title: Design of axial blood pumps for patients with dysfunctional fontan physiology: computational studies and performance testing.
abstract: Limited treatment options for patients having dysfunctional single ventricle physiology motivate the necessity for alternative therapeutic options. To address this unmet need, we are developing a collapsible axial flow blood pump. This study investigated the impact of geometric simplicity to facilitate percutaneous placement and maintain optimal performance. Three new pump designs were numerically evaluated. A transient simulation explored the impact of respiration on blood flow conditions over the entire respiratory cycle. Prototype testing of the top performing pump design was completed. The top performing Rec design generated the highest pressure rise range of 2-38 mm Hg for flow rates of 1-4 L/min at 4000-7000 RPM, exceeding the performance of the other two configurations by more than 26%. The blood damage indices for the new pump designs were determined to be below 0.5% and predicted hemolysis levels remained low at less than 7 × 10(-5)  g/100 L. Prototype testing of the Rec design confirmed numerical predictions to within an average of approximately 22%. These findings demonstrate that the pumps are reasonably versatile in operational ability, meet pressure-flow requirements to support Fontan patients, and are expected to have low levels of blood trauma.
authors.affiliation: Department of Mechanical and Nuclear Engineering, School of Engineering, Virginia Commonwealth University, Richmond, VA, USA.
authors.forename: Dhyaa H
authors.initials: DH
authors.lastname: Kafagy
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Dwyer
authors.forename: Kelli L
authors.initials: KL
authors.lastname: McKenna
authors.forename: Jean P
authors.initials: JP
authors.lastname: Mulles
authors.forename: Steven G
authors.initials: SG
authors.lastname: Chopski
authors.forename: William B
authors.initials: WB
authors.lastname: Moskowitz
authors.forename: Amy L
authors.initials: AL
authors.lastname: Throckmorton
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D017076:Computer-Aided Design; D019544:Equipment Failure Analysis; D004869:Equipment Safety; D005260:Female; D018729:Fontan Procedure / Q000009:adverse effects / Q000379:methods*; D006330:Heart Defects, Congenital / Q000175:diagnosis / Q000601:surgery*; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D008955:Models, Cardiovascular; D011474:Prosthesis Design; D018570:Risk Assessment
keywords: Blood pump; Computational fluid dynamics; Fontan physiology; Intravascular blood pump; Mechanical cavopulmonary assist; Pediatric circulatory support; Single ventricle physiology; Total cavopulmonary connection