Why the study?
Does a reduced beat rate alter fluid dynamics and increase thrombus risk in the 12 cc Penn State Pneumatic Pediatric VAD?
Does a reduced beat rate alter fluid dynamics and increase thrombus risk in the 12 cc Penn State Pneumatic Pediatric VAD?
Reducing the beat rate of the 12 cc Penn State Pediatric VAD during weaning alters fluid dynamics, potentially increasing the risk of thrombus deposition.
May warrant caution reducing beat rates in pediatric VAD weaning; hypothesis-generating for thrombus mitigation before clinical use.
Ventricular assist devices (VADs) have become a viable option for adult patients with end-stage heart failure during the bridge-to-transplant period and have recently shown promise in aiding in myocardial recovery. Because the number of available organs is insufficient, mechanical circulatory support systems such as VADs are also being developed for use in pediatric patients. During myocardial recovery, the system must be weaned from the patient to prepare for explant; for pulsatile devices, this often includes a reduction in flow rate, which can change the fluid dynamics of the device. These changes in flow need to be monitored because strong diastolic rotational flow, no areas of blood stasis, low blood residence time, and wall shear rates above 500 s, can help prevent thrombus deposition. Particle image velocimetry was used to observe the planar flow patterns and wall shear rates of the 12 cc Penn State Pneumatic Pediatric VAD (PVAD) at a normal operating condition and a reduced beat rate. At the reduced beat rate, the PVAD showed an earlier loss of rotational pattern, increased blood residence time, and an overall reduction in wall shear rate at the outer walls. Because this reduction in flow rate could lead to a possible increase in thrombus deposition, it may be necessary to look into other options for weaning a patient from the PVAD.
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Roszelle et al. (2008) studied this question.
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