Actively controlled cardiac afterload

Ex vivo (outside of the body) working heart models enable the evaluation of isolated hearts. They are envisioned to play an important role in increasing the currently low utilization rate of donor hearts for transplantation. For the heart to work in isolation, an afterload (flow impedance) is needed. To date, afterload devices have been constructed by combining multiple constituent elements such as pumps, flow resistances, and flow capacitances (compliances), typically to replicate the structure of so-called Windkessel models. This limits active control to that achievable by varying these elements, making it slow and subject to the problem of dynamic coupling between parameters. Here we present a novel concept to achieve Windkessel dynamics through a very simple variable flow impedance. The impedance is actively controlled using feedback from a pressure measurement. Through simulations we demonstrate the ability to perfectly emulate Windkessel dynamics, while imposing tight pressure limits needed for safe operation—something not achievable with the verbatim implementation using constituent elements.