Ventricular assist devices (VADs) provide long- and short-term support to chronically ill heart disease patients; these devices are expected to match the remarkable functionality of the natural heart, which makes their design a very challenging task. Blood pumps, the principal component of the VADs, must operate over a wide range of flow rates and pressure heads and minimise the damage to blood cells in the process. They should also be small to allow easy implantation in both children and adults. Mathematical methods and computational fluid dynamics (CFD) have recently emerged as powerful design tools in this context; a review of the recent advances in the field is presented here. This review focusses on the CFD-based design strategies applied to blood flow in blood pumps and other blood-handling devices. Both simulation methods for blood flow and blood damage models are reviewed. The literature is put into context with a discussion of the chronological development in the field. The review is illustrated with specific examples drawn from our group's Galerkin/least squares (GLS) finite-element simulations of the basic Newtonian flow problem for the continuous-flow centrifugal GYRO blood pump. The GLS formulation is outlined, and modifications to include models that better represent blood rheology are shown. Haemocompatibility analysis of the pump is reviewed in the context of haemolysis estimations based on different blood damage models. Our strain-based blood damage model that accounts for the viscoleasticity associated with the red blood cells is reviewed in detail. The viability of design improvement based on trial and error and complete simulation-based design optimisation schemes are also discussed.
Implantable ventricular assist devices give hope of a permanent clinical solution to heart failure. These devices, both pulsatile- and continuous-flow, are presently used as medium-term bridge to heart transplant or recovery. While long-term use of continuous-flow axial and centrifugal pumps is being explored, the excessive level of blood damage in these devices has emerged as a design challenge. Blood damage depends both on shear stress and exposure time, and device designers have relied traditionally on global space- and time-averaged estimates from experimental studies to make design decisions. Measuring distributions of shear stress levels and the blood cell's exposure to these conditions in complex rotary pump flow is difficult. On the other hand, computational fluid dynamics (CFD) is now being used as a tool for designing viable devices, offering more detailed information about the flow field. A tensor-based blood damage model for CFD analysis is proposed here. The model estimates the time- and space-dependent strain experienced by individual blood cells and correlates it to blood damage data from steady shear flow experiments. The blood cells are modeled as deforming droplets and their deformation is tracked along the pathlines of a computed flow. The model predicts that blood cells in a rapidly fluctuating shear flow can sustain high shear stress levels for very short exposure time without deforming considerably. In the context of mechanical modeling of the implantable Gyro blood pump being developed at Baylor College of Medicine, this suggests that blood cells traversing regions of highly fluctuating shear stress rapidly may not hemolyze significantly.
Hemolysis in the GYRO centrifugal blood pump, under development at the Baylor College of Medicine, Houston, TX, is numerically predicted using the newly proposed tensor-based blood-damage model, as well as a traditional model. Three typical operating conditions for the pump are simulated with a special-purpose finite element-based flow solver, and a novel approach for tracing the pathlines in discretely represented time-varying flow in a complex domain is presented, and 271 pathlines are traced through the pump. Hemolysis is computed along the pathlines, and the accumulated hemolysis at the outflow is converted into standard clinical units. The cumulative hemolysis at the outlet of the pump is weighted with the flow rate associated with the pathlines, and a temporal average is obtained by releasing the tracer particles at different time intervals. Numerical predictions are compared to experimental hemolysis studies performed according to the American Society for Testing and Materials standards at the Baylor College of Medicine. The tensor-based blood-damage model is found to match very well with the experimental results, whereas the traditional model overpredicts the hemolysis. The success of the tensor-based blood-damage model is attributed to its construction, which accounts for blood-specific physical properties and phenomena. Hemolysis values at the typical operating conditions of the pump are found to be within the clinically accepted range.
The Shear-slip Mesh Update Method (SSMUM) is being used in flow simulations involving large but regular displacements of one or more boundaries of the computational domain. We follow up the earlier discussion of the method with notes on practical implementation aspects. In order to establish a benchmark problem for this class of flow problems, we define and report results from a two-dimensional viscous flow around a rotating stirrer in a square chamber. The application potential of the method is demonstrated in the context of biomedical design problem, as we perform an analysis of blood flow in a centrifugal left ventricular assist device, or blood pump, which involves a rotating impeller in a non-axisymmetric housing.
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