Computational Evaluation of IABP, Impella 2.5, TandemHeart and Combined IABP and Impella 2.5 Support in Cardiogenic Shock

Rahmi Alkan, Beatrice De Lazzari, Massimo Capoccia, Claudio De Lazzari and Selim Bozkurt ()
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Rahmi Alkan: School of Engineering, Ulster University—Belfast, United Kingdom of Great Britain and Northern Ireland, York Street, Belfast BT15 1AP, UK
Beatrice De Lazzari: Human Movement and Sport Sciences, “Foro Italico” University of Rome, 00147 Rome, Italy
Massimo Capoccia: Northern General Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield S5 7AU, UK
Claudio De Lazzari: National Research Council, Institute of Clinical Physiology (IFC-CNR), 00185 Rome, Italy
Selim Bozkurt: School of Engineering, Ulster University—Belfast, United Kingdom of Great Britain and Northern Ireland, York Street, Belfast BT15 1AP, UK

Mathematics, 2023, vol. 11, issue 16, 1-17

Abstract: Cardiogenic shock is a life-threatening condition consisting of low cardiac output status leading to end-organ hypoperfusion following either acute left or right ventricular failure or decompensation of chronic heart failure. Partial or failed response to inotropic support in the acute phase may require the use of mechanical circulatory support. Although patients supported with different devices such as an IABP, Impella 2.5, or TandemHeart experience stability in the short term, the haemodynamic benefits of each device remain unclear. The aim of this study is to present a direct comparison of an IABP, Impella 2.5, TandemHeart, and combined IABP and Impella 2.5 support in cardiogenic shock to evaluate haemodynamic variables and left ventricular unloading using cardiovascular system modelling and simulation in terms of cardiac function, systemic, pulmonary, cardiac, and cerebral circulations. The simulation results showed that the IABP had a relatively low effect on the haemodynamic variables. Although both Impella 2.5 and TandemHeart improved the total blood flow rates, as well as coronary and cerebral perfusion with the increasing pump operating speed, TandemHeart had a more profound effect on the haemodynamic variables. Combining the IABP and Impella 2.5 also improved the haemodynamics, although at the expense of reverse blood flow in the cerebral circulation. Simulation results showed that TandemHeart support might have a more beneficial effect on the haemodynamics and left ventricular energetics in comparison to the IABP and Impella 2.5. Nevertheless, the combined use of the IABP and Impella 2.5 for short-term support may be considered an appropriate alternative.

Keywords: cardiovascular system model; IABP; Impella 2.5; TandemHeart; cardiogenic shock; haemodynamics (search for similar items in EconPapers)
JEL-codes: C (search for similar items in EconPapers)
Date: 2023
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