Hemodynamic Simulation Study of a Novel Intra-Aorta Left Ventricular Assist Device

The intra-aorta pump proposed here is a novel left ventricular assist device (LVAD). The mathematic model and the in vitro experiment demonstrate that the pump can satisfy the demand of human blood perfusion. However, the implantation of LVAD will change the fluid distribution or even generate a far-reaching influence on the aorta. At present, the characteristics of endaortic hemodynamics under the support of intra-aorta pump are still unclear. In this article, a computational fluid dynamics study based on a finite-element method was performed for the aorta under the support of intra-aorta pump. To explore the hemodynamic influence of intra-aorta pump on aorta, fully coupled fluid–solid interaction simulation was used in this study. From the flow profiles, we observed that the maximum disturbed flow and nonuniform flow existed within the aortic arch and the branches of the aortic arch. Flow waveforms at the inlets of aortas were derived from the lumped parameter model that we proposed in our previous study. The results demonstrated that the intra-aorta pump increased the blood flow in the aorta to normal physiologic conditions, but decreased the pulsatility of the flow and pressure. The pulsatility index changed from 2,540 to 1,370. The pressure gradient (PG) for heart failure conditions was 18.88 mm Hg/m vs. 25.51 mm Hg/m for normal physiologic conditions; for intra-aorta pump assist conditions, normal PG value could not be regained. Furthermore, our experimental results showed that the wall shear stress (WSS) of aorta under heart failure and normal physiologic conditions were 1.5 and 6.3 dynes/cm2, respectively. The intra-aorta pump increased the WSS value from 1.5 to 4.1 dynes/cm2.

[1]  Bin Gao,et al.  An anti-suction control for an intra-aorta pump using blood assistant index: a numerical simulation. , 2012, Artificial organs.

[2]  Bin Gao,et al.  A Blood Assist Index Control by Intraaorta Pump: A Control Strategy for Ventricular Recovery , 2011, ASAIO journal.

[3]  B. Gao,et al.  A Model-Free Adaptive Control to a Blood Pump Based on Heart Rate , 2011, ASAIO journal.

[4]  B. Gao,et al.  Physiological Control of Intraaorta Pump Based on Heart Rate , 2011, ASAIO journal.

[5]  Bin Gao,et al.  A Global Sliding Mode Controller Design for an Intra-Aorta Pump , 2010, ASAIO journal.

[6]  Bin Gao,et al.  A Hemodynamic Predict of an Intra-Aorta Pump Application in Vitro Using Numerical Analysis , 2009, WISM.

[7]  A. Qiao,et al.  Optimization of anastomotic configuration in CABG surgery , 2009 .

[8]  S. Deutsch,et al.  Numerical study of blood flow at the end-to-side anastomosis of a left ventricular assist device for adult patients. , 2008, Journal of biomechanical engineering.

[9]  S. Deutsch,et al.  Flow behavior within the 12-cc Penn State pulsatile pediatric ventricular assist device: an experimental study of the initial design. , 2008, Artificial organs.

[10]  H. N. Oscuii,et al.  BIOMECHANICAL ANALYSIS OF WALL REMODELING IN ELASTIC ARTERIES WITH APPLICATION OF FLUID–SOLID INTERACTION METHODS , 2007 .

[11]  A. Burns,et al.  Transendothelial flow inhibits neutrophil transmigration through a nitric oxide-dependent mechanism: potential role for cleft shear stress. , 2007, American journal of physiology. Heart and circulatory physiology.

[12]  George M Pantalos,et al.  Vascular pulsatility in patients with a pulsatile- or continuous-flow ventricular assist device. , 2007, The Journal of thoracic and cardiovascular surgery.

[13]  A. Diedrich,et al.  Contribution of Endothelial Nitric Oxide to Blood Pressure in Humans , 2007, Hypertension.

[14]  Alexandrina Untaroiu,et al.  Computational Design and Experimental Testing of a Novel Axial Flow LVAD , 2005, ASAIO journal.

[15]  S. Deutsch,et al.  Fluid dynamic analysis of the 50 cc Penn State artificial heart under physiological operating conditions using particle image velocimetry. , 2004, Journal of biomechanical engineering.

[16]  M. Kaazempur-Mofrad,et al.  Hemodynamics and wall mechanics in human carotid bifurcation and its consequences for atherogenesis: investigation of inter-individual variation , 2004, Biomechanics and modeling in mechanobiology.

[17]  Satoshi Saito,et al.  Hemodynamics of chronic nonpulsatile flow: implications for LVAD development. , 2004, The Surgical clinics of North America.

[18]  L. M. Filatova,et al.  Endothelial Dysfunction and Metabolic Effects of Nitric Oxide in Humans , 2003, Human Physiology.

[19]  J. Linneweber,et al.  Analysis of the arterial blood pressure waveform during left ventricular nonpulsatile assistance in animal models. , 2000, Artificial organs.

[20]  J. Linneweber,et al.  Analysis of the arterial blood pressure waveform using Fast Fourier Transform technique during left ventricular nonpulsatile assistance: in vitro study. , 2000, Artificial organs.

[21]  J. Tarbell,et al.  Numerical simulation of pulsatile flow in a compliant curved tube model of a coronary artery. , 2000, Journal of biomechanical engineering.

[22]  G Laufer,et al.  First clinical experience with the DeBakey VAD continuous-axial-flow pump for bridge to transplantation. , 2000, Circulation.

[23]  S. Sherwin,et al.  The influence of out-of-plane geometry on the flow within a distal end-to-side anastomosis. , 2000, Journal of biomechanical engineering.

[24]  J. Glueck,et al.  Feasibility of a tiny Gyro centrifugal pump as an implantable ventricular assist device. , 1999, Artificial organs.

[25]  J. R. Torczynski,et al.  A Lattice-Boltzmann Method for Partially Saturated Computational Cells , 1998 .

[26]  L. Taber A model for aortic growth based on fluid shear and fiber stresses. , 1998, Journal of biomechanical engineering.

[27]  J. Lekakis,et al.  Flow-mediated, endothelium-dependent vasodilation is impaired in subjects with hypothyroidism, borderline hypothyroidism, and high-normal serum thyrotropin (TSH) values. , 1997, Thyroid : official journal of the American Thyroid Association.

[28]  Yukihiko Nosé,et al.  Can We Develop a Nonpulsatile Permanent Rotary Blood Pump? Yes, We Can. , 1996, Artificial organs.

[29]  D Saloner,et al.  Calculation of the magnetization distribution for fluid flow in curved vessels , 1996, Magnetic resonance in medicine.

[30]  A. Ladd Numerical simulations of particulate suspensions via a discretized Boltzmann equation. Part 1. Theoretical foundation , 1993, Journal of Fluid Mechanics.

[31]  A. Ladd Numerical simulations of particulate suspensions via a discretized Boltzmann equation. Part 2. Numerical results , 1993, Journal of Fluid Mechanics.

[32]  J. Watanabe,et al.  Mechanical assistance of the left ventricle: acute effect on cardiac performance and coronary flow of different perfusion patterns. , 1992, The Journal of thoracic and cardiovascular surgery.

[33]  L. Boxt McDonald's blood flow in arteries , 1991, CardioVascular and Interventional Radiology.

[34]  L. Brush,et al.  McDonaldʼs Blood Flow in Arteries , 1991 .

[35]  S. Moncada,et al.  An L-arginine/nitric oxide pathway present in human platelets regulates aggregation. , 1990, Proceedings of the National Academy of Sciences of the United States of America.

[36]  F. Spencer,et al.  Quantification of pulsatile flow during cardiopulmonary bypass to permit direct comparison of the effectiveness of various types of "pulsatile" and "nonpulsatile" flow. , 1985, Surgery.

[37]  L. Sauvage,et al.  Extracorporeal circulation: the role of the pulse in maintenance of the systemic circulation during heart-lung by-pass. , 1955, Surgery.

[38]  H. Ead,et al.  A comparison of the effects of pulsatile and non‐pulsatile blood flow through the carotid sinus on the reflexogenic activity of the sinus baroceptors in the cat , 1952, The Journal of physiology.

[39]  Mahsa Dabagh,et al.  Computational Study of Pulstile Blood Flow in Aortic Arch: Effect of Blood Pressure , 2009 .

[40]  H. Schima,et al.  Effect of continuous arterial blood flow in patients with rotary cardiac assist device on the washout of a stenosis wake in the carotid bifurcation: a computer simulation study. , 2007, Journal of biomechanics.

[41]  Steven Deutsch,et al.  EXPERIMENTAL FLUID MECHANICS OF PULSATILE ARTIFICIAL BLOOD PUMPS , 2006 .

[42]  W S Pierce,et al.  Pierce-Donachy pediatric VAD: progress in development. , 1996, The Annals of thoracic surgery.

[43]  George P. Noon,et al.  Clinical Use of Cardiac Assist Devices , 1993 .