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两种离心式 LVAD 的血液相容性和血液动力学比较:HVAD 和 HeartMate3。

Hemocompatibility and hemodynamic comparison of two centrifugal LVADs: HVAD and HeartMate3.

机构信息

CMT-Motores Térmicos, Universitat Politècnica de València, Camino de Vera, S/N, 46022, Valencia, Spain.

出版信息

Biomech Model Mechanobiol. 2023 Jun;22(3):871-883. doi: 10.1007/s10237-022-01686-y. Epub 2023 Jan 17.

Abstract

Mechanical circulatory support using ventricular assist devices is a common technique for treating patients suffering from advanced heart failure. The latest generation of devices is characterized by centrifugal turbopumps which employ magnetic levitation bearings to ensure a gap clearance between moving and static parts. Despite the increasing use of these devices as a destination therapy, several long-term complications still exist regarding their hemocompatibility. The blood damage associated with different pump designs has been investigated profoundly in the literature, while the hemodynamic performance has been hardly considered. This work presents a novel comparison between the two main devices of the latest generation-HVAD and HM3-from both perspectives, hemodynamic performance and blood damage. Computational fluid dynamics simulations are performed to model the considered LVADs, and computational results are compared to experimental measurements of pressure head to validate the model. Enhanced performance and hemocompatibility are detected for HM3 owing to its design incorporating more conventional blades and larger gap clearances.

摘要

使用心室辅助装置的机械循环支持是治疗晚期心力衰竭患者的常用技术。最新一代的设备的特点是采用离心涡轮泵,利用磁悬浮轴承来确保动、静部件之间的间隙。尽管这些设备作为终末期治疗的应用越来越广泛,但它们的血液相容性仍存在一些长期并发症。文献中已经深入研究了不同泵设计相关的血液损伤,而血液动力学性能几乎没有被考虑。本工作从血液动力学性能和血液损伤两个方面对最新一代的两种主要设备(HVAD 和 HM3)进行了新颖的比较。通过计算流体动力学模拟来对所考虑的 LVAD 进行建模,并将计算结果与压力头的实验测量进行比较以验证模型。由于其设计采用了更传统的叶片和更大的间隙,HM3 检测到了增强的性能和血液相容性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b66c/10167126/f6636cdbe17a/10237_2022_1686_Fig1_HTML.jpg

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