Interaction of a Ventricular Assist Device With Patient-Specific Cardiovascular Systems: In-Silico Study With Bidirectional Coupling.

Abstract

Ventricular assist devices (VADs) are used to assist the heart function of patients with advanced heart failure. Computational fluid dynamics in VADs are widely applied in the development and optimization, for example, to evaluate blood damage. For these simulations, the pulsating operating conditions, in which the VAD operates, should be included accurately. Therefore, this study aims to evaluate the flow in a VAD by interacting with patient-specific cardiovascular systems of heart failure patients. A numeric method will be presented, which includes a patient-specific cardiovascular system model that is bidirectionally coupled with a three-dimensional (3D) flow simulation of the HeartMate 3. The cardiovascular system is represented by a lumped parameter model. Three heart failure patients are considered, based on clinical data from end-stage heart failure patients. Various parameters of the cardiovascular system and the VAD are analyzed, for example, flow rates, pressures, VAD heads, and efficiencies. A further important parameter is the blood damage potential of the VAD, which varies significantly among different patients. Moreover, the predicted blood damage fluctuates within a single heartbeat. The increase in blood damage is evaluated based on the operating conditions. Both, overload and especially partial load conditions during the pulsating operation result in elevated blood damage.