Computational Analysis of Pumping Efficacy of a Left Ventricular Assist Device according to Cannulation Site in Heart Failure with Valvular Regurgitation

Aulia Khamas Heikhmakhtiar; Ki Moo Lim

doi:10.1155/2016/6930482

January 1, 2016Computational and Mathematical Methods in MedicineOpen Access

Computational Analysis of Pumping Efficacy of a Left Ventricular Assist Device according to Cannulation Site in Heart Failure with Valvular Regurgitation

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Why the study?

Does the cannulation site of an LVAD (LAAO vs LVAO) affect pumping efficacy in heart failure with mitral or aortic regurgitation?

Structured PICO

Does the cannulation site of an LVAD (LAAO vs LVAO) affect pumping efficacy in heart failure with mitral or aortic regurgitation?

P

Population

Computational models of three ventricular conditions: normal (heart failure without valvular regurgitation), 5% mitral regurgitation (MR), and 5% aortic regurgitation (AR)

I

Intervention

Left ventricular assist device (LVAD) with cannulation from the left atrium to the aorta (LAAO) or from the left ventricle to the aorta (LVAO)

C

Comparator

Control (no LVAD)

O

Outcome

Pumping efficacy and contribution of LVAD to MR and ARsurrogate

Computational modeling suggests that LVAD cannulation from the left atrium to the aorta is optimal for HF with mitral regurgitation, while left ventricle to aorta cannulation is better for aortic regurgitation.

Implication

Hypothesis-generating for LVAD cannulation choice in MR or AR; prospective human studies needed before clinical adoption.

Abstract

Mitral valve regurgitation (MR) causes blood to flow in two directions during contraction of the left ventricle (LV), that is, forward into the aorta and backward into the left atrium (LA). In aortic valve regurgitation (AR), leakage occurs from the aorta into the LV during diastole. Our objective is to analyze the contribution of a left ventricular assist device (LVAD) to MR and AR for the following two different cannulation sites: from the LA to the aorta (LAAO) and from the LV to the aorta (LVAO). Using a computational method, we simulated three ventricular conditions (normal [HF without valvular regurgitation], 5% MR, and 5% AR) in three groups (control [no LVAD], LAAO, and LVAO). The results showed that LVAD with LAAO cannulation is appropriate for recovery of the MR heart, and the LVAD with LVAO cannulation is appropriate for treating the AR heart.