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Comparative Study of Continuous and Pulsatile Left Ventricular Assist Devices on Hemodynamics of a Pediatric End-to-Side Anastomotic Graft

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Abstract

Although there are many studies that focus on understanding the consequence of pumping mode (continuous vs. pulsatile) associated with ventricular assist devices (VADs) on pediatric vascular pulsatility, the impact on local hemodynamics has been largely ignored. Hence, we compare not only the hemodynamic parameters indicative of pulsatility but also the local flow fields in the aorta and the great vessels originating from the aortic arch. A physiologic graft anastomotic model is constructed based on a pediatric, patient specific, aorta with a graft attached on the ascending aorta. The flow is simulated using a previously validated second-order accurate Navier–Stokes flow solver based upon a finite volume approach. The major findings are: (1) pulsatile support provides a greater degree of vascular pulsatility when compared to continuous support, which, however, is still 20% less than pulsatility in the healthy aorta; (2) pulsatile support increases the flow in the great vessels, while continuous support decreases it; (3) complete VAD support results in turbulence in the aorta, with maximum principal Reynolds stresses for pulsatile support and continuous support of 7081 and 249 dyn/cm2, respectively; (4) complete pulsatile support results in a significant increase in predicted hemolysis in the aorta; and (5) pulsatile support causes both higher time-averaged wall shear stresses (WSS) and oscillatory shear indices (OSI) in the aorta than does continuous support. These findings will help to identify the risk of graft failure for pediatric patients with pulsatile and continuous VADs.

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Acknowledgments

This work was supported by NIH NHLBI HV 48191. The authors would like to thank Jason Holmes and Jeff Nucciarone of the High Performance Computing Group at the Pennsylvania State University for their technical support with PC clusters. The authors would also like to thank Dr. Ajit Yoganathan and Mr. Chris Haggerty from the Department of Biomedical Engineering at the Georgia Institute of Technology for providing the pediatric aortic model.

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Authors and Affiliations

  1. Department of Bioengineering, The Pennsylvania State University, University Park, PA, 16802, USA

    Ning Yang, Steven Deutsch & Keefe B. Manning

  2. The Applied Research Laboratory, The Pennsylvania State University, University Park, PA, 16802, USA

    Steven Deutsch & Eric G. Paterson

  3. Department of Mechanical Engineering, The Pennsylvania State University, University Park, PA, 16802, USA

    Eric G. Paterson

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  1. Ning Yang
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Correspondence to Keefe B. Manning.

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Yang, N., Deutsch, S., Paterson, E.G. et al. Comparative Study of Continuous and Pulsatile Left Ventricular Assist Devices on Hemodynamics of a Pediatric End-to-Side Anastomotic Graft. Cardiovasc Eng Tech 1, 88–103 (2010). https://doi.org/10.1007/s13239-010-0006-6

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