The hemodynamics of the Berlin pulsatile VAD and the role of its MHV configuration.
The 3D flow in a model of the Berlin ventricular assist device (VAD) chamber with monoleaflet valves placed in S-shape conduits was simulated numerically. The blood flow dynamics were described in terms of flow patterns, velocity, pressure, and shear stress. The hemodynamic properties and the VAD's potential risk for thrombosis were evaluated in terms of mixing and washout properties, and global estimations of platelet level of activation (LOA). In order to evaluate the role of valves on the flow in the chamber, the flow in a model with bileaflet valves in straight conduits was simulated and compared with the original case. The results showed that in both models a large rotating flow was developed in the chamber during filling. This vortex filled the entire chamber and moved constantly up to the peak ejection phase, resulting in relatively low shear stress (up to 0.4 Pa) and no lasting stagnation regions. Significant shear stresses were found near the valves with higher values near the outlet valve in both models. The configuration of valves and conduits had a large effect on VAD washout and mixing properties, with advantage to the bileaflet model. However, since the bileaflet valves exhibited higher shear stresses, higher LOA were found for the bileaflet model.
Avrahami
Idit
I
California Institute of Technology, MC 301-46, Pasadena, California 91125, USA. idit@caltech.edu
Rosenfeld
Moshe
M
Einav
Shmuel
S
D000818:Animals; D001783:Blood Flow Velocity; D001792:Blood Platelets / Q000378:metabolism; D003198:Computer Simulation; D006350:Heart Valve Prosthesis; D006351:Heart Valves / Q000378:metabolism / Q000503:physiopathology; D006353:Heart-Assist Devices; D006801:Humans; D008955:Models, Cardiovascular; D011673:Pulsatile Flow; D012307:Risk Factors; D033081:Shear Strength; D013927:Thrombosis / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology