Fluid mechanics of left ventricular assist system outflow housings.

Using the Novacor (Baxter Novacor, Oakland, CA) Left Ventricular Assist System (LVAS) as a test bed, phasic flow patterns were analyzed for three outflow valve housing designs: 1) a triple sinus; 2) an axisymmetric concentric sinus (CS); and 3) a modified triple sinus (MS). The 21 mm Carpentier-Edwards trileaflet pericardial heart valve prosthesis was used for all experiments done on the three housing designs. The LVAS was actuated by a laboratory model of the Novacor LVAS control console, and it was connected to a mock flow loop with an adjustable afterload system to provide physiologic pressures and flows (Pao, 120/80 mmHg; pump output [PO], 2-6 L/min). Laser illuminated flow visualization techniques were used to investigate the phasic flow patterns of the housings, and the visualization derived velocity was verified by laser Doppler velocimetry at several selected points in the field. Formation of vortices behind the leaflets during the LVAS ejection phase was observed in each of the housing designs. They were well organized, and they circulated with the greatest strength in MS. These vortices tended to lie in a plane parallel to the main flow axis, with the rotational velocity increasing with the stroke volume of the LVAS. In the CS and the MS housings, a circumferential flow that provided good washing of this region was observed behind the stents.