Computational Fluid Dynamics-based Study of Possibility of Generating Pulsatile Blood Flow Via a Continuous-flow VAD

Overview

Journal Med Biol Eng Comput

Publisher Springer

Specialties Biomedical Engineering
Medical Informatics

Date 2016 May 29

PMID 27234039

Citations 4

Authors

Erfan Nammakie

Hanieh Niroomand-Oscuii

Mojtaba Koochaki

Farzan Ghalichi

Affiliations

Soon will be listed here.

Abstract

Until recent years, it was almost beyond remedy to save the life of end-stage heart failure patients without considering a heart transplant. This is while the need for healthy organs has always far exceeded donations. However, the evolution of VAD technology has certainly changed the management of these patients. Today, blood pumps are designed either pulsatile flow or continuous flow, each of which has its own concerns and limitations. For instance, pulsatile pumps are mostly voluminous and hardly can be used for children. On the other hand, the flow generated by continuous-flow pumps is in contrast with pulsatile flow of the natural heart. In this project, having used computational fluid dynamics, we studied the possibility of generating pulsatile blood flow via a continuous-flow blood pump by adjusting the rotational speed of the pump with two distinct patterns (sinusoidal and trapezoidal), both of which have been proposed and set based on physiological needs and blood flow waveform of the natural heart. An important feature of this study is setting the outlet pressure of the pump similar to the physiological conditions of a patient with heart failure, and since these axial pumps are sensitive to outlet pressures, more secure and reliable results of their performance are achieved. Our results show a slight superiority of a sinusoidal pattern compared to a trapezoidal one with the potential to achieve an adequate pulsatile flow by precisely controlling the rotational speed.

Citing Articles

Optimization of a centrifugal blood pump designed using an industrial method through experimental and numerical study.

Yazdanpanah-Ardakani K, Niroomand-Oscuii H, Sahebi-Kuzeh Kanan R, Shokri N Sci Rep. 2024; 14(1):7443.

PMID: 38548818 PMC: 11350071. DOI: 10.1038/s41598-024-57019-9.

A Multi-Domain Simulation Study of a Pulsatile-Flow Pump Device for Heart Failure With Preserved Ejection Fraction.

Ozturk C, Rosalia L, Roche E Front Physiol. 2022; 13:815787.

PMID: 35145432 PMC: 8822361. DOI: 10.3389/fphys.2022.815787.

Proposal of hemodynamically improved design of an axial flow blood pump for LVAD.

Kannojiya V, Das A, Das P Med Biol Eng Comput. 2019; 58(2):401-418.

PMID: 31858420 DOI: 10.1007/s11517-019-02097-5.

Shear stress and blood trauma under constant and pulse-modulated speed CF-VAD operations: CFD analysis of the HVAD.

Chen Z, Jena S, Giridharan G, Sobieski M, Koenig S, Slaughter M Med Biol Eng Comput. 2018; 57(4):807-818.

PMID: 30406881 PMC: 6450749. DOI: 10.1007/s11517-018-1922-0.

References

Cheng A, Williamitis C, Slaughter M . Comparison of continuous-flow and pulsatile-flow left ventricular assist devices: is there an advantage to pulsatility?. Ann Cardiothorac Surg. 2014; 3(6):573-81. PMC: 4250555. DOI: 10.3978/j.issn.2225-319X.2014.08.24. View

Prosi M, Perktold K, Schima H . 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. J Biomech. 2006; 40(10):2236-43. DOI: 10.1016/j.jbiomech.2006.10.017. View

Kirklin J, Naftel D, Kormos R, Stevenson L, Pagani F, Miller M . Fifth INTERMACS annual report: risk factor analysis from more than 6,000 mechanical circulatory support patients. J Heart Lung Transplant. 2013; 32(2):141-56. DOI: 10.1016/j.healun.2012.12.004. View

Pirbodaghi T, Axiak S, Weber A, Gempp T, Vandenberghe S . Pulsatile control of rotary blood pumps: Does the modulation waveform matter?. J Thorac Cardiovasc Surg. 2012; 144(4):970-7. DOI: 10.1016/j.jtcvs.2012.02.015. View

Moazami N, Dembitsky W, Adamson R, Steffen R, Soltesz E, Starling R . Does pulsatility matter in the era of continuous-flow blood pumps?. J Heart Lung Transplant. 2014; 34(8):999-1004. DOI: 10.1016/j.healun.2014.09.012. View

Slaughter M, Rogers J, Milano C, Russell S, Conte J, Feldman D . Advanced heart failure treated with continuous-flow left ventricular assist device. N Engl J Med. 2009; 361(23):2241-51. DOI: 10.1056/NEJMoa0909938. View

Burgreen G, Antaki J, Griffith B . A design improvement strategy for axial blood pumps using computational fluid dynamics. ASAIO J. 1996; 42(5):M354-60. DOI: 10.1097/00002480-199609000-00010. View

Hayward C, Salamonsen R, Keogh A, Woodard J, Ayre P, Prichard R . Effect of alteration in pump speed on pump output and left ventricular filling with continuous-flow left ventricular assist device. ASAIO J. 2011; 57(6):495-500. DOI: 10.1097/MAT.0b013e318233b112. View

Apel J, Paul R, Klaus S, Siess T, Reul H . Assessment of hemolysis related quantities in a microaxial blood pump by computational fluid dynamics. Artif Organs. 2001; 25(5):341-7. DOI: 10.1046/j.1525-1594.2001.025005341.x. View

10.

Schmid C, Tjan T, Etz C, Schmidt C, Wenzelburger F, Wilhelm M . First clinical experience with the Incor left ventricular assist device. J Heart Lung Transplant. 2005; 24(9):1188-94. DOI: 10.1016/j.healun.2004.08.024. View

11.

Sansone F, Zingarelli E, Flocco R, Dato G, Parisi F, Punta G . Pulsed or continuous flow in long-term assist devices: a debated topic. Transplant Rev (Orlando). 2012; 26(4):241-5. DOI: 10.1016/j.trre.2012.06.001. View

12.

Soucy K, Koenig S, Giridharan G, Sobieski M, Slaughter M . Rotary pumps and diminished pulsatility: do we need a pulse?. ASAIO J. 2013; 59(4):355-66. DOI: 10.1097/MAT.0b013e31829f9bb3. View

13.

Frazier O, Khalil H, Benkowski R, Cohn W . Optimization of axial-pump pressure sensitivity for a continuous-flow total artificial heart. J Heart Lung Transplant. 2010; 29(6):687-91. DOI: 10.1016/j.healun.2009.12.017. View

14.

Miyazoe Y, Sawairi T, Ito K, Konishi Y, Yamane T, Nishida M . Computational fluid dynamics analysis to establish the design process of a centrifugal blood pump: second report. Artif Organs. 1999; 23(8):762-8. DOI: 10.1046/j.1525-1594.1999.06418.x. View

15.

Agarwal S, High K . Newer-generation ventricular assist devices. Best Pract Res Clin Anaesthesiol. 2012; 26(2):117-30. DOI: 10.1016/j.bpa.2012.01.003. View

16.

Margulies K, Rame J . Adaptations to pulsatile versus nonpulsatile ventricular assist device support. Circ Heart Fail. 2011; 4(5):535-7. DOI: 10.1161/CIRCHEARTFAILURE.111.963777. View

17.

Dexter E, Aluri S, Radcliffe R, Zhu H, Carlson D, Heilman T . In vivo demonstration of cavitation potential of a mechanical heart valve. ASAIO J. 1999; 45(5):436-41. DOI: 10.1097/00002480-199909000-00014. View

18.

Arora D, Behr M, Pasquali M . Hemolysis estimation in a centrifugal blood pump using a tensor-based measure. Artif Organs. 2006; 30(7):539-47. DOI: 10.1111/j.1525-1594.2006.00256.x. View

19.

Boyle A, Ascheim D, Russo M, Kormos R, John R, Naka Y . Clinical outcomes for continuous-flow left ventricular assist device patients stratified by pre-operative INTERMACS classification. J Heart Lung Transplant. 2010; 30(4):402-7. DOI: 10.1016/j.healun.2010.10.016. View

20.

Chan W, Wong Y, Ding Y, Chua L, Yu S . Numerical investigation of the effect of blade geometry on blood trauma in a centrifugal blood pump. Artif Organs. 2002; 26(9):785-93. DOI: 10.1046/j.1525-1594.2002.06954.x. View