computer model of the apparatus and generating simulated fluid flow 111. The flow pattern of the model is examined 115 to determine whether the design criteria are being met, including whether the flow is laminar, whether inertia of the blood is maintained, whether the discharge port is effectively washed by incoming flow, whether the exit port is washed by flow being ejected from the pump, whether areas of flow stagnation are avoided, whether zones of turbulent flow are avoided. Problems in bladder design may mandate reversion back to previous steps with further modification 117 of the size or shape of the housing, or shape or composition of the bladder, or design of the pump operating system. During this phase, progression from a two-dimensional to a three-dimensional model will occur. The design 117, computer modeling 111, testing 113 and evaluation 115 steps are modified or repeated until an acceptable flow pattern is achieved.
A prototype will then be constructed 119 based on the computer model. The prototype will be bench tested followed by animal and human testing 121. Test results will be evaluated 123. Further refinement of the bladder pump operating system 117 will be made following prototype testing to simulate flow in natural hearts, eliminate stagnation points, provide laminar flow, wash ports, conserve energy, and reduce the potential for thrombosis. The forgoing steps of computer modeling 111, testing 113 and evaluation 115, and prototype refinement 119, testing 121 and evaluation 123 are repeated as necessary to achieve the desired flow characteristics. While preferred embodiments of the present invention have been shown and described, it is to be understood that these represent the best mode of practicing the invention contemplated by the inventor at the present time, and that various modifications and changes could be made thereto without departing from the scope of the invention as defined in the appended claim

Claims

What is claimed is:
1. A method of pumping blood, comprising designing an initial blood flow pattern in an initial pumping chamber defined by an extensible bladder having inlet and discharge ports, wherein the blood flow pattern through the pumping chamber washes the pumping chamber, initial computer modeling using the initial blood flow pattern to determine the mechanical and hydraulic performance of each portion of the bladder, designing a bladder wherein each element of the bladder will have mechanical and hydraulic performance similar to the initial computer model, computer modeling the bladder design to simulate fluid flow in a pumping chamber defined by the bladder, and constructing a prototype bladder based on the computer model of the bladder design.
2. The method of claim 1 , wherein blood flow into the pumping chamber washes past the discharge port, and blood flow out of the pumping chamber washes past the inlet port.
3. The method of claim 1 , wherein the blood flow pattern in the pumping chamber is substantially continuous, maintaining the inertia of the blood flow.
4. The method of claim 1 wherein the blood flow is essentially laminar.
5. The method of claim 1 wherein the blood flow through the pumping chamber is substantially free of stagnant and turbulent zones.
6. The method of claim 1 wherein the blood flow is substantially continuous through the pumping chamber.
7. The method of claim 1 further comprising the step of refining the initial computer design prior to determining the physical characteristics of each portion of the bladder.
8. The method of claim 1 further comprising the step of refining the bladder design prior to constructing a prototype.
9. The method of claim 1 further comprising the steps of testing the prototype, and further refining the design to achieve the desired flow characteristics.
10. The method of claim 1 wherein at least the bladder design modeling step utilizes immersed boundary methods of computational fluid dynamics.
11. The method of claim 1 wherein the prototype constructing step involves the use of electrospinning techniques in constructing the bladder.
12. The method of claim 1 wherein the prototype bladder is comprised of plural material layers with directional elastic properties that mimic heart muscle layers.
13. A method of pumping blood, comprising providing a pump having an inlet port, a discharge port and an elastic bladder defining a pumping chamber, initially drawing blood into the pumping chamber through the inlet port by sequentially expanding the bladder and pumping chamber, guiding the blood flow with the expanding bladder to wash past the discharge port as blood is drawn into the pumping chamber, sequentially contracting the bladder and pumping chamber to pump blood out through the discharge port, and guiding the blood flow with the contracting bladder to wash past the inlet port prior to being ejected out of the discharge port.
14. The method of claim 13, wherein the flow of blood through the pumping chamber is substantially continuous maintaining the inertia of the blood flow.
15. The method of claim 13 wherein the blood flow is substantially laminar.
16. The method of claim 13 wherein the blood flow through the pumping chamber is substantially free of stagnant zones.
17. The method of claim 11 wherein the blood flow is circular through the pumping chamber.
18. A method of making a blood pump, comprising selecting an initial pump housing and bladder configuration, selecting an initial blood flow pattern for the pump based generally on blood flow in a natural heart, initial computer modeling the initial pump configuration and initial blood flow pattern, testing the initial computer model, refining the initial bladder configuration, initial blood flow pattern and initial computer model until satisfactory, from the initial computer model, determining the physical characteristics of each portion of that the bladder and designing a bladder and pump operating system, computer modeling the bladder and pump operating system, simulating fluid flow in the bladder and pump operating system, refining the design, pump operating system and computer model until a satisfactory flow pattern is achieved, constructing a prototype based on the computer model, testing the prototype, and further refining the design to achieve the desired flow characteristics.
19. The method of claim 18 wherein at least the prototype modeling step utilizes immersed boundary methods of computational fluid dynamics.
20. The method of claim 18 wherein the constructing step involves the use of electrospinning techniques in constructing the bladder.
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