Shear stress and blood trauma under constant and pulse-modulated speed CF-VAD operations: CFD analysis of the HVAD.
Shear stress and blood trauma under constant and pulse-modulated speed CF-VAD operations: CFD analysis of the HVAD.
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DOI：
10.1007/s11517-018-1922-0
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发表时间：
2019-04
影响因子：
3.2
通讯作者：
Wu ZJ
中科院分区：
文献类型：
--
作者：
Chen Z;Jena SK;Giridharan GA;Sobieski MA;Koenig SC;Slaughter MS;Griffith BP;Wu ZJ
已经提出并在临床上实施泵速调节，以改善连续流心室辅助装置患者的血管搏动。对具有前景的异步泵速调节的 HVAD 的流动动力学及其设备引起的血液损伤的潜在风险进行了数值研究。泵入口和出口处的边界条件是使用压力波形来定义的，该压力波形改编自大型动物缺血性心力衰竭 (IHF) 模型中实验记录的心室和动脉压力波形，该模型由在恒定和调制泵速下运行的 HVAD 支持。剪切应力场和溶血指数是从模拟流场得出的。在模拟恒定和脉冲调制速度操作下计算生成的流量波形的总体特征与实验记录的流量波形的总体特征相匹配。模拟表明，在恒速操作下，剪切应力场和溶血指数在整个心动周期中变化，并且在调制速度操作下也作为调制曲线的函数。计算模型没有表现出恒定泵速操作和调制泵速操作之间的时间平均溶血指数有任何差异，因此预测脉冲调制速度操作可能有助于恢复血管搏动，而不会进一步增加血液创伤的风险。
Modulation of pump speed has been proposed and implemented clinically to improve vascular pulsatility in continuous flow ventricular assist device patient. The flow dynamics of the HVAD with a promising asynchronous pump speed modulation and its potential risk for device-induced blood trauma was investigated numerically. The boundary conditions at the pump inlet and outlet were defined using the pressure waveforms adapted from the experimentally recorded ventricular and arterial pressure waveforms in a large animal ischemic heart failure (IHF) model supported by the HVAD operated at constant and modulated pump speeds. Shear stress fields and hemolysis indices were derived from the simulated flow fields. The overall features of the computationally generated flow waveforms at simulated constant and pulse-modulated speed operations matched with those of the experimentally recorded flow waveforms. The simulations showed that the shear stress field and hemolysis index vary throughout the cardiac cycle under the constant speed operation, and also as a function of modulation profile under modulated speed operation. The computational model didn’t demonstrate any differences in the time average hemolysis index between constant and modulated pump speed operations, thereby predicting pulse-modulated speed operation may help to restore vascular pulsatility without any further increased risk of blood trauma.
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