Maio 2014 vol. 1 num. 1 - 10th World Congress on Computational Mechanics

Full Article - Open Access.

Idioma principal

EFFECT OF OUTFLOW CANNULA PLACEMENT AND PULSATILITY OF BLOOD PUMPS ON CEREBRAL BLOOD FLOW AND WALL SHEAR STRESS DURING CARDIAC ASSIST

Kaufmann, T. A. S. ; Schmitz-Rode, T. ; Moritz, A. ; Steinseifer, U. ;

Full Article:

Device cannulation to the cardiovascular system (CVS) is an important considera-tion for cardiac assist. Some devices return blood via the ascending aorta, while others place the outflow cannula in the descending aorta. A Computational Fluid Dynamics study in de-pendency on different flow profiles representing different devices was undertaken for both approaches. The main goal was to develop a computational model to analyze the impact of different parameters of Ventricular Assist Devices (VAD) support on flow conditions in gen-eral and cerebral perfusion in particular. A 3D model of the human CVS was reconstructed from Magnetic Resonance Imaging data. A VAD outflow cannula was placed in four different positions inside ascending and proximal descending aorta. Transient numerical simulations were performed for each position assum-ing continuous and physiologically modulated device flow. The physiological flow from the heart was set to zero for a non-beating heart condition and 3 L/min for a weak heart condi-tion. Main flow variables are only slightly affected by the cannulation method but highly affected by the flow profile. Wall shear stress is increased for pulsatile support, whereby arterioscle-rotic plaque embolism might be induced. The cerebral blood flow is increased for cannulation of the descending aorta for each condition.

Full Article:

Download (PDF)

Palavras-chave: Computational Fluid Dynamics, Ventricular Assist Devices, Outflow Cannula, Pulsatility, Cerebral Blood Flow.,

Palavras-chave:

DOI: 10.5151/meceng-wccm2012-18131

Referências bibliográficas
  • [1] Hornick P., Taylor K., “Pulsatile and nonpulsatile perfusion: the continuing controversy”. J Cardiothorac Vasc Anesth, 11(3):310–315, 1997
  • [2] Ji B., Undar A., “An evaluation of the benefits of pulsatile versus nonpulsatile perfusion during cardiopulmonary bypass procedures in pediatric and adult cardiac patients”. ASAIO J , 52(4):357–361, 2006
  • [3] Tarcan O., Ozatik M. A., “Comparison of pulsatile and non-pulsatile cardiopulmonary bypass in patients with chronic obstructive pulmonary disease”. Med Sci Monit, 10(7):CR294–CR299, 2004.
  • [4] Undar A., Ji B., ”Detection and classification of gaseous microemboli during pulsatile and nonpulsatile perfusion in a simulated neonatal cpb model”. ASAIO J, 53(6):725–729, 2007.
  • [5] Grossi E. A., Kanchuger M. S., “Effect of cannula length on aortic arch flow: protection of the atheromatous aortic arch”. Ann Thorac Surg, 59(3):710–712, 199
  • [6] Orime Y., Shiono M., “Cytokine and endothelial damage in pulsatile and nonpulsatile cardiopulmonary bypass”. Artif Organs, 23(6):508–512, 1999.
  • [7] Bar-Yosef S., Anders M., “Aortic atheroma burden and cognitive dysfunction after coro-nary artery bypass graft surgery”. Ann Thorac Surg, 78(5):1556–1562, 2004.
  • [8] Kapetanakis E. I., Stamou S. C., “The impact of aortic manipulation on neurologic out-comes after coronary artery bypass surgery: a risk-adjusted study”. Ann Thorac Surg, 78(5):1564–1571.
  • [9] Undar A., Masai T., „Pulsatile and nonpulsatile flows can be quantified in terms of energy equivalent pressure during cardiopulmonary bypass for direct comparisons”. ASAIO J, 45(6):610–614, 199
  • [10] Nakamura K., Harasaki H., “Comparison of pulsatile and non-pulsatile cardiopulmo-nary bypass on regional renal blood flow in sheep”. Scand Cardiovasc J, 38(1):59–63, 2004.
  • [11] Scarborough J. E., White W., “Neurologic outcomes after coronary artery bypass graft-ing with and without cardiopulmonary bypass”. Semin Thorac Cardiovasc Surg, 15(1):52–62, 2003.
  • [12] Verdonck P. R., Siller U., “Hydrodynamical comparison of aortic arch cannulae”. Int J Artif Organs, 21(11):705–713.
  • [13] Albert A. A., Beller C. J., „Is there any impact of the shape of aortic end-hole cannula on stroke occurrence? clinical evaluation of straight and bent-tip aortic cannulae”. Perfu-sion, 17(6):451–456, 2002.
  • [14] Joubert-Huebner E., Gerdes A., „An in vitro evaluation of a new cannula tip design compared with two clinically established cannula-tip designs regarding aortic arch vessel perfusion characteristics”. Perfusion, 15(1):69–76, 2000.
  • [15] Fang J. C., “Rise of the machines–left ventricular assist devices as permanent therapy for advanced heart failure”. N Engl J Med, 361(23):2282–2285, 2009.
  • [16] Gerdes A., Joubert-Hübner E., “Hydrodynamics of aortic arch vessels during perfusion through the right subclavian artery”. Ann Thorac Surg, 69(5):1425–1430, 2000.
  • [17] Meyns B., Klotz S., “Proof of concept: hemodynamic response to long-term partial ven-tricular support with the synergy pocket micro-pump”. J Am Coll Cardiol, 54(1):79–86, 2009.
  • [18] Kaufmann T. A., Hormes M., “The impact of aortic/subclavian outflow cannulation for cardiopulmonary bypass and cardiac support: a computational fluid dynamics study”. Artif Organs, 33(9):727–732, 2009.
  • [19] Kaufmann T. A., Hormes M., “Flow distribution during cardiopulmonary bypass in dependency on the outflow cannula positioning”. Artif Organs, 33(11):988–992, 2009.
  • [20] Kaufmann T. A., Schmitz-Rode T., “Mimicking of the Human Regulatory System by Flow-Dependent Vascular Resistance: A Feasibility Study”. Artif Organs, 0.1111/j.1525-1594.2011.01433.x, 2012.
Como citar:

Kaufmann, T. A. S.; Schmitz-Rode, T.; Moritz, A.; Steinseifer, U.; "EFFECT OF OUTFLOW CANNULA PLACEMENT AND PULSATILITY OF BLOOD PUMPS ON CEREBRAL BLOOD FLOW AND WALL SHEAR STRESS DURING CARDIAC ASSIST", p. 822-835 . In: In Proceedings of the 10th World Congress on Computational Mechanics [= Blucher Mechanical Engineering Proceedings, v. 1, n. 1]. São Paulo: Blucher, 2014.
ISSN 2358-0828, DOI 10.5151/meceng-wccm2012-18131

últimos 30 dias | último ano | desde a publicação


downloads


visualizações


indexações