The impact of right ventricular hemodynamics on the performance of a left ventricular assist device in a numerical simulation model
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Titus L. Z. Thut
Abstract
Objectives
Left ventricular assist devices (LVADs) have been established as alternative to heart transplantation for patients with end-stage heart failure refractory to medical therapy. Right heart failure (RHF) after LVAD implantation is associated with inferior outcome. Its preoperative anticipation may influence the selection between a pure left ventricular and a biventricular device type and, thus, improve outcomes. Reliable algorithms to predict RHF are missing.
Methods
A numerical model was used for simulation of a cardiovascular circulation. The LVAD was placed as parallel circuit between left ventricle and aorta. In contrast to other studies, the dynamic hydraulic behavior of a pulsatile LVAD was replaced by that of a continuous LVAD. A variety of hemodynamic states was tested mimicking different right heart conditions. Adjustable parameters included heart rate (HR), pulmonary vascular resistance (PVR), tricuspid regurgitation (TR), right ventricular contractility (RVC) and pump speed. Outcome parameters comprised central venous pressure (CVP), mean pulmonary artery pressure (mPAP), cardiac output (CO) and occurrence of suction.
Results
Alteration of HR, PVR, TR, RVC and pump speed resulted in diverse effects on CO, CVP and mPAP, resulting in improvement, impairment or no change of the circulation, depending on the degree of alteration.
Conclusions
The numerical simulation model allows prediction of circulatory changes and LVAD behaviour following variation of hemodynamic parameters. Such a prediction may be of particular advantage to anticipate RHF after LVAD implantation. It may help preoperatively to choose the appropriate strategy of only left ventricular or both left and right ventricular support.
Acknowledgments
This work is part of the Zurich Heart project under the umbrella of University Medicine Zurich. We thank Mrs. Brigitte Rohrbach, the former secretary of the Institute for Dynamic Systems and Control at the ETH Zurich, Switzerland, for revision of the English language.
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Research funding: None declared.
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Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
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Competing interests: Authors state no conflict of interest.
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Informed consent: Not applicable.
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Ethical approval: Not applicable.
References
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Supplementary Material
This article contains supplementary material (https://doi.org/10.1515/bmt-2020-0188).
© 2023 Walter de Gruyter GmbH, Berlin/Boston
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Articles in the same Issue
- Frontmatter
- Review
- Research frontiers of electroporation-based applications in cancer treatment: a bibliometric analysis
- Research Articles
- Deep neural network to differentiate internet gaming disorder from healthy controls during stop-signal task: a multichannel near-infrared spectroscopy study
- A low power respiratory sound diagnosis processing unit based on LSTM for wearable health monitoring
- Effective deep learning classification for kidney stone using axial computed tomography (CT) images
- De- and recellularized urethral reconstruction with autologous buccal mucosal cells implanted in an ovine animal model
- The impact of right ventricular hemodynamics on the performance of a left ventricular assist device in a numerical simulation model
- Optimal assist strategy exploration for a direct assist device under stress‒strain dynamics
- Revisiting SFA stent technology: an updated overview on mechanical stent performance
- Parameter-based patient-specific restoration of physiological knee morphology for optimized implant design and matching
- Influences of smart glasses on postural control under single- and dual-task conditions for ergonomic risk assessment
