title: Hemodynamic assessment of partial mechanical circulatory support: data derived from computed tomography angiographic images and computational fluid dynamics.
abstract: Partial mechanical circulatory support represents a new concept for the treatment of advanced heart failure. The Circulite Synergy Micro Pump(®), where the inflow cannula is connected to the left atrium and the outflow cannula to the right subclavian artery, was one of the first devices to introduce this concept to the clinic. Using computational fluid dynamics (CFD) simulations, hemodynamics in the aortic tree was visualized and quantified from computed tomography angiographic (CTA) images in two patients. A realistic computational model was created by integrating flow information from the native heart and from the Circulite device. Diastolic flow augmentation in the descending aorta but competing/antagonizing flow patterns in the proximal innominate artery was observed. Velocity time curves in the ascending aorta correlated well with those in the left common carotid, the left subclavian and the descending aorta but poorly with the one in the innominate. Our results demonstrate that CFD may be useful in providing a better understanding of the main flow patterns in mechanical circulatory support devices.
authors.affiliation: 1 Magnetic Resonance Imaging Core, Houston Methodist Research Institute, Houston, Texas, USA ; 2 Department of Radiology, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio, USA ; 3 Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany ; 4 Department of Radiology E010, German Cancer Research Center (DKFZ), Heidelberg, Germany ; 5 Department of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany ; 6 Department of Cardiothoracic Transplantation and Mechanical Support, Royal Brompton and Harefield NHS Trust, Harefield Hospital, London, UK.
authors.forename: Christof
authors.initials: C
authors.lastname: Karmonik
authors.affiliation: 1 Magnetic Resonance Imaging Core, Houston Methodist Research Institute, Houston, Texas, USA ; 2 Department of Radiology, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio, USA ; 3 Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany ; 4 Department of Radiology E010, German Cancer Research Center (DKFZ), Heidelberg, Germany ; 5 Department of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany ; 6 Department of Cardiothoracic Transplantation and Mechanical Support, Royal Brompton and Harefield NHS Trust, Harefield Hospital, London, UK.
authors.forename: Sasan
authors.initials: S
authors.lastname: Partovi
authors.affiliation: 1 Magnetic Resonance Imaging Core, Houston Methodist Research Institute, Houston, Texas, USA ; 2 Department of Radiology, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio, USA ; 3 Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany ; 4 Department of Radiology E010, German Cancer Research Center (DKFZ), Heidelberg, Germany ; 5 Department of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany ; 6 Department of Cardiothoracic Transplantation and Mechanical Support, Royal Brompton and Harefield NHS Trust, Harefield Hospital, London, UK.
authors.forename: Fabian
authors.initials: F
authors.lastname: Rengier
authors.affiliation: 1 Magnetic Resonance Imaging Core, Houston Methodist Research Institute, Houston, Texas, USA ; 2 Department of Radiology, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio, USA ; 3 Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany ; 4 Department of Radiology E010, German Cancer Research Center (DKFZ), Heidelberg, Germany ; 5 Department of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany ; 6 Department of Cardiothoracic Transplantation and Mechanical Support, Royal Brompton and Harefield NHS Trust, Harefield Hospital, London, UK.
authors.forename: Hagen
authors.initials: H
authors.lastname: Meredig
authors.affiliation: 1 Magnetic Resonance Imaging Core, Houston Methodist Research Institute, Houston, Texas, USA ; 2 Department of Radiology, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio, USA ; 3 Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany ; 4 Department of Radiology E010, German Cancer Research Center (DKFZ), Heidelberg, Germany ; 5 Department of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany ; 6 Department of Cardiothoracic Transplantation and Mechanical Support, Royal Brompton and Harefield NHS Trust, Harefield Hospital, London, UK.
authors.forename: Mina Berty
authors.initials: MB
authors.lastname: Farag
authors.affiliation: 1 Magnetic Resonance Imaging Core, Houston Methodist Research Institute, Houston, Texas, USA ; 2 Department of Radiology, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio, USA ; 3 Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany ; 4 Department of Radiology E010, German Cancer Research Center (DKFZ), Heidelberg, Germany ; 5 Department of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany ; 6 Department of Cardiothoracic Transplantation and Mechanical Support, Royal Brompton and Harefield NHS Trust, Harefield Hospital, London, UK.
authors.forename: Matthias
authors.initials: M
authors.lastname: Müller-Eschner
authors.affiliation: 1 Magnetic Resonance Imaging Core, Houston Methodist Research Institute, Houston, Texas, USA ; 2 Department of Radiology, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio, USA ; 3 Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany ; 4 Department of Radiology E010, German Cancer Research Center (DKFZ), Heidelberg, Germany ; 5 Department of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany ; 6 Department of Cardiothoracic Transplantation and Mechanical Support, Royal Brompton and Harefield NHS Trust, Harefield Hospital, London, UK.
authors.forename: Rawa
authors.initials: R
authors.lastname: Arif
authors.affiliation: 1 Magnetic Resonance Imaging Core, Houston Methodist Research Institute, Houston, Texas, USA ; 2 Department of Radiology, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio, USA ; 3 Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany ; 4 Department of Radiology E010, German Cancer Research Center (DKFZ), Heidelberg, Germany ; 5 Department of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany ; 6 Department of Cardiothoracic Transplantation and Mechanical Support, Royal Brompton and Harefield NHS Trust, Harefield Hospital, London, UK.
authors.forename: Aron-Frederik
authors.initials: AF
authors.lastname: Popov
authors.affiliation: 1 Magnetic Resonance Imaging Core, Houston Methodist Research Institute, Houston, Texas, USA ; 2 Department of Radiology, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio, USA ; 3 Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany ; 4 Department of Radiology E010, German Cancer Research Center (DKFZ), Heidelberg, Germany ; 5 Department of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany ; 6 Department of Cardiothoracic Transplantation and Mechanical Support, Royal Brompton and Harefield NHS Trust, Harefield Hospital, London, UK.
authors.forename: Hans-Ulrich
authors.initials: HU
authors.lastname: Kauczor
authors.affiliation: 1 Magnetic Resonance Imaging Core, Houston Methodist Research Institute, Houston, Texas, USA ; 2 Department of Radiology, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio, USA ; 3 Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany ; 4 Department of Radiology E010, German Cancer Research Center (DKFZ), Heidelberg, Germany ; 5 Department of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany ; 6 Department of Cardiothoracic Transplantation and Mechanical Support, Royal Brompton and Harefield NHS Trust, Harefield Hospital, London, UK.
authors.forename: Matthias
authors.initials: M
authors.lastname: Karck
authors.affiliation: 1 Magnetic Resonance Imaging Core, Houston Methodist Research Institute, Houston, Texas, USA ; 2 Department of Radiology, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio, USA ; 3 Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany ; 4 Department of Radiology E010, German Cancer Research Center (DKFZ), Heidelberg, Germany ; 5 Department of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany ; 6 Department of Cardiothoracic Transplantation and Mechanical Support, Royal Brompton and Harefield NHS Trust, Harefield Hospital, London, UK.
authors.forename: Arjang
authors.initials: A
authors.lastname: Ruhparwar
keywords: Heart failure; computational fluid dynamics (CFD); flow; partial mechanical circulatory support