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The Impact of Left Ventricular Assist Device Outflow Graft Positioning on Aortic Hemodynamics: Improving Flow Dynamics to Mitigate Aortic Insufficiency

Heart failure is a global health concern with significant implications for healthcare systems. Left ventricular assist devices (LVADs) provide mechanical support for patients with severe heart failure. However, the placement of the LVAD outflow graft within the aorta has substantial implications for...

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Autores principales: Gu, Zhuohan, Ong, Chi Wei, Mi, Yongzhen, Seetharaman, Ashwin, Ling, Ryan Ruiyang, Ramanathan, Kollengode, Leo, Hwa Liang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10604423/
https://www.ncbi.nlm.nih.gov/pubmed/37887596
http://dx.doi.org/10.3390/biomimetics8060465
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author Gu, Zhuohan
Ong, Chi Wei
Mi, Yongzhen
Seetharaman, Ashwin
Ling, Ryan Ruiyang
Ramanathan, Kollengode
Leo, Hwa Liang
author_facet Gu, Zhuohan
Ong, Chi Wei
Mi, Yongzhen
Seetharaman, Ashwin
Ling, Ryan Ruiyang
Ramanathan, Kollengode
Leo, Hwa Liang
author_sort Gu, Zhuohan
collection PubMed
description Heart failure is a global health concern with significant implications for healthcare systems. Left ventricular assist devices (LVADs) provide mechanical support for patients with severe heart failure. However, the placement of the LVAD outflow graft within the aorta has substantial implications for hemodynamics and can lead to aortic insufficiency during long-term support. This study employs computational fluid dynamics (CFD) simulations to investigate the impact of different LVAD outflow graft locations on aortic hemodynamics. The introduction of valve morphology within the aorta geometry allows for a more detailed analysis of hemodynamics at the aortic root. The results demonstrate that the formation of vortex rings and subsequent vortices during the high-velocity jet flow from the graft interacted with the aortic wall. Time-averaged wall shear stress (TAWSS) and oscillatory shear index (OSI) indicate that modification of the outflow graft location changes mechanical states within the aortic wall and aortic valve. Among the studied geometric factors, both the height and inclination angle of the LVAD outflow graft are important in controlling retrograde flow to the aortic root, while the azimuthal angle primarily determines the rotational direction of blood flow in the aortic arch. Thus, precise positioning of the LVAD outflow graft emerges as a critical factor in optimizing patient outcomes by improving the hemodynamic environment.
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spelling pubmed-106044232023-10-28 The Impact of Left Ventricular Assist Device Outflow Graft Positioning on Aortic Hemodynamics: Improving Flow Dynamics to Mitigate Aortic Insufficiency Gu, Zhuohan Ong, Chi Wei Mi, Yongzhen Seetharaman, Ashwin Ling, Ryan Ruiyang Ramanathan, Kollengode Leo, Hwa Liang Biomimetics (Basel) Article Heart failure is a global health concern with significant implications for healthcare systems. Left ventricular assist devices (LVADs) provide mechanical support for patients with severe heart failure. However, the placement of the LVAD outflow graft within the aorta has substantial implications for hemodynamics and can lead to aortic insufficiency during long-term support. This study employs computational fluid dynamics (CFD) simulations to investigate the impact of different LVAD outflow graft locations on aortic hemodynamics. The introduction of valve morphology within the aorta geometry allows for a more detailed analysis of hemodynamics at the aortic root. The results demonstrate that the formation of vortex rings and subsequent vortices during the high-velocity jet flow from the graft interacted with the aortic wall. Time-averaged wall shear stress (TAWSS) and oscillatory shear index (OSI) indicate that modification of the outflow graft location changes mechanical states within the aortic wall and aortic valve. Among the studied geometric factors, both the height and inclination angle of the LVAD outflow graft are important in controlling retrograde flow to the aortic root, while the azimuthal angle primarily determines the rotational direction of blood flow in the aortic arch. Thus, precise positioning of the LVAD outflow graft emerges as a critical factor in optimizing patient outcomes by improving the hemodynamic environment. MDPI 2023-10-01 /pmc/articles/PMC10604423/ /pubmed/37887596 http://dx.doi.org/10.3390/biomimetics8060465 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Gu, Zhuohan
Ong, Chi Wei
Mi, Yongzhen
Seetharaman, Ashwin
Ling, Ryan Ruiyang
Ramanathan, Kollengode
Leo, Hwa Liang
The Impact of Left Ventricular Assist Device Outflow Graft Positioning on Aortic Hemodynamics: Improving Flow Dynamics to Mitigate Aortic Insufficiency
title The Impact of Left Ventricular Assist Device Outflow Graft Positioning on Aortic Hemodynamics: Improving Flow Dynamics to Mitigate Aortic Insufficiency
title_full The Impact of Left Ventricular Assist Device Outflow Graft Positioning on Aortic Hemodynamics: Improving Flow Dynamics to Mitigate Aortic Insufficiency
title_fullStr The Impact of Left Ventricular Assist Device Outflow Graft Positioning on Aortic Hemodynamics: Improving Flow Dynamics to Mitigate Aortic Insufficiency
title_full_unstemmed The Impact of Left Ventricular Assist Device Outflow Graft Positioning on Aortic Hemodynamics: Improving Flow Dynamics to Mitigate Aortic Insufficiency
title_short The Impact of Left Ventricular Assist Device Outflow Graft Positioning on Aortic Hemodynamics: Improving Flow Dynamics to Mitigate Aortic Insufficiency
title_sort impact of left ventricular assist device outflow graft positioning on aortic hemodynamics: improving flow dynamics to mitigate aortic insufficiency
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10604423/
https://www.ncbi.nlm.nih.gov/pubmed/37887596
http://dx.doi.org/10.3390/biomimetics8060465
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