title: Design method of a foldable ventricular assist device for minimally invasive implantation.
abstract: To date, ventricular assist devices (VADs) have become accepted as a therapeutic solution for end-stage heart failure patients when a donor heart is not available. Newer generation VADs allow for a significant reduction in size and an improvement in reliability. However, the invasive implantation still limits this technology to critically ill patients. Recently, expandable/deployable devices have been investigated as a potential solution for minimally invasive insertion. Such a device can be inserted percutaneously via peripheral vessels in a collapsed form and operated in an expanded form at the desired location. A common structure of such foldable pumps comprises a memory alloy skeleton covered by flexible polyurethane material. The material properties allow elastic deformation to achieve the folded position and withstand the hydrodynamic forces during operation; however, determining the optimal geometry for such a structure is a complex challenge. The numerical finite element method (FEM) is widely used and provides accurate structural analysis, but computation time is considerably high during the initial design stage where various geometries need to be examined. This article details a simplified two-dimensional analytical method to estimate the mechanical stress and deformation of memory alloy skeletons. The method was applied in design examples including two popular types of blade skeletons of a foldable VAD. Furthermore, three force distributions were simulated to evaluate the strength of the structures under different loading conditions experienced during pump operation. The results were verified with FEM simulations. The proposed two-dimensional method gives a close stress and deformation estimation compared with three-dimensional FEM simulations. The results confirm the feasibility of such a simplified analytical approach to reveal priorities for structural optimization before time-consuming FEM simulations, providing an effective tool in the initial structural design stage of foldable minimally invasive VADs.
authors.affiliation: Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University, Aachen, Germany.
authors.forename: Po-Lin
authors.initials: PL
authors.lastname: Hsu
authors.forename: Yaxin
authors.initials: Y
authors.lastname: Wang
authors.forename: Felipe
authors.initials: F
authors.lastname: Amaral
authors.forename: Jack
authors.initials: J
authors.lastname: Parker
authors.forename: Thomas
authors.initials: T
authors.lastname: Schmitz-Rode
authors.forename: Rüdiger
authors.initials: R
authors.lastname: Autschbach
authors.forename: Ulrich
authors.initials: U
authors.lastname: Steinseifer
mesh_terms: D006333:Heart Failure / Q000601:surgery*; D006353:Heart-Assist Devices; D006801:Humans; D011474:Prosthesis Design; D013314:Stress, Mechanical; D016896:Treatment Outcome
keywords: Foldable; Minimally invasive device; Nitinol; Ventricular assist device