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Numerical characterization of hemodynamics conditions near aortic valve after implantation of left ventricular assist device

1. Department of Mathematics, University of Houston 4800 Calhoun Rd, Houston (TX) 77204
2. Department of Mathematics, University of Houston, 4800 Calhoun Rd, Houston, TX 77204
3. Department of Cardiology, Texas Heart Institute at St. Lukes Episcopal Hospital, and Mickael E Debakey VA Medical Center, 2002 Holcombe Boulevard, Houston, TX 77030

## Abstract    Related pages

Left Ventricular Assist Devices (LVADs) are implantable mechanical pumps that temporarily aid the function of the left ventricle. The use of LVADs has been associated with thrombus formation next to the aortic valve and close to the anastomosis region, especially in patients in which the native cardiac function is negligible and the aortic valve remains closed. Stagnation points and recirculation zones have been implicated as the main fluid dynamics factors contributing to thrombus formation. The purpose of the present study was to develop and use computer simulations based on a fluid-structure interaction (FSI) solver to study flow conditions corresponding to different strategies in LVAD ascending aortic anastomosis providing a scenario with the lowest likelihood of thrombus formation. A novel FSI algorithm was developed to deal with the presence of multiple structures corresponding to different elastic properties of the native aorta and of the LVAD cannula. A sensitivity analysis of different variables was performed to assess their impact of flow conditions potentially leading to thrombus formation. It was found that the location of the anastomosis closest to the aortic valve (within 4 cm away from the valve) and at the angle of 30$^\circ$ minimizes the likelihood of thrombus formation. Furthermore, it was shown that the rigidity of the dacron anastomosis cannula plays almost no role in generating pathological conditions downstream from the anastomosis. Additionally, the flow analysis presented in this manuscript indicates that compliance of the cardiovascular tissue acts as a natural inhibitor of pathological flow conditions conducive to thrombus formation and should not be neglected in computer simulations.
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Citation: Annalisa Quaini, Sunčica Čanić, David Paniagua. Numerical characterization of hemodynamics conditions near aortic valve after implantation of left ventricular assist device. Mathematical Biosciences and Engineering, 2011, 8(3): 785-806. doi: 10.3934/mbe.2011.8.785

• 1. Rosario Mazzitelli, Fergal Boyle, Eoin Murphy, Attilio Renzulli, Gionata Fragomeni, Numerical prediction of the effect of aortic Left Ventricular Assist Device outflow-graft anastomosis location, Biocybernetics and Biomedical Engineering, 2016, 36, 2, 327, 10.1016/j.bbe.2016.01.005
• 2. Sahar Hendabadi, Javier Bermejo, Yolanda Benito, Raquel Yotti, Francisco Fernández-Avilés, Juan C. del Álamo, Shawn C. Shadden, Topology of Blood Transport in the Human Left Ventricle by Novel Processing of Doppler Echocardiography, Annals of Biomedical Engineering, 2013, 41, 12, 2603, 10.1007/s10439-013-0853-z
• 3. K. Wong, G. Samaroo, I. Ling, W. Dembitsky, R. Adamson, J.C. del Álamo, K. May-Newman, Intraventricular flow patterns and stasis in the LVAD-assisted heart, Journal of Biomechanics, 2014, 47, 6, 1485, 10.1016/j.jbiomech.2013.12.031
• 4. Javier Bermejo, Pablo Martínez-Legazpi, Juan C. del Álamo, The Clinical Assessment of Intraventricular Flows, Annual Review of Fluid Mechanics, 2015, 47, 1, 315, 10.1146/annurev-fluid-010814-014728
• 5. Lorenzo Rossini, Pablo Martinez-Legazpi, Vi Vu, Leticia Fernández-Friera, Candelas Pérez del Villar, Sara Rodríguez-López, Yolanda Benito, María-Guadalupe Borja, David Pastor-Escuredo, Raquel Yotti, María J. Ledesma-Carbayo, Andrew M. Kahn, Borja Ibáñez, Francisco Fernández-Avilés, Karen May-Newman, Javier Bermejo, Juan C. del Álamo, A clinical method for mapping and quantifying blood stasis in the left ventricle, Journal of Biomechanics, 2016, 49, 11, 2152, 10.1016/j.jbiomech.2015.11.049
• 6. Mojgan Ghodrati, Thananya Khienwad, Alexander Maurer, Francesco Moscato, Francesco Zonta, Heinrich Schima, Philipp Aigner, Validation of numerically simulated ventricular flow patterns during left ventricular assist device support, The International Journal of Artificial Organs, 2020, 039139882090405, 10.1177/0391398820904056