title: Steady flow analysis of mechanical cavopulmonary assistance in MRI-derived patient-specific fontan configurations.
abstract: This numerical study examined the performance of an intravascular axial flow blood pump for mechanical hemodynamic support of patients in the setting of Fontan failure, which presently has few treatment options. Three anatomically accurate geometries of the total cavopulmonary connection (TCPC) were generated using patients' magnetic resonance imaging data. These patient-specific geometries, as well as an idealized version with cylindrical vessels, were computationally analyzed with and without a pump in the inferior vena cava. Pressure flow characteristics, energy gain calculations, and blood damage analyses were performed for each model. The pump produced pressures of 1-14 mm Hg for 1500-4000 revolutions per minute, flow rates of 1-4 L/min, and pulmonary artery pressures of 8-24 mm Hg. Comparison of pump performance among the four models showed minimal intermodel differences (<5% deviation) in the pressure rise generated by the pump, the IVC pressure, and the energy imparted to the system by the pump. Blood damage analysis showed maximum fluid scalar stress values of 372 Pa or less, and the blood damage index was less than 2% in all of the models. These results suggest that this axial flow blood pump performs consistently in a variety of TCPC vessel geometries with low risk of blood trauma.
authors.affiliation: Department of Mechanical and Nuclear Engineering, School of Engineering, Virginia Commonwealth University, Richmond, USA.
authors.forename: Emily A
authors.initials: EA
authors.lastname: Downs
authors.forename: William B
authors.initials: WB
authors.lastname: Moskowitz
authors.forename: Amy L
authors.initials: AL
authors.lastname: Throckmorton
mesh_terms: D003198:Computer Simulation; D004867:Equipment Design; D018729:Fontan Procedure / Q000295:instrumentation*; D006353:Heart-Assist Devices; D006439:Hemodynamics; D006801:Humans; D008279:Magnetic Resonance Imaging; D008953:Models, Anatomic; D008955:Models, Cardiovascular; D011651:Pulmonary Artery / Q000033:anatomy & histology / Q000502:physiology / Q000601:surgery; D014682:Vena Cava, Inferior / Q000033:anatomy & histology / Q000502:physiology / Q000601:surgery