Computational analysis of the effect of the type of LVAD flow on coronary perfusion and ventricular afterload.
We developed a computational model to investigate the hemodynamic effects of a pulsatile left ventricular assist device (LVAD) on the cardiovascular system. The model consisted of 16 compartments for the cardiovascular system, including coronary circulation and LVAD, and autonomic nervous system control. A failed heart was modeled by decreasing the end-systolic elastance of the ventricle and blocking the mechanism controlling heart contractility. We assessed the physiological effect of the LVAD on the cardiovascular system for three types of LVAD flow: co-pulsation, counter-pulsation, and continuous flow modes. The results indicated that the pulsatile LVAD with counter-pulsation mode gave the most physiological coronary blood perfusion. In addition, the counter-pulsation mode resulted in a lower peak pressure of the left ventricle than the other modes, aiding cardiac recovery by reducing the ventricular afterload. In conclusion, these results indicate that, from the perspective of cardiovascular physiology, a pulsatile LVAD with counter-pulsation operation is a plausible alternative to the existing LVAD with continuous flow mode.
Lim
Ki Moo
KM
Department of Mechanical and Biomedical Engineering, Kangwon National University, Hyoja-dong, Chuncheon, Gangwon-do, Republic of Korea.
Kim
In Su
IS
Choi
Seong Wook
SW
Min
Byung Goo
BG
Won
Yong Soon
YS
Kim
Heon Young
HY
Shim
Eun Bo
EB
D001341:Autonomic Nervous System / Q000502:physiology; D003326:Coronary Circulation / Q000502:physiology*; D006353:Heart-Assist Devices / Q000706:statistics & numerical data*; D006801:Humans; D008955:Models, Cardiovascular; D015233:Models, Statistical; D011673:Pulsatile Flow / Q000502:physiology; D016277:Ventricular Function, Left / Q000502:physiology; D017725:Ventricular Pressure / Q000502:physiology