Validation of numerically simulated ventricular flow patterns during left ventricular assist device support

Intraventricular flow patterns during left ventricular assist device support have been investigated via computational fluid dynamics by several groups. Based on such simulations, specific parameters for thrombus formation risk analysis have been developed. However, computational fluid dynamic simulations of complex flow configurations require proper validation by experiments. To meet this need, a ventricular model with a well-defined inflow section was analyzed by particle image velocimetry and replicated by transient computational fluid dynamic simulations. To cover the laminar, transitional, and turbulent flow regime, four numerical methods including the laminar, standard k-omega, shear-stress transport, and renormalized group k-epsilon were applied and compared to the particle image velocimetry results in 46 different planes in the whole left ventricle. The simulated flow patterns for all methods, except renormalized group k-epsilon, were comparable to the flow patterns measured using particle image velocimetry (absolute error over whole left ventricle: laminar: 10.5, standard k-omega: 11.3, shear–stress transport: 11.3, and renormalized group k-epsilon: 17.8 mm/s). Intraventricular flow fields were simulated using four numerical methods and validated with experimental particle image velocimetry results. In the given setting and for the chosen boundary conditions, the laminar, standard K-omega, and shear–stress transport methods showed acceptable similarity to experimental particle image velocimetry data, with the laminar model showing the best transient behavior.

[1]  G. Pedrizzetti,et al.  Emerging trends in CV flow visualization. , 2012, JACC. Cardiovascular imaging.

[2]  Michael Neidlin,et al.  Title: Ventricular flow dynamics with varying LVAD inflow cannula lengths: in-silico evaluation in a multiscale model Type of work: Original Article Running head: Influence of LVAD inflow cannula insertion length , 2018 .

[3]  Sebastian Schmitter,et al.  4D Flow MRI , 2018 .

[4]  Igor Gregoric,et al.  HeartWare ventricular assist system for bridge to transplant: combined results of the bridge to transplant and continued access protocol trial. , 2013, The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation.

[5]  Christian Poelma,et al.  Ultrasound Imaging Velocimetry: a review , 2016 .

[6]  Robert L Kormos,et al.  Eighth annual INTERMACS report: Special focus on framing the impact of adverse events. , 2017, The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation.

[7]  P. Jansz,et al.  Evaluation of the HeartWare ventricular assist device Lavare cycle in a particle image velocimetry model and in clinical practice. , 2016, European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery.

[8]  A. Aliseda,et al.  Left Ventricular Assist Device Inflow Cannula Angle and Thrombosis Risk , 2018, Circulation. Heart failure.

[9]  T. Trucano,et al.  Verification, Validation, and Predictive Capability in Computational Engineering and Physics , 2004 .

[10]  Steven Deutsch,et al.  Assessment of CFD Performance in Simulations of an Idealized Medical Device: Results of FDA’s First Computational Interlaboratory Study , 2012 .

[11]  Markus Raffel,et al.  Particle Image Velocimetry: A Practical Guide , 2002 .

[12]  K. May-Newman,et al.  Intraventricular flow patterns and stasis in the LVAD-assisted heart. , 2014, Journal of biomechanics.

[13]  S. Gregory,et al.  Numerical prediction of thrombus risk in an anatomically dilated left ventricle: the effect of inflow cannula designs , 2016, Biomedical engineering online.

[14]  Ulrich Steinseifer,et al.  FDA Benchmark Medical Device Flow Models for CFD Validation , 2017, ASAIO journal.

[15]  K. Fraser,et al.  Ventricular Flow Field Visualization During Mechanical Circulatory Support in the Assisted Isolated Beating Heart , 2019, Annals of Biomedical Engineering.

[16]  D. Paniagua,et al.  Numerical characterization of hemodynamics conditions near aortic valve after implantation of Left Ventricular Assist Device. , 2011, Mathematical biosciences and engineering : MBE.

[17]  E. Oikonomou,et al.  Heart transplantation versus left ventricular assist devices as destination therapy or bridge to transplantation for 1-year mortality: a systematic review and meta-analysis. , 2018, Annals of cardiothoracic surgery.

[18]  Volkmar Falk,et al.  Diagnosis and Treatment Algorithm for Blood Flow Obstructions in Patients With Left Ventricular Assist Device. , 2016, Journal of the American College of Cardiology.

[19]  S. Russell,et al.  Clinical management of continuous-flow left ventricular assist devices in advanced heart failure. , 2010, The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation.

[20]  Danny Bluestein,et al.  Research approaches for studying flow-induced thromboembolic complications in blood recirculating devices , 2004, Expert review of medical devices.

[21]  Richard B Devereux,et al.  Recommendations for chamber quantification: a report from the American Society of Echocardiography's Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardio , 2005, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[22]  Juan Carlos del Alamo,et al.  Intraventricular thrombus formation in the LVAD-assisted heart studied in a mock circulatory loop , 2017 .

[23]  M. Morshuis,et al.  Long‐term evaluation of a fully magnetically levitated circulatory support device for advanced heart failure—two‐year results from the HeartMate 3 CE Mark Study , 2018, European journal of heart failure.

[24]  G. MacGowan,et al.  Patient survival and therapeutic outcome in the UK bridge to transplant left ventricular assist device population , 2018, Heart.