Why the study?
Does descending aorta cannulation for LVAD outflow produce different flow rates and pressure waveforms compared to ascending aorta cannulation in numerical simulations?
Does descending aorta cannulation for LVAD outflow produce different flow rates and pressure waveforms compared to ascending aorta cannulation in numerical simulations?
Numerical simulations indicate that descending aorta cannulation for LVADs provides similar hemodynamic support to ascending aorta cannulation, supporting its potential as a less invasive alternative.
Validates multiscale models incorporating viscoelasticity for arterial flow; extends computational tools but leaves open LVAD cannulation decisions.
In this work we present numerical simulations of continuous flow left ventricle assist device implantation with the aim of comparing difference in flow rates and pressure patterns depending on the location of the anastomosis and the rotational speed of the device. Despite the fact that the descending aorta anastomosis approach is less invasive, since it does not require a sternotomy and a cardiopulmonary bypass, its benefits are still controversial. Moreover, the device rotational speed should be correctly chosen to avoid anomalous flow rates and pressure distribution in specific location of the cardiovascular tree. With the aim of assessing the differences between these two approaches and device rotational speed in terms of flow rate and pressure waveforms, we set up numerical simulations of network of one-dimensional models where we account for the presence of an outflow cannula anastomosed to different locations of the aorta. Then, we use the resulting network to compare the results of the two different cannulations for several stages of heart failure and different rotational speed of the device. The inflow boundary data for the heart and the cannulas are obtained from a lumped parameters model of the entire circulatory system with an assist device, which is validated with clinical data. The results show that ascending and descending aorta cannulations lead to similar waveforms and mean flow rate in all the considered cases. Moreover, regardless of the anastomosis region, the rotational speed of the device has an important impact on wave profiles; this effect is more pronounced at high RPM.
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Bonnemain et al. (2013) studied Healthy (n=2). Geometrical multiscale models (3-D FSI coupled with 1-D networks) vs. Full 1-D network and stand-alone 3-D FSI was evaluated on Flow rate, pressure waveforms, and solid wall displacement.
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