The present disclosure provides methods for treating pulmonary hypertension in a patient with left ventricular assist device (LVAD) implantation and methods of improving cardiac transplant eligibility in a patient with LVAD implantation. The methods include administering to a patient in need thereof a therapeutically effective amount of macitentan or aprocitentan.

Apparatus and methods are described including an axial shaft and an impeller configured for rotation within a subject's body. A coupling element includes a first portion, which is disposed around the axial shaft, is shaped to define one or more slits that facilitate a radial expansion of the first portion such that the first portion is placeable around the axial shaft, and is shape-set to have an inner diameter that is smaller than a diameter of the axial shaft such that, following placement of the first portion around the axial shaft, the first portion becomes radially contracted around, and thus locked in place with respect to, the axial shaft. A second portion of the coupling element is coupled to a bushing of the impeller. Other applications are also described.

Apparatus and methods are described including an axial shaft and an impeller configured for rotation within a subject's body. A coupling element includes a first portion, which is disposed around the axial shaft, is shaped to define one or more slits that facilitate a radial expansion of the first portion such that the first portion is placeable around the axial shaft, and is shape-set to have an inner diameter that is smaller than a diameter of the axial shaft such that, following placement of the first portion around the axial shaft, the first portion becomes radially contracted around, and thus locked in place with respect to, the axial shaft. A second portion of the coupling element is coupled to a bushing of the impeller. Other applications are also described.

Apparatus and methods are described including a left-ventricular assist device that includes a pump-outlet tube shaped to define one or more blood-outlet openings and configured for insertion, through an aorta of a subject, into a left ventricle of a heart of the subject such that the pump-outlet tube traverses an aortic valve of the subject with the blood-outlet openings being disposed within the aorta. A blood pump is disposed at least partly within a distal portion of the pump-outlet tube and is configured to pump blood of the subject proximally through the pump-outlet tube. A proximal end of the pump-outlet tube is folded inwardly so as to define one or more surfaces configured to direct the blood through the blood-outlet openings by virtue of being oblique with respect to a longitudinal axis of the pump-outlet tube. Other applications are also described.

Apparatus and methods are described including a left-ventricular assist device that includes a pump-outlet tube shaped to define one or more blood-outlet openings and configured for insertion, through an aorta of a subject, into a left ventricle of a heart of the subject such that the pump-outlet tube traverses an aortic valve of the subject with the blood-outlet openings being disposed within the aorta. A blood pump is disposed at least partly within a distal portion of the pump-outlet tube and is configured to pump blood of the subject proximally through the pump-outlet tube. A proximal end of the pump-outlet tube is folded inwardly so as to define one or more surfaces configured to direct the blood through the blood-outlet openings by virtue of being oblique with respect to a longitudinal axis of the pump-outlet tube. Other applications are also described.

An example cardiac pump system includes a catheter shaft having a proximal end region coupled to a handle and a distal end region coupled to a cardiac pump, wherein the cardiac pump includes an impeller housing, a cannula and an impeller, wherein the cannula includes a distal end region and a proximal end region, wherein the distal end region of the cannula is configured to be positioned in a left ventricle of a heart. Further, the cardiac pump system includes a first flow sensor coupled to the cannula or the catheter shaft, wherein the first flow sensor is configured to directly sense a first velocity of blood flowing adjacent to the first flow sensor.

An example cardiac pump system includes a catheter shaft having a proximal end region coupled to a handle and a distal end region coupled to a cardiac pump, wherein the cardiac pump includes an impeller housing, a cannula and an impeller, wherein the cannula includes a distal end region and a proximal end region, wherein the distal end region of the cannula is configured to be positioned in a left ventricle of a heart. Further, the cardiac pump system includes a first flow sensor coupled to the cannula or the catheter shaft, wherein the first flow sensor is configured to directly sense a first velocity of blood flowing adjacent to the first flow sensor.

Some embodiments of the disclosure are directed to a novel system for pumping liquid such as blood without damaging cells. In some embodiments, the system includes one or more inflatable elements such as balloons which force liquid from a heart assist pump. In some embodiments, one or more pumping elements are configured to directionally inflate. In some embodiments, the heart assist pump includes a reduced cross-section between two pumping elements. In some embodiments, the reduced cross-section is configured to enable the heart assist pump to be seated in the heart using the aortic valve. In some embodiments, the reduced cross-section gives the heart assist pump and hourglass shape, which allows a greater volume of fluid to be pumped through the aortic valve. In some embodiments, a controller independently controls fluid pumping elements on either side of the reduced cross-section.

Some embodiments of the disclosure are directed to a novel system for pumping liquid such as blood without damaging cells. In some embodiments, the system includes one or more inflatable elements such as balloons which force liquid from a heart assist pump. In some embodiments, one or more pumping elements are configured to directionally inflate. In some embodiments, the heart assist pump includes a reduced cross-section between two pumping elements. In some embodiments, the reduced cross-section is configured to enable the heart assist pump to be seated in the heart using the aortic valve. In some embodiments, the reduced cross-section gives the heart assist pump and hourglass shape, which allows a greater volume of fluid to be pumped through the aortic valve. In some embodiments, a controller independently controls fluid pumping elements on either side of the reduced cross-section.

Apparatus and methods for cleaning a single-port fluidic device, such as a single-port, diaphragm-based cardiac pump, with a continuous stream of fresh cleaning fluid, while simultaneously draining soiled fluid, via a single input-output port of the fluidic device. A first coupler releasably mates with the input-output port. The first coupler includes an injector nozzle and a return port. The injector nozzle is oriented to direct a stream of pressurized cleaning fluid toward an interior chamber of the single-port fluidic device. The return port simultaneously removes soiled cleaning fluid from the interior chamber. A circulation pump delivers the pressurized cleaning fluid from a tank to the injector nozzle, and returns soiled cleaning fluid from the return port to the tank, via a cleaning fluid circulation circuit. Optionally, the diaphragm may be alternately driven between two positions, to agitate the cleaning fluid within the interior chamber, thereby enhancing cleaning efficiency.