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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.

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We investigate the influence of the fluid constitutive model on the outcome of shape optimization tasks, motivated by optimal design problems in biomedical engineering. Our computations are based on the Navier-Stokes equations generalized to non-Newtonian fluid, with the modified Cross model employed to account for the shear-thinning behavior of blood. The generalized Newtonian treatment exhibits striking differences in the velocity field for smaller shear rates. We apply sensitivity-based optimization procedure to a flow through an idealized arterial graft. For this problem we study the influence of the inflow velocity, and thus the shear rate. Furthermore, we introduce an additional factor in the form of a geometric parameter, and study its effect on the optimal shape obtained.