Blood Damage in Ventricular Assist Devices

Thamsen, Bente; Granegger, Marcus; Kertzscher, Ulrich

doi:10.5301/ijao.5000506

Cited by 12 publications

(15 citation statements)

References 25 publications

(27 reference statements)

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“…A widely adopted approach to estimate blood damage is the use of numerical damage prediction models implemented into flow simulations (computational fluid dynamics (CFD)). 7 Many of those models base on the evaluation of shear stresses. [8][9][10][11][12][13][14] Numerical blood damage estimation is currently confined on the use of unsteady Reynolds-averaged Navier-Stokes (URANS) simulations.…”

Section: Introductionmentioning

confidence: 99%

Large eddy simulation in a rotary blood pump: Viscous shear stress computation and comparison with unsteady Reynolds-averaged Navier–Stokes simulation

et al. 2018

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The results show the potential of the large eddy simulation as a high-quality comparative case to check the suitability of a chosen Reynolds-averaged Navier-Stokes setup and turbulence model. Furthermore, the results lead to suggest that large eddy simulations are superior to unsteady Reynolds-averaged Navier-Stokes simulations when instantaneous stresses are applied for the blood damage prediction.

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Section: Introductionmentioning

confidence: 99%

Large eddy simulation in a rotary blood pump: Viscous shear stress computation and comparison with unsteady Reynolds-averaged Navier–Stokes simulation

et al. 2018

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“…Over the years, extensive research has been conducted to improve device thromboresistance, focusing, in particular, on the optimization of the pump geometry as a means of reducing hypershear within the pump. [18][19][20][21][22][23] However, despite significant technological advancements, postimplant thrombosis continues to occur even with the latest generation of devices, suggesting involvement of other factors beyond pump hypershear. Moreover, although LVAD systems that abated the occurrence of in-pump thrombosis are now commercially available, these are not free from thromboembolic events (namely stroke).…”

Section: Introductionmentioning

confidence: 99%

Blood damage in Left Ventricular Assist Devices: Pump thrombosis or system thrombosis?

et al. 2018

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Introduction: Despite significant technical advancements in the design and manufacture of Left Ventricular Assist Devices, post-implant thrombotic and thromboembolic complications continue to affect long-term outcomes. Previous efforts, aimed at optimizing pump design as a means of reducing supraphysiologic shear stresses generated within the pump and associated prothrombotic shear-mediated platelet injury, have only partially altered the device hemocompatibility. Methods: We examined hemodynamic mechanisms that synergize with hypershear within the pump to contribute to the thrombogenic potential of the overall Left Ventricular Assist Device system. Results: Numerical simulations of blood flow in differing regions of the Left Ventricular Assist Device system, that is the diseased native left ventricle, the pump inflow cannula, the impeller, the outflow graft and the anastomosed downstream aorta, reveal that prothrombotic hemodynamic conditions might occur at these specific sites. Furthermore, we show that beyond hypershear, additional hemodynamic abnormalities exist within the pump, which may elicit platelet activation, such as recirculation zones and stagnant platelet trajectories. We also provide evidences that particular Left Ventricular Assist Device implantation configurations and specific post-implant patient management strategies, such as those allowing aortic valve opening, are more hemodynamically favorable and reduce the thrombotic risk. Conclusion: We extend the perspective of pump thrombosis secondary to the supraphysiologic shear stress environment of the pump to one of Left Ventricular Assist Device system thrombosis, raising the importance of comprehensive characterization of the different prothrombotic risk factors of the total system as the target to achieve enhanced hemocompatibility and improved clinical outcomes.

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“…1 The blood pump is widely used in the treatment of heart failure, such as bridge-to-recovery, bridge-to-transplantation, or destination therapies. 2,3 The main function of the blood pump is to drive the blood in the ventricle to flow into the artery. The non-physiological shear stress generated in the flow field will damage the blood, and destroy red blood cells and platelet activation, resulting in serious hemolysis and thrombosis, as well as endangering the life of patients.…”

Section: Introductionmentioning

confidence: 99%

Numerical study on the performance of centrifugal blood pump with superhydrophobic surface

Qiu

et al. 2022

Int J Artif Organs

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Aim: In order to reduce the blood damage of an artificial heart pump and optimize its hydraulic performance, a centrifugal blood pump with superhydrophobic characteristics is proposed in this study. Methods: To study the influence of superhydrophobic surface characteristics on the performance of centrifugal blood pumps, the Navier slip model is used to simulate the slip characteristics of superhydrophobic surfaces, which is realized by the user defined function of ANSYS fluent. The user defined functions with different values of slip length are verified by two benchmark solutions of laminar flow and turbulence in the pipeline. The blood pump model adopts the designed centrifugal blood pump, and its head, hydraulic efficiency and hemolysis index are calculated. The Navier slip boundary condition (a constant slip-length of 50 μm) is applied to the walls of the blood pump impeller and a volute at different positions, and the influence of the superhydrophobic surface on the performance of the blood pump at the design point Q = 6 L/min was compared and analyzed. Results: The results show that the centrifugal blood pump model used in this paper has good blood compatibility and meets the design requirements; the superhydrophobic surface can significantly reduce the scalar shear stress in the blood pump. At the design point, when the slip length is 50 μm, the mass-average scalar shear stress in the impeller area and the volute area reduction rate is about 5.9%, the hydraulic efficiency growth rate is about 3.8%, the hemolysis index reduction rate is about 18.4%, and the pressure head changes little with a growth rate of 0.3%. Conclusions: Centrifugal blood pumps with superhydrophobic surfaces can improve the efficiency of blood pumps and reduce hemolysis. Based on these encouraging results, vitro investigations for actual blood damage would be practicable.

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Blood Damage in Ventricular Assist Devices

Cited by 12 publications

References 25 publications

Large eddy simulation in a rotary blood pump: Viscous shear stress computation and comparison with unsteady Reynolds-averaged Navier–Stokes simulation

Large eddy simulation in a rotary blood pump: Viscous shear stress computation and comparison with unsteady Reynolds-averaged Navier–Stokes simulation

Blood damage in Left Ventricular Assist Devices: Pump thrombosis or system thrombosis?

Numerical study on the performance of centrifugal blood pump with superhydrophobic surface

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