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左心室辅助装置对特定患者左心血液动力学的影响。

Effect of left ventricular assist device on the hemodynamics of a patient-specific left heart.

机构信息

Mechanical and Industrial Engineering Department, IIT Roorkee, Roorkee, 247667, Uttarakhand, India.

Department of Mechanical Engineering, IIT Kharagpur, Kharagpur, West Bengal, India.

出版信息

Med Biol Eng Comput. 2022 Jun;60(6):1705-1721. doi: 10.1007/s11517-022-02572-6. Epub 2022 Apr 20.

Abstract

This article describes the numerical efforts made to investigate the influence of a left ventricular assist device (LVAD) on the patient-specific left heart's hemodynamics. Two different computational geometries with left heart have been simulated over the entire cardiac cycle (case 1: healthy heart without LVAD and case 2: diseased heart with LVAD). The blood flow was simulated by implementing Bird-Carreau non-Newtonian model. Simulation results show that implantation of LVAD pump imparts major influence on the hemodynamics of the heart; it also provides a cardiac output of 4.87 L/min even at the diastolic phase. Furthermore, post LVAD implantation, approximately eight times more wall shear stress, is noticed at the aorta during the ventricular systole. In particular, major changes in the fluidics are observed inside the aortic region. A possibility of flow stagnation is noticed near the aortic root during the diastolic phase due to the bisection of incoming bloodstreams from the outflow graft. The flow characteristics of the LVAD pump are also observed to be significantly different from the idealized simulations (idealized tubular inlet situation). The observation of this study can help in understanding post-implant critical hemodynamic issues due to pump performance and its subsequent impact on the heart. A simulation approach-based study has been performed to investigate the influence of LVAD on the hemodynamics of a heart. A 3D computational model of a patient-specific heart has been created from CT scan datasets for diastole and systole phases (a). An axial flow blood pump has been implanted computationally into the left heart (b). The implanted blood pump enhances the cardiac output and elevates shear generation (c) and (d).

摘要

本文描述了为研究左心室辅助装置 (LVAD) 对特定患者左心血液动力学的影响而进行的数值研究。在整个心动周期内模拟了两个具有左心的不同计算几何形状(病例 1:无 LVAD 的健康心脏和病例 2:有 LVAD 的患病心脏)。通过实施 Bird-Carreau 非牛顿模型来模拟血流。模拟结果表明,LVAD 泵的植入对心脏血液动力学产生重大影响;即使在舒张期,它也能提供 4.87 L/min 的心输出量。此外,LVAD 植入后,在心室收缩期间,主动脉处的壁面切应力增加约 8 倍。特别是,在主动脉区域内部观察到流体力学的重大变化。由于从流出移植物流入的血流被分流,在舒张期注意到主动脉根部附近出现流动停滞的可能性。还观察到 LVAD 泵的流动特性与理想化模拟(理想化管状入口情况)有很大不同。这项研究的观察结果可以帮助理解由于泵性能及其对心脏的后续影响而导致的植入后关键血液动力学问题。已经进行了基于模拟方法的研究,以研究 LVAD 对心脏血液动力学的影响。从 CT 扫描数据集创建了特定于患者的心脏的 3D 计算模型,用于舒张和收缩阶段(a)。在计算上向左心植入了轴向血流血泵(b)。植入的血泵提高了心输出量并增加了剪切生成(c)和(d)。

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