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新型磁悬浮 CH-VAD 泵与 HVAD 和 HeartMate II 泵的血流和血液损伤潜力的计算特性。

Computational characterization of flow and blood damage potential of the new maglev CH-VAD pump versus the HVAD and HeartMate II pumps.

机构信息

Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA.

Fischell Department of Bioengineering, A. James Clark School of Engineering, University of Maryland, College Park, MD, USA.

出版信息

Int J Artif Organs. 2020 Oct;43(10):653-662. doi: 10.1177/0391398820903734. Epub 2020 Feb 11.

Abstract

Left ventricular assist devices are routinely used to treat patients with advanced heart failure as a bridge to transplant or a destination therapy. However, non-physiological shear stress generated by left ventricular assist devices damages blood cells. The continued development of novel left ventricular assist devices is essential to improve the left ventricular assist device therapy for heart failure patients. The CH-VAD is a new maglev centrifugal left ventricular assist device. In this study, the CH-VAD pump was numerically analyzed and compared with the HVAD and HeartMate II pumps under two clinically relevant conditions (flow: 4.5 L/min, pressure head: normal ~80 and hypertension ~120 mmHg). The velocity and shear stress fields, washout, and hemolysis index of the three pumps were assessed with computational fluid dynamics analysis. Under the same condition, the CH-VAD hemolysis index was two times lower than the HVAD and HeartMate II pumps; the CH-VAD had the least percentage volume with shear stress larger than 100 Pa (i.e. normal condition: 0.4% vs HVAD 1.0%, and HeartMate II 2.9%). Under the normal condition, more than 98% was washed out of the three pumps within 0.4 s. The washout times were slightly shorter under the hypertension condition for the three pumps. No regions inside the CH-VAD or HVAD had extremely long residential time, while areas near the straightener of the HeartMate II pump had long residential time (>4 s) indicating elevated risks of thrombosis. The computational fluid dynamics results suggested that the CH-VAD pump has a better hemolytic biocompatibility than the HVAD and HeartMate II pumps under the normal and hypertension conditions.

摘要

左心室辅助装置(LVAD)通常被用于治疗晚期心力衰竭患者,作为移植的桥梁或终点治疗。然而,LVAD 产生的非生理切变力会损害血细胞。持续开发新型 LVAD 对于改善心力衰竭患者的 LVAD 治疗至关重要。CH-VAD 是一种新型磁悬浮离心式 LVAD。在这项研究中,对 CH-VAD 泵进行了数值分析,并在两种临床相关条件(流量:4.5L/min,压力头:正常80mmHg 和高血压120mmHg)下与 HVAD 和 HeartMate II 泵进行了比较。使用计算流体动力学分析评估了这三种泵的速度和切变应力场、冲洗和溶血指数。在相同条件下,CH-VAD 的溶血指数比 HVAD 和 HeartMate II 泵低两倍;CH-VAD 的剪切应力大于 100Pa 的体积百分比最小(即正常条件:0.4%比 HVAD 为 1.0%,HeartMate II 为 2.9%)。在正常条件下,三种泵在 0.4s 内的冲洗量超过 98%。在高血压条件下,三种泵的冲洗时间略有缩短。CH-VAD 或 HVAD 内部没有区域的滞留时间极长,而 HeartMate II 泵的变流器附近区域的滞留时间较长(>4s),表明血栓形成的风险较高。计算流体动力学结果表明,在正常和高血压条件下,CH-VAD 泵的溶血生物相容性优于 HVAD 和 HeartMate II 泵。

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