PUCA pump and IABP comparison: use of a numerical model to study their hemodynamic effects.

Objectives: Aim of this work is to compare the pulsatile catheter pump (PUCA pump) with the intra-aortic balloon pump (IABP) for different hemodynamic situations and working conditions. Materials and Methods: Numerical models for both devices have been developed and connected to the cardiovascular simulator CARDIOSIM©. The validation of PUCA pump and IABP models was performed using in vivo experimental data and literature data, respectively. After validation of the models, the hemodynamic parameters, such as the cardiac output (CO) and mean coronary blood flow (CBF) in different hemodynamic conditions were assessed. For this purpose we considered different values of: left ventricular systolic elastance (Emaxl= 0.6÷1.8 mmHg?cm-3), systemic arterial compliance (Cas=1÷4 cm3?mmHg-1) and PUCA pump flow (QPUCA=2.75÷5 l/min). Results: Both numerical models reproduce experimental and literature data with a good approximation (percentage error <10%). Numerical experiments evidence that both IABP and PUCA pump performances reduce for higher values of Emaxl and Cas. IABP shows a higher sensitivity to these parameters so that in some cases CO does not increase and CBF even drops. PUCA pump, on the contrary, provides an effective performance in all conditions. On the other hand, for lower values of Cas, a QPUCA of at least 5 l/min is necessary to assure CO and CBF increments comparable to those of the IABP. Conclusions: Numerical models can reproduce the in vivo short-time effects of any assist device. Moreover, they have the advantages to permit the assessment of different hemodynamic conditions by simply changing a single parameter in a given cardiovascular model.