Performance and Robustness of Physiological Controllers with Integrated Pressure Sensors on Inflow Cannula

The control of left ventricular assist devices (LVADs) requires sensors and/or estimators to account for the physiological state of the patient and apply advanced controllers. Sensor characteristics are a challenge when using implantable pressure sensors because they influence the quality of physiological control and the robustness of the controlled system. The objective of this work is to investigate the performance and robustness of LVAD controllers that operate based on LVAD integrated pressure sensors. Four pressure-based LVAD controllers are tested with a HeartMate 3 that has an integrated pressure sensor. Controller sensitivity as well as robustness to sensor drift and noise are evaluated based on controller response to large changes in preload and afterload. A fail-safe strategy for sensor failure used also to investigate the reliable operation of the LVAD in realistic conditions. All tested controllers are sensitive to drifting pressure signals, which can lead to unstable behavior. The results show that two controllers are robust to noise. The other two controllers show high deviation and oscillation in cardiac output even for small noise. Additionally, a noticeable difference of the controller's response between simulated and measured pressure input was observed, indicating the need for a robust controller design. Reliable operation even in the event of a sensor failure was achieved on the basis of a fail-safe control system.