Not Applicable.
Not Applicable.
The present invention relates in general to circulatory assist devices, and, more specifically, to an implanted device for a pumping system partitioned into separable pumping and motor units.
Many types of circulatory assist devices are available for either short term or long term support for patients having cardiovascular disease. For example, a heart pump system known as a left ventricular assist device (LVAD) can provide long term patient support with an implantable pump associated with an externally-worn pump control unit and batteries. The LVAD improves circulation throughout the body by assisting the left side of the heart in pumping blood. One such system is the DuraHeart® LVAS system made by Terumo Heart, Inc., of Ann Arbor, Mich. The DuraHeart® system employs a centrifugal pump with a magnetically levitated impeller to pump blood from the left ventricle to the aorta. An electric motor magnetically coupled to the impeller is driven at a speed appropriate to obtain the desired blood flow through the pump.
A typical cardiac assist system includes a pumping unit, electrical motor (e.g., a brushless DC motor integrated in the pump housing), drive electronics, microprocessor control unit, and an energy source such as rechargeable batteries and/or an AC power conditioning circuit. The system is implanted during a surgical procedure in which a centrifugal pump is placed in the patient's chest. An inflow conduit is pierced into the left ventricle to supply blood to the pump. One end of an outflow conduit is mechanically fitted to the pump outlet and the other end is surgically attached to the patient's aorta by anastomosis. A percutaneous cable connects to the pump, exits the patient through an incision, and connects to the external control unit.
The goal of the control unit is to autonomously control the pump performance to satisfy the physiologic needs of the patient while maintaining safe and reliable system operation. A control system for varying pump speed to achieve a target blood flow based on physiologic conditions is shown in U.S. Pat. No. 7,160,243, issued Jan. 9, 2007, which is incorporated herein by reference in its entirety. A target blood flow rate may be established based on the patient's heart rate so that the physiologic demand is met. The control unit may establish a speed setpoint for the pump motor to achieve the target blood flow.
A typical pump motor employed for a blood pump is a three-phase permanent magnet electric motor that can be driven as a brushless DC or a synchronous AC motor without any position sensor. The need for a position sensor is avoided by controlling motor operation with one of a variety of methods that use the measured stator phase currents to infer the position. Vector control is one typical method used in variable frequency drives to control the torque and speed of a three-phase electric motor by controlling the current fed to the motor phases. This control can be implemented using a fixed or variable voltage drive delivered via an inverter comprised of pulse width modulated H-bridge power switches arranged in phase legs.
Reliability, fault detection, and fault tolerance are important characteristics of an electrically-powered blood pump, drive system, and cable. Co-pending application U.S. Ser. No. 13/418,447, filed Mar. 13, 2012, entitled “Fault Monitor For Fault Tolerant Implantable Pump,” which is hereby incorporated by reference, discloses a fault-tolerant inverter/cable system wherein redundant inverter legs are coupled to the motor phases by redundant, parallel conductors between the external unit and the implanted pump. For a three-phase motor, the redundant interconnect system includes six conductors in the cable. By monitoring the equality of the current and/or voltage of the two conductors on the same phase, a fault or impending fault can be detected for each individual conductor. Co-pending application U.S. Ser. No. 13/742,469, filed Jan. 16, 2013, entitled “Motor Fault Monitor for Implantable Blood Pump,” which is hereby incorporated by reference, discloses technology for detecting other pump failures such as a soldering terminal failure, a coil wire breakage, damage to a flex circuit substrate, a coil turn-to-turn short, a layer-to-layer short, and a core/yoke detachment.
The conventional pumping unit for an implanted system has employed a hermetically sealed housing containing the elements of the pump and motor (i.e., the housing body includes a pumping chamber for containing the impeller and one or more other chambers for containing the motor, magnetic components, and electronics). In the event of a fault associated with any one of the pumping chamber, impeller, motor, magnetic components, or electronics that is serious enough to require replacement, then a surgical explantation procedure is performed in which the pumping unit is detached from the inflow and outflow conduits and then removed. A replacement unit is then implanted and attached to the existing conduits or conduits the conduits may sometimes also be replaced. It would be desirable to reduce the invasiveness of such surgical replacement procedures.
With an integrated housing containing an inlet and an outlet for the pumping chamber and a connector/cable exit, the angular separation between the direction in which the outlet extends and the direction in which the cable exits is fixed by the housing design. A nominal angle has been chosen that provides an optimal placement for a person having an average physiology. However, structural differences in the physiology of individual patients may present obstructions that could be avoided if the cable exited at an angular separation from the outlet other than at the conventional fixed position.
In one aspect of the invention, a centrifugal blood pump system is provided for implanting into a patient. A self-contained pumping unit comprises a pump housing having an inlet, an outlet, and a pump chamber, and an impeller disposed in the pump chamber. The inlet extends axially from the pump housing on an inlet side of the pump housing, and the outlet extends radially from the pump housing. The pump housing has a substantially planar face opposite from the inlet side. A self-contained motor unit comprises a motor housing, a motor stator disposed in the motor housing, and a percutaneous cable passing through a radial exit from the motor housing. The motor housing has a substantially planar face configured to mate with the substantially planar face of the pump housing. The pumping unit and the motor unit are configured to latch together in a plurality of orientations, each orientation having the substantially planar faces mated and the outlet and radial exit at a different respective angular separation. The pumping unit and the motor unit are configured such that after the pumping unit is implanted, the motor unit can be unlatched and a replacement motor unit latched with the pumping unit at the plurality of orientations.
Referring to
Motor unit 32 has a motor housing 50 containing a multi-phase motor stator 45 which includes windings 46 and 47 and respective magnetic cores 48 and 49. Although a stationary stator which couples with the impeller is shown (i.e., wherein impeller 36 is directly driven as a rotor of the stationary stator), motor unit 32 can alternatively carry a spinning rotor which carries permanent magnets on the rotor for magnetically driving impeller 36 as known in the art. Housings 35 and 50 may be comprised of biocompatible thermoplastics.
A cable portion 51 on motor unit 32 enters/exits at a radial cable exit feature 52. Electrical conductor 53 connects to windings 46 and 47 to supply electrical power for operating stator 45. An electrical connector (not shown) may be located within radial exit 52. With or without a connector, radial exit 52 is sealed against ingress of fluids or tissues.
Pump housing 35 has a substantially planar face 55 on the side opposite from the inlet side. Motor housing 50 has a substantially planar face 56 configured to mate with planar face 55. A raised collar 57 extends around the periphery of planar face 56 so that pumping unit 31 and motor unit 32 can be brought together in a nested relationship. Preferably, both planar faces 55 and 56 are circular so that the units can be nested together in any rotated orientation, i.e., with pump outlet 34 and radial cable exit 52 at any radial positions with any desired angular separation.
To ensure proper control of the rotation of impeller 36, planar faces 55 and 56 must be intimately attached according to the desired relative positioning. In the embodiment shown in
Flange 117 slides radially into groove 110. A capture mechanism is comprised of a sliding pin 121 received in a pocket 120 in pumping unit 105 that is placed radially outward from the mated planar faces on the opposite side from the semicircular collar. The capture mechanism has a capture member with an cam end 122 with an angled cam surface at one end and a knob 123 at the other end. A spring 124 is disposed between pocket 120 and cam end 122 so that end 122 is urged downward. When flange 117 is being slid into groove 110, motor unit 115 forces cam end 122 into the pocket against spring 124. Once flange 117 fully enters groove 110 then cam end 122 extends downward so that motor unit 115 is captured on pumping unit 105 with their planar faces securely fastened until a manual pull on knob 123 releases them.