Aortic Root Vortex Formation During Left Ventricular Assist Device Support.

ASAIO J

From the Department of Mechanical Engineering, Bioengineering Program, San Diego State University, San Diego, California.

Published: August 2024

AI Article Synopsis

  • The vortex in the aortic sinus is crucial for proper blood flow and can prevent clot formation, especially in conditions like LVAD support.
  • The study utilized a mock circulatory model to visualize how these vortices are affected as blood flow decreases, finding that they remain present until the valve fully closes.
  • Maintaining regular opening of the aortic valve is essential for patients with LVAD, as it helps sustain blood flow and prevent stagnation.

Article Abstract

The vortex that forms in the aortic sinus plays a vital role in optimizing blood flow. Disruption of the vortex can result in flow stagnation and activate thrombus formation in the aortic root, especially when aortic valve flow is reduced as during left ventricular assist device (LVAD) support. Our goal in this study was to visualize vortex formation in an experimental model of the aortic root as flow is progressively reduced. A mock circulatory loop that reproduces heart failure hemodynamics was combined with a HeartMate II LVAD and velocity measured in a transparent aortic root with a bioprosthetic valve. The aortic valve sinus vortices are clearly visible as counter-rotating structures in the velocity field at baseline and for all conditions with flow through the aortic valve. As LVAD speed increases, the central jet narrows but the vortices persist, disappearing only when the valve is completely closed. The vortices preserve fluid momentum and generate shear stress along the tissue surfaces which disrupts flow stasis. These features underscore the importance of maintaining "intermittent" aortic valve opening, as recommended for LVAD patients. This study is the first to report vortex formation in the aortic root during LVAD support, providing a motivation for further evaluation.

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Source
http://dx.doi.org/10.1097/MAT.0000000000002298DOI Listing

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