Impact of Short-Term Percutaneous Interventional Left Ventricular Assist Devices Support Modes on Aortic Hemodynamics

Heart failure (HF) is a significant health threat, and the short-term percutaneous interventional left ventricular assist devices (PLVADs) play an important role in the management of it. However, studies on PLVAD blood flow patterns at varying rotational speeds are limited. Therefore, it is essential to explore the hemodynamic profiles of PLVADs under varying modes. A patient-specific model was developed, and the lumped-parameter model (LPM) was used as boundary conditions. The hemodynamic changes of PLVAD under pulsating flow (PF) and counterpulsating flow (CPF) were analyzed using computational fluid dynamics (CFD). Key parameters, including pressure, wall shear stress (WSS), oscillatory shear index (OSI), time-averaged wall shear stress (TAWSS), endothelial cell activation potential (ECAP), relative residence time (RRT), and velocity, were calculated and compared under continuous-flow (CF) condition. PLVAD support reduced afterload, and both pulsatile modes exhibited better pulsatility than CF, particularly the PF mode. In CPF mode, the native heart performed the least work, which may be more conducive to recovery. The trends for WSS, pressure, and velocity were similar across conditions, but their magnitudes varied. Overall, PLVAD support can increase TAWSS and decrease OSI, RRT, and ECAP. Although there was no significant difference in TAWSS and OSI among CF, PF, and CPF, we observed the smallest RRT for PF and the smallest ECAP for CPF. Hemodynamic data suggest that pulsatile patterns appear to reduce the risk of thrombosis and other complications compared to CF.