An Accelerated Thrombosis Model for Computational Fluid Dynamics Simulations in Rotary Blood Pumps.

Purpose: Thrombosis ranks among the major complications in blood-carrying medical devices and a better understanding to influence the design related contribution to thrombosis is desirable. Over the past years many computational models of thrombosis have been developed. However, numerically cheap models able to predict localized thrombus risk in complex geometries are still lacking.

Intraventricular Flow Simulations in Singular Right Ventricles Reveal Deteriorated Washout and Low Vortex Formation.

Purpose: Patients with a functionally univentricular heart represent one of the most common severe cardiac lesions with a prevalence of 3 per 10,000 live births. Hemodynamics of the singular ventricle is a major research topic in cardiology and there exists a relationship between fluid dynamical features and cardiac behavior in health and disease. The aim of the present work was to compare intraventricular flow in single right ventricle (SRV) patients and subjects with healthy left hearts (LV) through patient-specific CFD simulations.

Optimizing cerebral perfusion and hemodynamics during cardiopulmonary bypass through cannula design combining in silico, in vitro and in vivo input.

Cardiopulmonary bypass (CPB) is a standard technique for cardiac surgery, but comes with the risk of severe neurological complications (e.g. stroke) caused by embolisms and/or reduced cerebral perfusion.

In-vitro performance of a single-chambered total artificial heart in a Fontan circulation.

An in-vitro study was conducted to investigate the general feasibility of using only one pumping chamber of the SynCardia total artificial heart (TAH) as a replacement of the single ventricle palliated by Fontan circulation. A mock circulation loop was used to mimic a Fontan circulation. The combination of both ventricle sizes (50 and 70 cc) and driver (Freedom Driver and Companion C2 Driver) was investigated.

Hemolysis at low blood flow rates: in-vitro and in-silico evaluation of a centrifugal blood pump.

Background: Treating severe forms of the acute respiratory distress syndrome and cardiac failure, extracorporeal membrane oxygenation (ECMO) has become an established therapeutic option. Neonatal or pediatric patients receiving ECMO, and patients undergoing extracorporeal CO removal (ECCOR) represent low-flow applications of the technology, requiring lower blood flow than conventional ECMO. Centrifugal blood pumps as a core element of modern ECMO therapy present favorable operating characteristics in the high blood flow range (4 L/min-8 L/min).

Estimation of left ventricular stroke work based on a large cohort of healthy children.

Left ventricular stroke work is an important prognostic marker to analyze cardiac function. Standard values for children are, however, missing. For clinicians, standards can help to improve the treatment decision of heart failures.

How Computational Modeling can Help to Predict Gas Transfer in Artificial Lungs Early in the Design Process.

Wearable extracorporeal membrane oxygenation (ECMO) circuits may soon become a viable alternative to conventional ECMO treatment. Common device-induced complications, however, such as blood trauma and oxygenator thrombosis, must first be addressed to improve long-term reliability, since ambulatory patients cannot be monitored as closely as intensive care patients. Additionally, an efficient use of the membrane surface can reduce the size of the devices, priming volume, and weight to achieve portability.

Low-flow assessment of current ECMO/ECCOR rotary blood pumps and the potential effect on hemocompatibility.

Background: Extracorporeal carbon dioxide removal (ECCOR) uses an extracorporeal circuit to directly remove carbon dioxide from the blood either in lieu of mechanical ventilation or in combination with it. While the potential benefits of the technology are leading to increasing use, there are very real risks associated with it. Several studies demonstrated major bleeding and clotting complications, often associated with hemolysis and poorer outcomes in patients receiving ECCOR.

An energy-dissipation-based power-law formulation for estimating hemolysis.

Hemolysis is a major concern in blood-circulating devices, which arises due to non-physiological stresses on red blood cells from ambient flow environment or moving mechanical structures. Computational fluid dynamics (CFD) and empirical hemolysis prediction models have been increasingly used for the design and optimization of blood-circulating devices. The commonly used power-law models for hemolysis prediction often use Reynolds stress to represent effective stress, tend to over-predict hemolysis and fail to capture trends of flow-related hemolysis.

Crucial Aspects for Using Computational Fluid Dynamics as a Predictive Evaluation Tool for Blood Pumps.

The suitability of computational fluid dynamics (CFD) as a regulatory tool for safety assessment of medical devices is still limited: A lack of standardized validation and evaluation methods impairs the quantitative comparability and reliability of simulation studies, particularly regarding the assessment of hemocompatibility. This study investigated important aspects of validation and verification for three common turbulence modeling approaches (laminar, k-ω shear stress transport [SST] and stress-blended eddy simulation [SBES]) and three different mesh refinements. Simulation results for pressure head, characteristic velocity, and shear stress for the benchmark blood pump model of the Food and Drug Administration critical path initiative were compared with its published experimental results.

Mesh Sensitivity Analysis for Quantitative Shear Stress Assessment in Blood Pumps Using Computational Fluid Dynamics.

The reduction of excessive, nonphysiologic shear stresses leading to blood trauma can be the key to overcome many of the associated complications in blood recirculating devices. In that regard, computational fluid dynamics (CFD) are gaining in importance for the hydraulic and hemocompatibility assessment. Still, direct hemolysis assessments with CFD remain inaccurate and limited to qualitative comparisons rather than quantitative predictions.

On the Accuracy of Hemolysis Models in Couette-Type Blood Shearing Devices.

Hemolysis is one of the most challenging issues faced by blood contacting devices. Empirical hemolysis models often relate hemolysis to shear stress and exposure time. These models were generally derived from the experimental results of Couette-type blood shearing devices, with assumption of uniform exposure time and shear stress.

Fluid Dynamics in Rotary Piston Blood Pumps.

Mechanical circulatory support can maintain a sufficient blood circulation if the native heart is failing. The first implantable devices were displacement pumps with membranes. They were able to provide a sufficient blood flow, yet, were limited because of size and low durability.

The spiral groove bearing as a mechanism for enhancing the secondary flow in a centrifugal rotary blood pump.

The rapid evolution of rotary blood pump (RBP) technology in the last few decades was shaped by devices with increased durability, frequently employing magnetic or hydrodynamic suspension techniques. However, the potential for low flow in small gaps between the rotor and pump casing is still a problem for hemocompatibility. In this study, a spiral groove hydrodynamic bearing (SGB) is applied with two distinct objectives: first, as a mechanism to enhance the washout in the secondary flow path of a centrifugal RBP, lowering the exposure to high shear stresses and avoiding thrombus formation; and second, as a way to allow smaller gaps without compromising the washout, enhancing the overall pump efficiency.