Development of Aortic Regurgitation/Insufficiency Following Implantation of Continuous Flow Left Ventricular Assist Device (LVAD) and Outcomes

Muthiah, K.; Phan, J.; Robson, D.; Macdonald, P.; Keogh, Anne; Kotlyar, Eugene; Granger, Emily; Dhital, K.; Spratt, Phillip; Jansz, P.; Hayward, Chris

doi:10.1016/j.hlc.2011.05.158

Cited by 1 publication

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“…23 One of the reasons why aortic valve remains closed is the large aortic root pressure in LVAD implantations. 23 One of the reasons why aortic valve remains closed is the large aortic root pressure in LVAD implantations.…”

Section: Resultsmentioning

confidence: 99%

Effect of LVAD Outlet Graft Anastomosis Angle on the Aortic Valve, Wall, and Flow

Inci

Sorgüven

2012

ASAIO Journal

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Left ventricular assist devices (LVADs), which pump blood from the left ventricle to the aorta are an important therapy option for patients with end-stage cardiovascular diseases. Recent publications show that even with optimized LVADs fatal complications can occur because of the blood deformations around the inflow cannula or through the LVAD outlet graft-aorta anastomosis. This study investigates the effects of the anastomosis geometry on the flow through the aorta, on the pressure and wall shear stress (WSS) distributions on the aortic wall and on the total entropy generation in the anastomosis region. Anastomosis geometry is defined with two angles, one on the coronal plane and the other on the transversal plane. Turbulent flow simulations are performed for each geometry. Results indicate that 3% to 5% of the work given by the LVAD is dissipated because of the viscous losses in the anastomosis region. The entropy generation, as well as the maximum WSS, increases as the inclination angle decreases. Some portion of the blood streaming out of the LVAD conduit flows toward the aortic valve; therefore the reverse-flow region extends up to the aortic valve in some cases, which may be one of the causes of aortic-valve dysfunction. Results of this study provide insight on the importance of the anastomosis geometry on the hemodynamics in the aorta and downstream the aortic valve, stresses on the aortic wall, and viscous losses.

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Section: Resultsmentioning

confidence: 99%