Publications by authors named "Jose Biscegli"

14 Publications

  • Page 1 of 1

Apical aortic blood pump preclinical assessment for long-term use: Durability test and stator topology to reduce wear in the bearing system.

Artif Organs 2020 Aug 6;44(8):779-784. Epub 2019 Nov 6.

Engineering Center for Circulatory Assistante, Institute Dante Pazzanese of Cardiology, Sao Paulo, Brazil.

This study presents an assessment for long-term use of the apical aortic blood pump (AABP), focusing on wear reduction in the bearing system. AABP is a centrifugal left ventricle assist device initially developed for bridge to transplant application. To analyze AABP performance in long-term applications, a durability test was performed. This test indicated that wear in the lower bearing pivot causes device failure in long-term. A wear test in the bearing system was conducted to demonstrate the correlation of the load in the bearing system with wear. Results from the wear test showed a direct correlation between load and wear at the lower bearing pivot. In order to reduce load, thus reducing wear, a new stator topology has been proposed. In this topology, a radial stator would replace the axial stator previously used. Another durability test with the new stator has accounted twice the time without failure when compared with the original model.
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http://dx.doi.org/10.1111/aor.13587DOI Listing
August 2020

Clinical evaluation of the Spiral Pump® after improvements to the original project in patients submitted to cardiac surgeries with cardiopulmonary bypass.

Rev Bras Cir Cardiovasc 2014 Jul-Sep;29(3):330-7

Instituto Dante Pazzanese de Cardiologia (IDPC), São Paulo, SP, Brazil.

Objective: The objective of this paper is to present the results from Spiral Pump clinical trial after design modifications performed at its previous project. This pump applies axial end centrifugal hydraulic effects for blood pumping during cardiopulmonary bypass for patients under cardiac surgery.

Methods: This study was performed in 52 patients (51% males), between 20 to 80 (67±14.4) years old weighing 53 to 102 (71.7±12.6) kg, mostly under myocardial revascularization surgery (34.6%) and valvular surgery (32.8%). Besides the routine evaluation of the data observed in these cases, we monitored pump rotational speed, blood flow, cardiopulmonary bypass duration, urine free hemoglobin for blood cell trauma analysis (+ to 4+), lactate desidrogenase (UI/L), fibrinogen level (mg/dL) and platelet count (nº/mm3).

Results: Besides maintaining appropriate blood pressure and metabolic parameters it was also observed that the Free Hemoglobin levels remained normal, with a slight increase after 90 minutes of cardiopulmonary bypass. The Lactate Dehydrogenase showed an increase, with medians varying between 550-770 IU/L, whereas the decrease in Fibrinogen showed medians of 130-100 mg/dl. The number of platelets showed a slight decrease with the medians ranging from 240,000 to 200,000/mm3. No difficulty was observed during perfusion terminations, nor were there any immediate deaths, and all patients except one, were discharged in good condition.

Conclusion: The Spiral Pump, as blood propeller during cardiopulmonary bypass, demonstrated to be reliable and safe, comprising in a good option as original and national product for this kind of application.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4412321PMC
http://dx.doi.org/10.5935/1678-9741.20140095DOI Listing
May 2015

In vivo evaluation of centrifugal blood pump for cardiopulmonary bypass-Spiral Pump.

Artif Organs 2013 Nov;37(11):954-7

Adib Jatene Foundation, Sao Paulo, São Paulo, Brazil.

The Spiral Pump (SP), a centrifugal blood pump for cardiopulmonary bypass (CPB), has been developed at the Dante Pazzanese Institute of Cardiology/Adib Jatene Foundation laboratories, with support from Sintegra Company (Pompeia, Brazil). The SP is a disposable pump with an internal rotor-a conically shaped fuse with double entrance threads. This rotor is supported by two ball bearings, attached to a stainless steel shaft fixed to the housing base. Worm gears provide axial motion to the blood column, and the rotational motion of the conically shaped impeller generates a centrifugal pumping effect, improving pump efficiency without increasing hemolysis. In vitro tests were performed to evaluate the SP's hydrodynamic performance, and in vivo experiments were performed to evaluate hemodynamic impact during usual CPB. A commercially available centrifugal blood pump was used as reference. In vivo experiments were conducted in six male pigs weighing between 60 and 90 kg, placed on CPB for 6 h each. Blood samples were collected just before CPB (T0) and after every hour of CPB (T1-T6) for hemolysis determination and laboratory tests (hematological and biochemical). Values of blood pressure, mean flow, pump rotational speed, and corporeal temperature were recorded. Also, ergonomic conditions were recorded: presence of noise, difficulty in removing air bubbles, trouble in installing the pump in the drive module (console), and difficulties in mounting the CPB circuit. Comparing the laboratory and hemolysis results for the SP with those of the reference pump, we can conclude that there is no significant difference between the two devices. In addition, reports made by medical staff and perfusionists described a close similarity between the two devices. During in vivo experiments, the SP maintained blood flow and pressure at physiological levels, consistent with those applied in cardiac surgery with CPB, without presenting any malfunction. Also, the SP needed lower rotational speed to obtain average blood flow and pressure, compared with the reference pump.
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http://dx.doi.org/10.1111/aor.12230DOI Listing
November 2013

Centrifugal blood pump for temporary ventricular assist devices with low priming and ceramic bearings.

Artif Organs 2013 Nov 13;37(11):942-5. Epub 2013 Nov 13.

Dante Pazzanese Institute of Cardiology, São Paulo, São Paulo, Brazil.

A new model of centrifugal blood pump for temporary ventricular assist devices has been developed and evaluated. The design of the device is based on centrifugal pumping principles and the usage of ceramic bearings, resulting in a pump with reduced priming (35 ± 2 mL) that can be applied for up to 30 days. Computational fluid dynamic (CFD) analysis is an efficient tool to optimize flow path geometry, maximize hydraulic performance, and minimize shear stress, consequently decreasing hemolysis. Initial studies were conducted by analyzing flow behavior with different impellers, aiming to determine the best impeller design. After CFD studies, rapid prototyping technology was used for production of pump prototypes with three different impellers. In vitro experiments were performed with those prototypes, using a mock loop system composed of Tygon tubes, oxygenator, digital flow meter, pressure monitor, electronic driver, and adjustable clamp for flow control, filled with a solution (1/3 water, 1/3 glycerin, 1/3 alcohol) simulating blood viscosity and density. Flow-versus-pressure curves were obtained for rotational speeds of 1000, 1500, 2000, 2500, and 3000 rpm. As the next step, the CFD analysis and hydrodynamic performance results will be compared with the results of flow visualization studies and hemolysis tests.
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http://dx.doi.org/10.1111/aor.12231DOI Listing
November 2013

Cardiovascular simulator improvement: pressure versus volume loop assessment.

Artif Organs 2011 May;35(5):454-8

Department of Bioengineering, Institute Dante Pazzanese of Cardiology, São Paulo, Brazil.

This article presents improvement on a physical cardiovascular simulator (PCS) system. Intraventricular pressure versus intraventricular volume (PxV) loop was obtained to evaluate performance of a pulsatile chamber mimicking the human left ventricle. PxV loop shows heart contractility and is normally used to evaluate heart performance. In many heart diseases, the stroke volume decreases because of low heart contractility. This pathological situation must be simulated by the PCS in order to evaluate the assistance provided by a ventricular assist device (VAD). The PCS system is automatically controlled by a computer and is an auxiliary tool for VAD control strategies development. This PCS system is according to a Windkessel model where lumped parameters are used for cardiovascular system analysis. Peripheral resistance, arteries compliance, and fluid inertance are simulated. The simulator has an actuator with a roller screw and brushless direct current motor, and the stroke volume is regulated by the actuator displacement. Internal pressure and volume measurements are monitored to obtain the PxV loop. Left chamber internal pressure is directly obtained by pressure transducer; however, internal volume has been obtained indirectly by using a linear variable differential transformer, which senses the diaphragm displacement. Correlations between the internal volume and diaphragm position are made. LabVIEW integrates these signals and shows the pressure versus internal volume loop. The results that have been obtained from the PCS system show PxV loops at different ventricle elastances, making possible the simulation of pathological situations. A preliminary test with a pulsatile VAD attached to PCS system was made.
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http://dx.doi.org/10.1111/j.1525-1594.2011.01266.xDOI Listing
May 2011

A new model of centrifugal blood pump for cardiopulmonary bypass: design improvement, performance, and hemolysis tests.

Artif Organs 2011 May;35(5):443-7

Institute "Dante Pazzanese" of Cardiology University of Campinas, Campinas, São Paulo UNIPAC Division, Pompéia, Brazil.

A new model of blood pump for cardiopulmonary bypass (CPB) application has been developed and evaluated in our laboratories. Inside the pump housing is a spiral impeller that is conically shaped and has threads on its surface. Worm gears provide an axial motion of the blood column. Rotational motion of the conical shape generates a centrifugal pumping effect and improves pumping performance. One annular magnet with six poles is inside the impeller, providing magnetic coupling to a brushless direct current motor. In order to study the pumping performance, a mock loop system was assembled. Mock loop was composed of Tygon tubes (Saint-Gobain Corporation, Courbevoie, France), oxygenator, digital flowmeter, pressure monitor, electronic driver, and adjustable clamp for flow control. Experiments were performed on six prototypes with small differences in their design. Each prototype was tested and flow and pressure data were obtained for rotational speed of 1000, 1500, 2000, 2500, and 3000 rpm. Hemolysis was studied using pumps with different internal gap sizes (1.35, 1.45, 1.55, and 1.7 mm). Hemolysis tests simulated CPB application with flow rate of 5 L/min against total pressure head of 350 mm Hg. The results from six prototypes were satisfactory, compared to the results from the literature. However, prototype #6 showed the best results. Best hemolysis results were observed with a gap of 1.45 mm, and showed a normalized index of hemolysis of 0.013 g/100 L. When combined, axial and centrifugal pumping principles produce better hydrodynamic performance without increasing hemolysis.
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http://dx.doi.org/10.1111/j.1525-1594.2011.01254.xDOI Listing
May 2011

Implantable centrifugal blood pump with dual impeller and double pivot bearing system: electromechanical actuator, prototyping, and anatomical studies.

Artif Organs 2011 May;35(5):437-42

Center for Engineering in Cardiac Assistance, CEAC, Institute Dante Pazzanese of Cardiology, Campinas State University, São Paulo, Brazil.

An implantable centrifugal blood pump has been developed with original features for a left ventricular assist device. This pump is part of a multicenter and international study with the objective to offer simple, affordable, and reliable devices to developing countries. Previous computational fluid dynamics investigations and wear evaluation in bearing system were performed followed by prototyping and in vitro tests. In addition, previous blood tests for assessment of normalized index of hemolysis show results of 0.0054±2.46 × 10⁻³ mg/100 L. An electromechanical actuator was tested in order to define the best motor topology and controller configuration. Three different topologies of brushless direct current motor (BLDCM) were analyzed. An electronic driver was tested in different situations, and the BLDCM had its mechanical properties tested in a dynamometer. Prior to evaluation of performance during in vivo animal studies, anatomical studies were necessary to achieve the best configuration and cannulation for left ventricular assistance. The results were considered satisfactory, and the next step is to test the performance of the device in vivo.
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http://dx.doi.org/10.1111/j.1525-1594.2011.01260.xDOI Listing
May 2011

Mock circulatory system for the evaluation of left ventricular assist devices, endoluminal prostheses, and vascular diseases.

Artif Organs 2008 Jun 16;32(6):461-7. Epub 2008 Apr 16.

Institute Dante Pazzanese of Cardiology, Escola Politécnica, University of São Paulo, Brazil.

A new digital computer mock circulatory system has been developed in order to replicate the physiologic and pathophysiologic characteristics of the human cardiovascular system. The computer performs the acquisition of pressure, flow, and temperature in an open loop system. A computer program has been developed in Labview programming environment to evaluate all these physical parameters. The acquisition system was composed of pressure, flow, and temperature sensors and also signal conditioning modules. In this study, some results of flow, cardiac frequencies, pressures, and temperature were evaluated according to physiologic ventricular states. The results were compared with literature data. In further works, performance investigations will be conducted on a ventricular assist device and endoprosthesis. Also, this device should allow for evaluation of several kinds of vascular diseases.
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http://dx.doi.org/10.1111/j.1525-1594.2008.00569.xDOI Listing
June 2008

A new technique to control brushless motor for blood pump application.

Artif Organs 2008 Apr;32(4):355-9

Department of Bioengineering, Institute Dante Pazzanese of Cardiology, São Paulo, Brazil.

This article presents a back-electromotive force (BEMF)-based technique of detection for sensorless brushless direct current motor (BLDCM) drivers. The BLDCM has been chosen as the energy converter in rotary or pulsatile blood pumps that use electrical motors for pumping. However, in order to operate properly, the BLDCM driver needs to know the shaft position. Usually, that information is obtained through a set of Hall sensors assembled close to the rotor and connected to the electronic controller by wires. Sometimes, a large distance between the motor and controller makes the system susceptible to interference on the sensor signal because of winding current switching. Thus, the goal of the sensorless technique presented in this study is to avoid this problem. First, the operation of BLDCM was evaluated on the electronic simulator PSpice. Then, a BEMF detector circuitry was assembled in our laboratories. For the tests, a sensor-dependent system was assembled where the direct comparison between the Hall sensors signals and the detected signals was performed. The obtained results showed that the output sensorless detector signals are very similar to the Hall signals at speeds of more than 2500 rpm. Therefore, the sensorless technique is recommended as a responsible or redundant system to be used in rotary blood pumps.
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http://dx.doi.org/10.1111/j.1525-1594.2008.00554.xDOI Listing
April 2008

Computational fluid dynamics investigation of a centrifugal blood pump.

Artif Organs 2008 Apr;32(4):342-8

Institute Dante Pazzanese of Cardiology, Escola Politécnica, University of São Paulo, São Paulo, SP, Brazil.

In the development of a ventricular assist device, computational fluid dynamics (CFD) analysis is an efficient tool to obtain the best design before making the final prototype. In this study, different designs of a centrifugal blood pump were developed to investigate flow characteristics and performance. This study assumed the blood flow as being an incompressible homogeneous Newtonian fluid. A constant velocity was applied at the inlet; no slip boundary conditions were applied at device wall; and pressure boundary conditions were applied at the outlet. The CFD code used in this work was based on the finite volume method. In the future, the results of CFD analysis can be compared with flow visualization and hemolysis tests.
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http://dx.doi.org/10.1111/j.1525-1594.2008.00552.xDOI Listing
April 2008

New centrifugal blood pump with dual impeller and double pivot bearing system: wear evaluation in bearing system, performance tests, and preliminary hemolysis tests.

Artif Organs 2008 Apr;32(4):329-33

Department of Bioengineering, Institute Dante Pazzanese of Cardiology, IDPC, Sao Paulo, Brazil.

A new dual impeller centrifugal blood pump has been developed as a research collaboration between Baylor College of Medicine and Institute Dante Pazzanese of Cardiology for long-term left ventricle assist device (LVAD). A design feature of this new pump is a dual impeller that aims to minimize a stagnant flow pattern around the inlet port. Several different materials were tested in order to adopt a double pivot bearing design originally developed by Prof. Dr. Yukihiko Nosé from Baylor College of Medicine. Hydraulic performance tests were conducted with two different inlet ports' angle configurations 30 degrees and 45 degrees . Pump with inlet port angle of 45 degrees achieved best values of pressure ahead and flow after 1800 rpm. Preliminary hemolysis tests were conducted using human blood. The pump showed good performance results and no alarming trace of hemolysis, proving to be a feasible long-term LVAD.
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http://dx.doi.org/10.1111/j.1525-1594.2008.00550.xDOI Listing
April 2008

Endurance test on a textured diaphragm for the auxiliary total artificial heart (ATAH).

Artif Organs 2003 May;27(5):457-60

Department of Bioengineering, Institute Dante Pazzanese of Cardiology, São Paulo, SP, Brazil.

We performed an endurance test on a textured diaphragm made of polyurethane (BioSpan, The Polymer Technology Group, San Francisco, CA, U.S.A.) to be used in the auxiliary total artificial heart (ATAH), an electromechanical device that can be totally implantable without removing the natural heart due to the device's reduced dimension. The objective of this endurance test was to predict whether this diaphragm would be capable of resisting in vivo tests with the ATAH implanted for fifteen days in calves. In this study, a mock loop system simulating the human circulatory system was used. The test protocol was elaborated to reproduce extreme physiological conditions. The technique to produce the textured diaphragms made of polyurethane is shown. The textured surface is used as basis to fix a layer of calf-skin gelatin. The technique used to make the diaphragm guaranteed a totally textured surface without cracking. The diaphragm demonstrated enough resistance to be used at the 15 day in vivo experiments.
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http://dx.doi.org/10.1046/j.1525-1594.2003.07238.xDOI Listing
May 2003

Improvement on the auxiliary total artificial heart (ATAH) left chamber design.

Artif Organs 2003 May;27(5):452-6

Department of Bioengineering, Institute Dante Pazzanese of Cardiology, São Paulo, Brazil.

The auxiliary total artificial heart (ATAH) is an electromechanically driven artificial heart with reduced dimensions, which is able to be implanted in the right thoracic or abdominal cavities of an average human patient without removing the natural heart or the heart neurohumoral inherent control mechanism for the arterial pressure. This device uses a brushless direct current motor and a mechanical actuator (roller screw) to move two diaphragms. The ATAH's beating frequency is regulated through the change of the left preload, based on Frank-Starling's law, assisting the native heart in obtaining adequate blood flow. The ATAH left and right stroke volumes are 38 ml and 34 ml, respectively, giving approximately 5 L/min of cardiac output at 160 bpm. Flow visualization studies were performed in critical areas on the ATAH left chamber. A closed circuit loop was used with water and glycerin (37%) at 25 degrees C. Amberlite particles (80 mesh) were illuminated by a 1 mm planar helium-neon laser light. With left mean preload fixed at 10 mm Hg and the afterload at 100 mm Hg, the heart rate varied from 60 to 200 bpm. Two porcine valves were used on the inlet and outlet ports. The flow pattern images were obtained using a color micro-camera and a video recorder. Subsequently, these images were digitized using a PC computer. A persistent stagnant flow was detected in the left chamber inlet port. After improvement on the left chamber design, this stagnant flow disappeared.
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http://dx.doi.org/10.1046/j.1525-1594.2003.07236.xDOI Listing
May 2003

Characteristics of a Blood Pump Combining the Centrifugal and Axial Pumping Principles: The Spiral Pump.

Artif Organs 1996 May;20(5):605-612

Institute Dante Pazzanese of Cardiology, Department of Bioengineering, Sao Paulo, BrazilBaylor College of Medicine, Department of Surgery, Houston, Texas, U.S.A.

Two well-known centrifugal and axial pumping principles are used simultaneously in a new blood pump design. Inside the pump housing is a spiral impeller, a conically shaped structure with threads on the surface. The worm gears provide an axial motion of the blood column through the threads of the central cone. The rotational motion of the conical shape generates the centrifugal pumping effect and improves the efficiency of the pump without increasing hemolysis. The hydrodynamic performance of the pump was examined with a 40% glycerin-water solution at several rotation speeds. The gap between the housing and the top of the thread is a very important factor: when the gap increases, the hydrodynamic performance decreases. To determine the optimum gap, several in vitro hemolysis tests were performed with different gaps using bovine blood in a closed circuit loop under two conditions. The first simulated condition was a left ventricular assist device (LVAD) with a flow rate of 5 L/min against a pressure head of 100 mm Hg, and the second was a cardiopulmonary bypass (CPB) simulation with a flow rate of 5 L/min against 350 mm Hg of pressure. The best hemolysis results were seen at a gap of 1.5 mm with the normalized index of hemolysis (NIH) of 0.0063 ± 0.0020 g/100 L and 0.0251 ± 0.0124 g/100 L (mean ± SD; n = 4) for LVAD and CPB conditions, respectively.
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http://dx.doi.org/10.1111/j.1525-1594.1996.tb04489.xDOI Listing
May 1996
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