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Malinowski D, Fournier Y, Horbach A, Frick M, Magliani M, Kalverkamp S, Hildinger M, Spillner J, Behbahani M, Hima F. Computational fluid dynamics analysis of endoluminal aortic perfusion. Perfusion 2023; 38:1222-1229. [PMID: 35549763 PMCID: PMC10466979 DOI: 10.1177/02676591221099809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION In peripheral percutaneous (VA) extracorporeal membrane oxygenation (ECMO) procedures the femoral arteries perfusion route has inherent disadvantages regarding poor upper body perfusion due to watershed. With the advent of new long flexible cannulas an advancement of the tip up to the ascending aorta has become feasible. To investigate the impact of such long endoluminal cannulas on upper body perfusion, a Computational Fluid Dynamics (CFD) study was performed considering different support levels and three cannula positions. METHODS An idealized literature-based- and a real patient proximal aortic geometry including an endoluminal cannula were constructed. The blood flow was considered continuous. Oxygen saturation was set to 80% for the blood coming from the heart and to 100% for the blood leaving the cannula. 50% and 90% venoarterial support levels from the total blood flow rate of 6 l/min were investigated for three different positions of the cannula in the aortic arch. RESULTS For both geometries, the placement of the cannula in the ascending aorta led to a superior oxygenation of all aortic blood vessels except for the left coronary artery. Cannula placements at the aortic arch and descending aorta could support supra-aortic arteries, but not the coronary arteries. All positions were able to support all branches with saturated blood at 90% flow volume. CONCLUSIONS In accordance with clinical observations CFD analysis reveals, that retrograde advancement of a long endoluminal cannula can considerably improve the oxygenation of the upper body and lead to oxygen saturation distributions similar to those of a central cannulation.
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Affiliation(s)
- Daniel Malinowski
- Institute for Bioengineering, Biomaterials Laboratory, University of Applied Sciences Aachen, Aachen, Germany
| | - Yvan Fournier
- Fluid Mechanics, Energy and Environment Dpt., EDF R&D, Chatou, France
| | - Andreas Horbach
- Institute for Bioengineering, Biomaterials Laboratory, University of Applied Sciences Aachen, Aachen, Germany
| | - Michael Frick
- Department of Cardiology, Angiology, and Intensive Care, University Hospital Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Mirko Magliani
- Division of Thoracic Surgery and Thoracic Organ Support, University Hospital Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Sebastian Kalverkamp
- Division of Thoracic Surgery and Thoracic Organ Support, University Hospital Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Martin Hildinger
- Division of Thoracic Surgery and Thoracic Organ Support, University Hospital Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Jan Spillner
- Division of Thoracic Surgery and Thoracic Organ Support, University Hospital Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Mehdi Behbahani
- Institute for Bioengineering, Biomaterials Laboratory, University of Applied Sciences Aachen, Aachen, Germany
| | - Flutura Hima
- Division of Thoracic Surgery and Thoracic Organ Support, University Hospital Medical Faculty, RWTH Aachen University, Aachen, Germany
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Hugenroth K, Krooß F, Hima F, Strudthoff L, Kopp R, Arens J, Kalverkamp S, Steinseifer U, Neidlin M, Spillner J. Inflow from a Cardiopulmonary Assist System to the Pulmonary Artery and Its Implications for Local Hemodynamics-a Computational Fluid Dynamics Study. J Cardiovasc Transl Res 2023; 16:842-851. [PMID: 36662482 PMCID: PMC10480287 DOI: 10.1007/s12265-022-10349-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 12/19/2022] [Indexed: 01/21/2023]
Abstract
When returning blood to the pulmonary artery (PA), the inflow jet interferes with local hemodynamics. We investigated the consequences for several connection scenarios using transient computational fluid dynamics simulations. The PA was derived from CT data. Three aspects were varied: graft flow rate, anastomosis location, and inflow jet path length from anastomosis site to impingement on the PA wall. Lateral anastomosis locations caused abnormal flow distribution between the left and right PA. The central location provided near-physiological distribution but induced higher wall shear stress (WSS). All effects were most pronounced at high graft flows. A central location is beneficial regarding flow distribution, but the resulting high WSS might promote detachment of local thromboembolisms or influence the autonomic nervous innervation. Lateral locations, depending on jet path length, result in lower WSS at the cost of an unfavorable flow distribution that could promote pulmonary vasculature changes. Case-specific decisions and further research are necessary.
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Affiliation(s)
- Kristin Hugenroth
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Medical Faculty, RWTH Aachen University, Aachen, Germany.
| | - Felix Krooß
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Flutura Hima
- Department of Thoracic and Cardiovascular Surgery, Medical Faculty, University Hospital, RWTH Aachen University, Aachen, Germany
| | - Lasse Strudthoff
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Rüdger Kopp
- Department of Intensive Care Medicine and Intermediate Care, Medical Faculty, University Hospital, RWTH Aachen University, Aachen, Germany
| | - Jutta Arens
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Sebastian Kalverkamp
- Department of Thoracic and Cardiovascular Surgery, Medical Faculty, University Hospital, RWTH Aachen University, Aachen, Germany
| | - Ulrich Steinseifer
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Michael Neidlin
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Jan Spillner
- Department of Thoracic and Cardiovascular Surgery, Medical Faculty, University Hospital, RWTH Aachen University, Aachen, Germany
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Ho R, McDonald C, Pauls JP, Li Z. Effect of aortic cannulation depth on air emboli transport during cardiopulmonary bypass: A computational study. Perfusion 2022:2676591221092942. [DOI: 10.1177/02676591221092942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction Varying the insertion depth of the aortic cannula during cardiopulmonary bypass (CPB) has been investigated as a strategy to mitigate cerebral emboli, yet its effectiveness associated with CPB flow is not fully understood. We compared different arterial cannula insertion depths and pump flow influencing air microemboli entering the aortic arch branch arteries (AABA). Methods A computational approach used a patient-specific aorta model to evaluate four cannula locations at (1) proximal arch, (2) mid arch, (3) distal arch, and (4) descending aorta. We injected 0.1 mm microemboli (N=720) at 2 and 5 L/min and assessed the embolic load and the particle averaged transit times ( entering the AABA. Results Location 4 had the lowest embolic load (2 L/min: N= 63) and (5 L/min: N= 54) compared to locations 1 to 3 in the range of (N= 118 to 116 at 2 L/min:) and (N= 92 to 146 at 5 L/min). There was no significant difference between 2 L/min and 5 L/min (p = 0.31), despite 5 L/min attaining a lower mean (±standard deviation) than 2 L/min (38.0±23.4 vs 44.5±21.1), respectively. Progressing from location 1 to 4, increased 3.11s -7.40 s at 2 L/min and 1.81s -4.18s at 5 L/min. Conclusion It was demonstrated that the elongated cannula insertion length resulted in lower embolic loads, particularly at a higher flow rate. The numerical results suggest that CPB management could combine active flow variation with improving cannula performance and provide a foundation for a future experimental and clinical investigation to reduce surgical cerebral air microemboli.
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Affiliation(s)
- Raymond Ho
- School of Mechanical, Medical and Process Engineering, Faculty of Engineering, Queensland University of Technology (QUT), Brisbane, QLD, Australia
- Innovative Cardiovascular Engineering and Technology Laboratory (ICETLAB), Critical Care Research Group, The Prince Charles Hospital, Brisbane, Qld, Australia
| | - Charles McDonald
- Department of Anaesthesia and Perfusion, The Prince Charles Hospital, Chermside, Qld, Australia
| | - Jo P Pauls
- Innovative Cardiovascular Engineering and Technology Laboratory (ICETLAB), Critical Care Research Group, The Prince Charles Hospital, Brisbane, Qld, Australia
- School of Engineering and Built Environment, Griffith University, Southport, QLD, Australia
| | - Zhiyong Li
- School of Mechanical, Medical and Process Engineering, Faculty of Engineering, Queensland University of Technology (QUT), Brisbane, QLD, Australia
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Hugenroth K, Neidlin M, Engelmann UM, Kaufmann TAS, Steinseifer U, Heilmann T. Tipless transseptal cannula concept combines improved hemodynamic properties and risk-reduced placement: An in silico proof-of-concept. Artif Organs 2021; 45:1024-1035. [PMID: 33851427 DOI: 10.1111/aor.13964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 03/17/2021] [Accepted: 04/06/2021] [Indexed: 11/30/2022]
Abstract
As a leading cause of death worldwide, heart failure is a serious medical condition in which many critically ill patients require temporary mechanical circulatory support (MCS) as a bridge-to-recovery or bridge-to-decision. In many cases, the TandemHeart system is used to unload the left heart by draining blood from the left atrium (LA) to the femoral artery via a transseptal multistage cannula. However, even though the correct positioning of the cannula is crucial for a safe treatment, the long cannula tip currently used in transseptal cannulas complicates positioning, making the cannula vulnerable to displacement during MCS. To overcome these limitations, we propose the development of a new tipless transseptal cannula with improved hemodynamic properties. We discuss the tipless cannula concept by comparing it to the common multistage cannula concept using computational fluid dynamics simulations and assess the flow field in the LA, the wall shear stresses (WSS), and the pressure loss. Across the two distinct time points of end-systole and end-diastole and two drainage flow rates of 3.5 and 5.0 L/min, we find a more homogeneous inlet flow pattern for the tipless cannula concept, accompanied by a remarkably reduced area of platelet-activating WSS (up to 10-times smaller area compared to the multistage cannula). Moreover, pressure loss is up to 14.5% lower in the tipless cannula concept, confirming overall improved hemodynamic properties of the tipless cannula concept. Finally, a diameter-dependent study reveals that lower WSS and pressure losses can be further reduced by large-lumen designs for any simulation setting. Overall, our results suggest that a tipless cannula concept remedies the crucial disadvantages of a long-tip multistage cannula by reducing the risk of misplacement, and it furthermore promotes optimized hemodynamics. With this successful proof-of-concept, we underscore the potential for and encourage the realization of further experimental investigations regarding the development of a tipless transseptal cannula for MCS.
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Affiliation(s)
- Kristin Hugenroth
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Faculty of Medicine, RWTH Aachen University, Aachen, Germany.,enmodes GmbH, Aachen, Germany
| | - Michael Neidlin
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - Ulrich M Engelmann
- enmodes GmbH, Aachen, Germany.,Department of Medical Engineering and Applied Mathematics, FH Aachen University of Applied Sciences, Aachen, Germany
| | - Tim A S Kaufmann
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Faculty of Medicine, RWTH Aachen University, Aachen, Germany.,enmodes GmbH, Aachen, Germany
| | - Ulrich Steinseifer
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
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Rasooli R, Pekkan K. Heart valve inspired and multi‐stream aortic cannula: Novel designs for cardiopulmonary bypass improvement in neonates. Artif Organs 2019; 43:E233-E248. [DOI: 10.1111/aor.13462] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 03/14/2019] [Accepted: 03/21/2019] [Indexed: 12/14/2022]
Affiliation(s)
- Reza Rasooli
- Department of Mechanical Engineering Koç University Sarıyer, Istanbul Turkey
| | - Kerem Pekkan
- Department of Mechanical Engineering Koç University Sarıyer, Istanbul Turkey
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Fulker D, Sayed Z, Simmons A, Barber T. Computational Fluid Dynamic Analysis of the Hemodialysis Plastic Cannula. Artif Organs 2017; 41:1035-1042. [DOI: 10.1111/aor.12901] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 10/13/2016] [Accepted: 10/19/2016] [Indexed: 12/26/2022]
Affiliation(s)
- David Fulker
- School of Mechanical and Manufacturing Engineering; University of New South Wales; Sydney Australia
| | - Zakir Sayed
- School of Mechanical and Manufacturing Engineering; University of New South Wales; Sydney Australia
| | - Anne Simmons
- School of Mechanical and Manufacturing Engineering; University of New South Wales; Sydney Australia
| | - Tracie Barber
- School of Mechanical and Manufacturing Engineering; University of New South Wales; Sydney Australia
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Pike D, Shiu YT, Somarathna M, Guo L, Isayeva T, Totenhagen J, Lee T. High resolution hemodynamic profiling of murine arteriovenous fistula using magnetic resonance imaging and computational fluid dynamics. Theor Biol Med Model 2017; 14:5. [PMID: 28320412 PMCID: PMC5360029 DOI: 10.1186/s12976-017-0053-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 03/14/2017] [Indexed: 11/21/2022] Open
Abstract
Background Arteriovenous fistula (AVF) maturation failure remains a major cause of morbidity and mortality in hemodialysis patients. The two major etiologies of AVF maturation failure are early neointimal hyperplasia development and persistent inadequate outward remodeling. Although hemodynamic changes following AVF creation may impact AVF remodeling and contribute to neointimal hyperplasia development and impaired outward remodeling, detailed AVF hemodynamics are not yet fully known. Since murine AVF models are valuable tools for investigating the pathophysiology of AVF maturation failure, there is a need for a new approach that allows the hemodynamic characterization of murine AVF at high resolutions. Methods This methods paper presents a magnetic resonance imaging (MRI)-based computational fluid dynamic (CFD) method that we developed to rigorously quantify the evolving hemodynamic environment in murine AVF. The lumen geometry of the entire murine AVF was reconstructed from high resolution, non-contrast 2D T2-weighted fast spin echo MRI sequence, and the flow rates of the AVF inflow and outflow were extracted from a gradient echo velocity mapping sequence. Using these MRI-obtained lumen geometry and inflow information, CFD modeling was performed and used to calculate blood flow velocity and hemodynamic factors at high resolutions (on the order of 0.5 μm spatially and 0.1 ms temporally) throughout the entire AVF lumen. We investigated both the wall properties (including wall shear stress (WSS), wall shear stress spatial gradient, and oscillatory shear index (OSI)) and the volumetric properties (including vorticity, helicity, and Q-criterion). Results Our results demonstrate increases in AVF flow velocity, WSS, spatial WSS gradient, and OSI within 3 weeks post-AVF creation when compared to pre-surgery. We also observed post-operative increases in flow disturbances and vortices, as indicated by increased vorticity, helicity, and Q-criterion. Conclusions This novel protocol will enable us to undertake future mechanistic studies to delineate the relationship between hemodynamics and AVF development and characterize biological mechanisms that regulate local hemodynamic factors in transgenic murine AVF models. Electronic supplementary material The online version of this article (doi:10.1186/s12976-017-0053-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Daniel Pike
- Department of Bioengineering, University of Utah, Salt Lake City, UT, USA.,Division of Nephrology and Hypertension, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - Yan-Ting Shiu
- Department of Bioengineering, University of Utah, Salt Lake City, UT, USA.,Division of Nephrology and Hypertension, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - Maheshika Somarathna
- Department of Medicine and Division of Nephrology, University of Alabama at Birmingham, 1720 2nd Ave South, Birmingham, AL, 35294-0007, USA
| | - Lingling Guo
- Department of Medicine and Division of Nephrology, University of Alabama at Birmingham, 1720 2nd Ave South, Birmingham, AL, 35294-0007, USA
| | - Tatyana Isayeva
- Department of Medicine and Division of Nephrology, University of Alabama at Birmingham, 1720 2nd Ave South, Birmingham, AL, 35294-0007, USA
| | - John Totenhagen
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Timmy Lee
- Department of Medicine and Division of Nephrology, University of Alabama at Birmingham, 1720 2nd Ave South, Birmingham, AL, 35294-0007, USA. .,Veterans Affairs Medical Center, Birmingham, AL, USA.
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Neidlin M, Corsini C, Sonntag SJ, Schulte-Eistrup S, Schmitz-Rode T, Steinseifer U, Pennati G, Kaufmann TAS. Hemodynamic analysis of outflow grafting positions of a ventricular assist device using closed-loop multiscale CFD simulations: Preliminary results. J Biomech 2016; 49:2718-2725. [PMID: 27298155 DOI: 10.1016/j.jbiomech.2016.06.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Revised: 05/30/2016] [Accepted: 06/01/2016] [Indexed: 11/17/2022]
Abstract
Subclavian arteries are a possible alternate location for left ventricular assist device (LVAD) outflow grafts due to easier surgical access and application in high risk patients. As vascular blood flow mechanics strongly influence the clinical outcome, insights into the hemodynamics during LVAD support can be used to evaluate different grafting locations. In this study, the feasibility of left and right subclavian artery (SA) grafting was investigated for the HeartWare HVAD with a numerical multiscale model. A 3-D CFD model of the aortic arch was coupled to a lumped parameter model of the cardiovascular system under LVAD support. Grafts in the left and right SA were placed at three different anastomoses angles (90°, 60° and 30°). Additionally, standard grafting of the ascending and descending aorta was modelled. Full support LVAD (5l/min) and partial support LVAD (3l/min) in co-pulsation and counter-pulsation mode were analysed. The grafting positions were investigated regarding coronary and cerebral perfusion. Furthermore, the influence of the anastomosis angle on wall shear stress (WSS) was evaluated. Grafting of left or right subclavian arteries has similar hemodynamic performance in comparison to standard cannula positions. Angularity change of the graft anastomosis from 90° to 30° slightly increases the coronary and cerebral blood flow by 6-9% while significantly reduces the WSS by 35%. Cannulation of the SA is a feasible anastomosis location for the HVAD in the investigated vessel geometry.
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Affiliation(s)
- Michael Neidlin
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University, Aachen, Germany; Enmodes GmbH, Aachen, Germany.
| | - Chiara Corsini
- Laboratory of Biological Structure Mechanics, Department of Chemistry, Materials and Chemical Engineering ''Giulio Natta'', Politecnico di Milano, Milano, Italy
| | - Simon J Sonntag
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University, Aachen, Germany; Enmodes GmbH, Aachen, Germany
| | | | - Thomas Schmitz-Rode
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University, Aachen, Germany
| | - Ulrich Steinseifer
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University, Aachen, Germany
| | - Giancarlo Pennati
- Laboratory of Biological Structure Mechanics, Department of Chemistry, Materials and Chemical Engineering ''Giulio Natta'', Politecnico di Milano, Milano, Italy
| | - Tim A S Kaufmann
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University, Aachen, Germany; Enmodes GmbH, Aachen, Germany
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Percutaneous Double Lumen Cannula for Right Ventricle Assist Device System: A Computational Fluid Dynamics Study. Biocybern Biomed Eng 2016; 36:482-490. [PMID: 27570334 DOI: 10.1016/j.bbe.2016.04.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVES Our goal is to develop a double lumen cannula (DLC) for a percutaneous right ventricular assist device (pRVAD) in order to eliminate two open chest surgeries for RVAD installation and removal. The objective of this study was to evaluate the performance, flow pattern, blood hemolysis, and thrombosis potential of the pRVAD DLC. METHODS Computational fluid dynamics (CFD), using the finite volume method, was performed on the pRVAD DLC. For Reynolds numbers <4000, the laminar model was used to describe the blood flow behavior, while shear-stress transport k-ω model was used for Reynolds numbers >4000. Bench testing with a 27 Fr prototype was performed to validate the CFD calculations. RESULTS There was <1.3% difference between the CFD and experimental pressure drop results. The Lagrangian approach revealed a low index of hemolysis (0.012% in drainage lumen and 0.0073% in infusion lumen) at 5 l/min flow rate. Blood stagnancy and recirculation regions were found in the CFD analysis, indicating a potential risk for thrombosis. CONCLUSIONS The pRVAD DLC can handle up to 5 l/min flow with limited potential hemolysis. Further modification of the pRVAD DLC is needed to address blood stagnancy and recirculation.
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Gu K, Zhang Y, Gao B, Chang Y, Zeng Y. Hemodynamic Differences Between Central ECMO and Peripheral ECMO: A Primary CFD Study. Med Sci Monit 2016; 22:717-26. [PMID: 26938949 PMCID: PMC4780269 DOI: 10.12659/msm.895831] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background Veno-arterial extracorporeal membrane oxygenation (VAECMO), including central ECMO (cECMO) and peripheral ECMO (pECMO), is widely used in cardiopulmonary surgery. The outcomes and complications of both types of ECMO are quite different from each other. The hemodynamic differences among them are hypothesized as a key factor. Hence, a numerical study was conducted to test this hypothesis. Material/Methods Ideal cardiovascular models with pECMO and cECMO were established. The aortic pressure and flow rate were chosen as boundary conditions. The flow pattern, blood flow distributions, flow junction, harmonic index (HI) of blood flow, wall shear stress (WSS), and the oscillatory shear index (OSI) were calculated to evaluate the hemodynamic states. Results pECMO could achieve better upper limb and brain perfusion (0.05458 vs. 0.05062 kg/s), and worse lower limb perfusion (0.03067 vs. 0.03401 kg/s). There exist low WSS (<0.4 pa) regions at the inner and posterior wall of the aorta, and high WSS (>2 pa) region at the access of the femoral artery. These regions also have relatively high OSI value (reaching 0.45). In contrast, for cECMO, there exist high WSS at the posterior wall of the aortic arch. Conclusions The hemodynamic performances of various types of ECMO are different from each other, which maybe the key reasons for the differences in the outcomes and complications. Therefore, for pEMCO, the lower-extremity ischemia is a complication that must be considered. The type, support level, and duration of ECMO should also be carefully regulated according to the patients’ condition, as they are the important factors related to vascular complications.
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Affiliation(s)
- Kaiyun Gu
- of Life Science and BioEngineering, Beijing University of Technology, Beijing, China (mainland)
| | - Ya Zhang
- School of Life Science and BioEngineering, Beijing University of Technology, Beijing, China (mainland)
| | - Bin Gao
- School of Life Science and BioEngineering, Beijing University of Technology, Beijing, China (mainland)
| | - Yu Chang
- School of Life Science and BioEngineering, Beijing University of Technology, Beijing, China (mainland)
| | - Yi Zeng
- School of Life Science and BioEngineering, Beijing University of Technology, Beijing, China (mainland)
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Piskin S, Ündar A, Pekkan K. Computational Modeling of Neonatal Cardiopulmonary Bypass Hemodynamics With Full Circle of Willis Anatomy. Artif Organs 2015; 39:E164-75. [DOI: 10.1111/aor.12468] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- Senol Piskin
- Department of Mechanical Engineering; Koc University; Istanbul Turkey
| | - Akif Ündar
- Pediatric Cardiovascular Research Center; Department of Pediatrics, Surgery and Bioengineering; Penn State Hershey College of Medicine; Hershey PA USA
| | - Kerem Pekkan
- Department of Mechanical Engineering; Koc University; Istanbul Turkey
- Department of Biomedical Engineering; Carnegie Mellon University; Pittsburgh PA USA
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