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Girfoglio M, Ballarin F, Infantino G, Nicoló F, Montalto A, Rozza G, Scrofani R, Comisso M, Musumeci F. Non-intrusive PODI-ROM for patient-specific aortic blood flow in presence of a LVAD device. Med Eng Phys 2022; 107:103849. [DOI: 10.1016/j.medengphy.2022.103849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 06/23/2022] [Accepted: 07/10/2022] [Indexed: 10/17/2022]
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2
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Ghodrati M, Khienwad T, Maurer A, Moscato F, Zonta F, Schima H, Aigner P. Validation of numerically simulated ventricular flow patterns during left ventricular assist device support. Int J Artif Organs 2020; 44:30-38. [PMID: 32022612 PMCID: PMC7780364 DOI: 10.1177/0391398820904056] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Intraventricular flow patterns during left ventricular assist device support have been investigated via computational fluid dynamics by several groups. Based on such simulations, specific parameters for thrombus formation risk analysis have been developed. However, computational fluid dynamic simulations of complex flow configurations require proper validation by experiments. To meet this need, a ventricular model with a well-defined inflow section was analyzed by particle image velocimetry and replicated by transient computational fluid dynamic simulations. To cover the laminar, transitional, and turbulent flow regime, four numerical methods including the laminar, standard k-omega, shear-stress transport, and renormalized group k-epsilon were applied and compared to the particle image velocimetry results in 46 different planes in the whole left ventricle. The simulated flow patterns for all methods, except renormalized group k-epsilon, were comparable to the flow patterns measured using particle image velocimetry (absolute error over whole left ventricle: laminar: 10.5, standard k-omega: 11.3, shear–stress transport: 11.3, and renormalized group k-epsilon: 17.8 mm/s). Intraventricular flow fields were simulated using four numerical methods and validated with experimental particle image velocimetry results. In the given setting and for the chosen boundary conditions, the laminar, standard K-omega, and shear–stress transport methods showed acceptable similarity to experimental particle image velocimetry data, with the laminar model showing the best transient behavior.
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Affiliation(s)
- Mojgan Ghodrati
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Austria.,Ludwig Boltzmann Institute for Cardiovascular Research, Vienna, Austria
| | - Thananya Khienwad
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Austria
| | - Alexander Maurer
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Austria.,Ludwig Boltzmann Institute for Cardiovascular Research, Vienna, Austria
| | - Francesco Moscato
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Austria.,Ludwig Boltzmann Institute for Cardiovascular Research, Vienna, Austria
| | - Francesco Zonta
- Institute of Fluid Dynamics and Heat Transfer, Technical University of Vienna, Austria
| | - Heinrich Schima
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Austria.,Ludwig Boltzmann Institute for Cardiovascular Research, Vienna, Austria.,Department for Cardiac Surgery, Medical University of Vienna, Austria
| | - Philipp Aigner
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Austria.,Ludwig Boltzmann Institute for Cardiovascular Research, Vienna, Austria
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Mazzitelli R, Boyle F, Murphy E, Renzulli A, Fragomeni G. Numerical prediction of the effect of aortic Left Ventricular Assist Device outflow-graft anastomosis location. Biocybern Biomed Eng 2016. [DOI: 10.1016/j.bbe.2016.01.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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4
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Rossini L, Martinez-Legazpi P, Vu V, Fernández-Friera L, Pérez Del Villar C, Rodríguez-López S, Benito Y, Borja MG, Pastor-Escuredo D, Yotti R, Ledesma-Carbayo MJ, Kahn AM, Ibáñez B, Fernández-Avilés F, May-Newman K, Bermejo J, Del Álamo JC. A clinical method for mapping and quantifying blood stasis in the left ventricle. J Biomech 2015; 49:2152-2161. [PMID: 26680013 DOI: 10.1016/j.jbiomech.2015.11.049] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Accepted: 11/07/2015] [Indexed: 11/30/2022]
Abstract
In patients at risk of intraventrcular thrombosis, the benefits of chronic anticoagulation therapy need to be balanced with the pro-hemorrhagic effects of therapy. Blood stasis in the cardiac chambers is a recognized risk factor for intracardiac thrombosis and potential cardiogenic embolic events. In this work, we present a novel flow image-based method to assess the location and extent of intraventricular stasis regions inside the left ventricle (LV) by digital processing flow-velocity images obtained either by phase-contrast magnetic resonance (PCMR) or 2D color-Doppler velocimetry (echo-CDV). This approach is based on quantifying the distribution of the blood Residence Time (TR) from time-resolved blood velocity fields in the LV. We tested the new method in illustrative examples of normal hearts, patients with dilated cardiomyopathy and one patient before and after the implantation of a left ventricular assist device (LVAD). The method allowed us to assess in-vivo the location and extent of the stasis regions in the LV. Original metrics were developed to integrate flow properties into simple scalars suitable for a robust and personalized assessment of the risk of thrombosis. From a clinical perspective, this work introduces the new paradigm that quantitative flow dynamics can provide the basis to obtain subclinical markers of intraventricular thrombosis risk. The early prediction of LV blood stasis may result in decrease strokes by appropriate use of anticoagulant therapy for the purpose of primary and secondary prevention. It may also have a significant impact on LVAD device design and operation set-up.
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Affiliation(s)
- Lorenzo Rossini
- Mechanical and Aerospace Engineering Department, University of California San Diego, La Jolla, CA 92093, United States
| | - Pablo Martinez-Legazpi
- Mechanical and Aerospace Engineering Department, University of California San Diego, La Jolla, CA 92093, United States; Department of Cardiology, Hospital General Universitario Gregorio Marañón and Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; Department of Mechanical Engineering, San Diego State University, San Diego, CA 92182, United States.
| | - Vi Vu
- Department of Mechanical Engineering, San Diego State University, San Diego, CA 92182, United States
| | | | - Candelas Pérez Del Villar
- Department of Cardiology, Hospital General Universitario Gregorio Marañón and Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Sara Rodríguez-López
- Biomedical Image Technologies, Universidad Politécnica de Madrid & CIBER-BBN, Spain
| | - Yolanda Benito
- Department of Cardiology, Hospital General Universitario Gregorio Marañón and Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - María-Guadalupe Borja
- Mechanical and Aerospace Engineering Department, University of California San Diego, La Jolla, CA 92093, United States
| | | | - Raquel Yotti
- Department of Cardiology, Hospital General Universitario Gregorio Marañón and Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | | | - Andrew M Kahn
- Department of Medicine, University of California San Diego, La Jolla, CA 92037, United States
| | - Borja Ibáñez
- Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain
| | - Francisco Fernández-Avilés
- Department of Cardiology, Hospital General Universitario Gregorio Marañón and Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Karen May-Newman
- Department of Mechanical Engineering, San Diego State University, San Diego, CA 92182, United States
| | - Javier Bermejo
- Department of Cardiology, Hospital General Universitario Gregorio Marañón and Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Juan C Del Álamo
- Mechanical and Aerospace Engineering Department, University of California San Diego, La Jolla, CA 92093, United States; Institute for Engineering in Medicine, University of California San Diego, La Jolla, CA 92093, United States
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Wong K, Samaroo G, Ling I, Dembitsky W, Adamson R, del Álamo JC, May-Newman K. Intraventricular flow patterns and stasis in the LVAD-assisted heart. J Biomech 2014; 47:1485-94. [PMID: 24612721 DOI: 10.1016/j.jbiomech.2013.12.031] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Revised: 12/19/2013] [Accepted: 12/21/2013] [Indexed: 12/01/2022]
Abstract
Left ventricular assist device (LVAD) support disrupts the natural blood flow path through the heart, introducing flow patterns associated with thrombosis, especially in the presence of medical devices. The aim of this study was to quantitatively evaluate the flow patterns in the left ventricle (LV) of the LVAD-assisted heart, with a focus on alterations in vortex development and stasis. Particle image velocimetry of a LVAD-supported LV model was performed in a mock circulatory loop. In the Pre-LVAD flow condition, a vortex ring initiating from the LV base migrated toward the apex during diastole and remained in the LV by the end of ejection. During LVAD support, vortex formation was relatively unchanged although vortex circulation and kinetic energy increased with LVAD speed, particularly in systole. However, as pulsatility decreased and aortic valve opening ceased, a region of fluid stasis formed near the left ventricular outflow tract. These findings suggest that LVAD support does not substantially alter vortex dynamics unless cardiac function is minimal. The altered blood flow introduced by the LVAD results in stasis adjacent to the LV outflow tract, which increases the risk of thrombus formation in the heart.
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Affiliation(s)
- K Wong
- Bioengineering Program, San Diego State University, Department of Mechanical Engineering, San Diego, CA 92182-1323, United States
| | - G Samaroo
- Bioengineering Program, San Diego State University, Department of Mechanical Engineering, San Diego, CA 92182-1323, United States
| | - I Ling
- Bioengineering Program, San Diego State University, Department of Mechanical Engineering, San Diego, CA 92182-1323, United States
| | - W Dembitsky
- Mechanical Circulatory Support, Cardiothoracic Surgery, Sharp Memorial Hospital, San Diego, CA 92182-1323, United States
| | - R Adamson
- Mechanical Circulatory Support, Cardiothoracic Surgery, Sharp Memorial Hospital, San Diego, CA 92182-1323, United States
| | - J C del Álamo
- Mechanical and Aerospace Engineering, U.C. San Diego, La Jolla, CA 92093-0411, United States; Institute for Engineering in Medicine, U.C. San Diego, La Jolla, CA 92093, United States
| | - K May-Newman
- Bioengineering Program, San Diego State University, Department of Mechanical Engineering, San Diego, CA 92182-1323, United States.
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Hendabadi S, Bermejo J, Benito Y, Yotti R, Fernández-Avilés F, del Álamo JC, Shadden SC. Topology of blood transport in the human left ventricle by novel processing of Doppler echocardiography. Ann Biomed Eng 2013; 41:2603-16. [PMID: 23817765 DOI: 10.1007/s10439-013-0853-z] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2012] [Accepted: 06/20/2013] [Indexed: 01/28/2023]
Abstract
Novel processing of Doppler-echocardiography data was used to study blood transport in the left ventricle (LV) of six patients with dilated cardiomyopathy and six healthy volunteers. Bi-directional velocity field maps in the apical long axis of the LV were reconstructed from color-Doppler echocardiography. Resulting velocity field data were used to perform trajectory-based computation of Lagrangian coherent structures (LCS). LCS were shown to reveal the boundaries of blood injected and ejected from the heart over multiple beats. This enabled qualitative and quantitative assessments of blood transport patterns and residence times in the LV. Quantitative assessments of stasis in the LV are reported, as well as characterization of LV vortex formations from E-wave and A-wave filling.
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Affiliation(s)
- Sahar Hendabadi
- Department of Mechanical, Materials and Aerospace Engineering, Illinois Institute of Technology, Chicago, IL, USA
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