Patient-specific, Echocardiography Compatible Flow Loop Model of Aortic Valve Regurgitation in the Setting of a Mechanical Assist Device

Overview

Journal Front Cardiovasc Med

Specialty Cardiology & Vascular Diseases

Date 2023 Feb 27

PMID 36844719

Authors

Mahwash Kassi

Stefano Filippini

Eleonora Avenatti

Susan Xu

Kinan Carlos El-Tallawi

Clara I Angulo

Marija Vukicevic

Stephen H Little

Affiliations

Soon will be listed here.

Abstract

Background: Aortic regurgitation (AR) occurs commonly in patients with continuous-flow left ventricular assist devices (LVAD). No gold standard is available to assess AR severity in this setting. Aim of this study was to create a patient-specific model of AR-LVAD with tailored AR flow assessed by Doppler echocardiography.

Methods: An echo-compatible flow loop incorporating a 3D printed left heart of a Heart Mate II (HMII) recipient with known significant AR was created. Forward flow and LVAD flow at different LVAD speed were directly measured and AR regurgitant volume (RegVol) obtained by subtraction. Doppler parameters of AR were simultaneously measured at each LVAD speed.

Results: We reproduced hemodynamics in a LVAD recipient with AR. AR in the model replicated accurately the AR in the index patient by comparable Color Doppler assessment. Forward flow increased from 4.09 to 5.61 L/min with LVAD speed increasing from 8,800 to 11,000 RPM while RegVol increased by 0.5 L/min (2.01 to 2.5 L/min).

Conclusions: Our circulatory flow loop was able to accurately replicate AR severity and flow hemodynamics in an LVAD recipient. This model can be reliably used to study echo parameters and aid clinical management of patients with LVAD.

Citing Articles

The role of innovative modeling and imaging techniques in improving outcomes in patients with LVAD.

Wilson S, Ingram K, Oh A, Moreno M, Kassi M Front Cardiovasc Med. 2023; 10:1248300.

PMID: 37692033 PMC: 10484111. DOI: 10.3389/fcvm.2023.1248300.

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