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

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

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

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

[5]  Yu Chang,et al.  Physiological Control of Intraaorta Pump Based on Heart Rate , 2011, ASAIO journal.

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

[7]  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.

[8]  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.

[9]  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.

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

[11]  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.

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

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

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

[15]  S. Deutsch,et al.  Numerical study of blood flow at the end-to-side anastomosis of a left ventricular assist device for adult patients. , 2009, Journal of biomechanical engineering.

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

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

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

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

[20]  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.

[21]  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.

[22]  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.

[23]  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.

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

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

[26]  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.

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

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

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

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

[31]  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.

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

[33]  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.

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

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

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

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

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

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

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

[41]  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.

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

[43]  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.