On the impact of vessel wall stiffness on quantitative flow dynamics in a synthetic model of the thoracic aorta

Zimmermann, Judith; Loecher, Michael; Kolawole, Fikunwa O.; Bäumler, Kathrin; Gifford, Kyle; Dual, Seraina A.; Levenston, Marc E.; Marsden, Alison L.; Ennis, Daniel B.

doi:10.1038/s41598-021-86174-6

Cited by 15 publications

(14 citation statements)

References 43 publications

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“…The current setup has been previously validated in its ability to reproduce realistic pressure and flow conditions that accurately recapitulate in vivo vascular hemodynamics. [ 41 ] Furthermore, we present evaluative hemodynamic metrics that can be accurately obtained from this setup and be directly compared to clinical literature, namely diastolic pressure augmentation and systolic pressure reduction. These metrics are of interest in the explorative benefit analysis for RV performance and biomechanics.…”

Section: Discussionmentioning

confidence: 99%

Electrohydraulic Vascular Compression Device (e‐VaC) with Integrated Sensing and Controls

Pirozzi

Kight

Liang

et al. 2022

Adv Materials Technologies

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pulmonary circulation, remains a major clinical burden bearing high morbidity and mortality, particularly in the perioperative setting. [1] Specifically, procedures including valve repairs, implantation of LVAD devices or cardiopulmonary bypass bear a high risk of refractory RV failure due to sudden altered hemodynamic demand on the ventricle, which requires fast adaptation. [2,3] The development of suitable mechanical circulatory solutions to provide adequate perioperative support to the RV is an active area of research. Two primary clinical requirements drive this system design challenge: 1) Solutions should be designed to avoid contact with blood and 2) Solutions should be designed toward the elimination of pneumatic drivelines. The ideal solution should provide temporary perioperative support, with the potential for long-term implantation.Despite ongoing research and development efforts toward artificial cardiac assist devices, often heart transplantation remains the sole definitive treatment option for patients suffering from severe heart failure. [4] Mechanical alternatives to transplantation have been the focus of decades of research, with ventricular assist devices (VADs) and vascular pulsation devices emerging as key clinical strategies to provide mechanical cardiac support. Vascular pulsatile support has been widely investigated and clinically adopted to provide Right ventricular (RV) failure remains a significant clinical burden particularly during the perioperative period surrounding major cardiac surgeries, such as implantation of left ventricular assist devices (LVADs), bypass procedures or valvular surgeries. Device solutions designed to support the function of the RV do not keep up with the pace of development of left-sided solutions, leaving the RV vulnerable to acute failure in the challenging hemodynamic environments of the perioperative setting. This work describes the design of a biomimetic, soft, conformable sleeve that can be prophylactically implanted on the pulmonary artery to support RV ventricular function during major cardiac surgeries, through afterload reduction and augmentation of flow. Leveraging electrohydraulic principles, a technology is proposed that is non-blood contacting and obviates the necessity for drivelines by virtue of being electrically powered. In addition, the integration of an adjacent is demonstrate, continuous pressure sensing module to support physiologically adaptive control schemes based on a real-time biological signal. In vitro experiments conducted in a pulsatile flowloop replicating physiological flow and pressure conditions show a reduction of mean pulmonary arterial pressure of 8 mmHg (25% reduction), a reduction in peak systolic arterial pressure of up to 10 mmHg (20% reduction), and a concomitant 19% increase in diastolic pulmonary flow. Computational simulations further predict substantial augmentation of cardiac output as a result of reduced RV ventricular stress and RV dilatation.

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Section: Discussionmentioning

confidence: 99%

Electrohydraulic Vascular Compression Device (e‐VaC) with Integrated Sensing and Controls

Pirozzi

Kight

Liang

et al. 2022

Adv Materials Technologies

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“…Numerous other flow circuits with compliant flow phantoms fabricated from silicone, polyurethane, or latex 15,16,34 have also been engineered to investigate cardiovascular hemodynamics in health and disease and to further assess the performance of implantable devices. Recent advances in 3D printing techniques, 13 including PolyJet and stereolithography, now enable rapid, repeatable printing of compliant patient-specific flow phantoms from novel photopolymers 5,11,36 without the need for laborious procedures. Importantly, mechanical characterization of these cost-effective phantoms can be performed to inform FSI validation studies.…”

Section: Glossary Of Termsmentioning

confidence: 99%

“…In a previously published study, 36 we demonstrated the use of novel compliant 3D printing to fabricate patient-specific aortic phantoms of three stiffness values, which were then embedded in an MRI-compatible flow circuit under physiological hemodynamic conditions. In our current study, we focus only on the most compliant phantom and assess the RUC formulation by drawing direct comparisons to the experimentally measured three-component 3D velocities, flow rates, pressures, luminal area changes, and pulse wave velocity.…”

Section: Glossary Of Termsmentioning

confidence: 99%

Validation of the Reduced Unified Continuum Formulation Against In Vitro 4D-Flow MRI

Lan¹,

Liu²,

Yang³

et al. 2022

Preprint

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In our recent work, we introduced the reduced unified continuum formulation for vascular fluid-structure interaction (FSI) and demonstrated enhanced solver accuracy, scalability, and performance compared to conventional approaches. We further verified the formulation against Womersley's deformable wall theory. In this study, we assessed its performance in a compliant patient-specific aortic model by leveraging 3D printing, 2D magnetic resonance imaging (MRI), and 4D-flow MRI to extract high-resolution anatomical and hemodynamic information from an in vitro flow circuit. To accurately reflect experimental conditions, we additionally enabled in-plane vascular motion at each inlet and outlet, and implemented viscoelastic external tissue support and vascular tissue prestressing. Validation of our formulation is achieved through close quantitative agreement in pressures, lumen area changes, pulse wave velocity, and early systolic velocities, as well as qualitative agreement in late systolic flow structures. Our validated suite of FSI techniques can be used to investigate vascular disease initiation, progression, and treatment at a computational cost on the same order as that of rigid-walled simulations. This study is the first to validate a cardiovascular FSI formulation against an in vitro flow circuit involving a compliant vascular phantom of complex patient-specific anatomy.

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“…Cardiac blood flow analysis is commonly assessed via both imaging and experimental techniques. For instance, 4D flow MRI [7], one of the most advanced imaging techniques, allows the detection of a time-dependent blood flow field [8], the estimate of haemodynamics parameters as flow stasis, mean velocity [9], and particle tracking [10]. However, the resolution provided by 4D flow MRI might be not enough to accurately catch the complexity of cardiac flows and their transitional effects: formation of shear layers, small vortices, and their interactions [11,12,13,14,15].…”

Section: Introductionmentioning

confidence: 99%

Impact of Atrial Fibrillation on Left Atrium Haemodynamics: A Computational Fluid Dynamics Study

Corti¹,

Zingaro²,

Dedè³

et al. 2022

Preprint

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We analyze left atrium haemodynamics, highlighting differences among healthy individuals and patients affected by atrial fibrillation. The computational study is based on patient-specific geometries of the left atria to simulate blood flow dynamics. We devise a novel procedure aimed at recovering the boundary conditions for the 3D haemodynamics simulations, particularly useful in absence of specific ones provided by clinical measurements. With this aim, we introduce a parametric definition of the atria displacement, and we employ a closed-loop lumped parameter model of the whole cardiocirculatory system conveniently tuned on the basis of the patient characteristics. We evaluate a number of fluid dynamics indicators for the atrial haemodynamics, validating our numerical results in terms of several clinical measurements; we investigate the impact of geometrical and clinical features on the risk of thrombosis. To analyse the correlation of thrombus formation with atrial fibrillation, coherently with the medical evidence, we propose a novel indicator, which we call age stasis and that arises from the combination of Eulerian and Lagrangian quantities. This indicator identifies regions where the slow flow cannot rinse the chamber properly, accumulating stale blood particles and creating optimal conditions for clot formation.

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On the impact of vessel wall stiffness on quantitative flow dynamics in a synthetic model of the thoracic aorta

Cited by 15 publications

References 43 publications

Electrohydraulic Vascular Compression Device (e‐VaC) with Integrated Sensing and Controls

Electrohydraulic Vascular Compression Device (e‐VaC) with Integrated Sensing and Controls

Validation of the Reduced Unified Continuum Formulation Against In Vitro 4D-Flow MRI

Impact of Atrial Fibrillation on Left Atrium Haemodynamics: A Computational Fluid Dynamics Study

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