A System of Systems Approach to Patient Treatment with The Left Ventricular Assist Device

Patients with congestive heart failure are often implanted with a Left Ventricular Assist Device (LVAD) as a mechanism to help the left ventricle in pumping blood into the circulatory system. The resulting system of systems (SoS) consisting of a biological system (the heart) and a mechanical system (the LVAD) represents a challenge for systems engineers to model and control. The interdependence and interactions of these two systems to accomplish the common objective of keeping the patient alive with an improved quality of life represents a formidable challenge to biomedical systems engineers. The device is typically used as a bridge to transplantation and is removed when a donor heart becomes available. For patients who are not transplantation candidates the LVAD may be kept permanently in the patient as a destination therapy device. For a small number of patients whose hearts may recover as a result of the treatment, the LVAD is used as a bridge to recovery and is removed when their heart recovers. In this paper, we will review these two systems including their interactions and interdependency as a unified SoS and discuss some of the challenges that the LVAD technology will face as its usage becomes more and more frequent in the future of healthcare.