Gao Xinyi, Xu Zhike, Chen Chenghan, Hao Pengfei, He Feng, Zhang Xiwen
Applied Mechanics Laboratory, Department of Engineering Mechanics, Tsinghua University, Beijing, China.
Tsinghua University (School of Materials Science and Engineering)-AVIC Aerodynamics Research Institute Joint Research Center for Advanced Materials and Anti-Icing, Beijing, China.
Front Physiol. 2023 May 25;14:1192610. doi: 10.3389/fphys.2023.1192610. eCollection 2023.
Ventricular assist devices have been widely used and accepted to treat patients with end-stage heart failure. The role of VAD is to improve circulatory dysfunction or temporarily maintain the circulatory status of patients. In order to be closer to the medical practice, a multi-Domain model of the left ventricular coupled axial flow artificial heart was considered to study the effect of its hemodynamics on the aorta. Because whether LVAD itself was connected between the left ventricular apex and the ascending aorta by catheter in the loop was not very important for the analysis of simulation results, on the premise of ensuring the multi-Domain simulation, the simulation data of the import and export ends of LVAD were imported to simplify the model. In this paper, the hemodynamic parameters in the ascending aorta, such as blood flow velocity vector, wall shear stress distribution, vorticity current intensity, vorticity flow generation, etc., have been calculated. The numerical conclusion of this study showed the vorticity intensity under LVAD was significantly higher than that under patients' conditions and the overall condition is similar to that of a healthy ventricular spin, which can improve heart failure patients' condition while minimizing other pitfalls. In addition, high velocity blood flow during left ventricular assist surgery is mainly concentrated near the lining of the ascending aorta lumen. What's more, the paper proposes to use Q criterion to determine the generation of vorticity flow. The Q criterion of LVAD is much higher than that of patients with heart failure, and the closer the LVAD is to the wall of the ascending aorta, the greater the Q criterion is. All these are beneficial to the effectiveness of LVAD in the treatment of heart failure patients and provide clinical suggestions for the LVAD implantation in clinical practice.
心室辅助装置已被广泛应用并被接受用于治疗终末期心力衰竭患者。心室辅助装置的作用是改善循环功能障碍或暂时维持患者的循环状态。为了更贴近医学实践,考虑建立左心室耦合轴流人工心脏的多域模型来研究其血流动力学对主动脉的影响。由于左心室辅助装置本身在回路中通过导管连接在左心室心尖和升主动脉之间对于模拟结果的分析并非非常重要,在确保多域模拟的前提下,导入左心室辅助装置进出口端的模拟数据以简化模型。本文计算了升主动脉中的血流动力学参数,如血流速度矢量、壁面剪应力分布、涡电流强度、涡旋流产生等。本研究的数值结论表明,左心室辅助装置下的涡旋强度明显高于患者自身情况,总体情况类似于健康心室的旋转,在将其他隐患降至最低的同时可改善心力衰竭患者的状况。此外,左心室辅助手术期间的高速血流主要集中在升主动脉管腔内膜附近。而且,本文提出使用Q准则来确定涡旋流的产生。左心室辅助装置的Q准则远高于心力衰竭患者,且左心室辅助装置离升主动脉壁越近,Q准则越大。所有这些都有利于左心室辅助装置治疗心力衰竭患者的有效性,并为临床实践中的左心室辅助装置植入提供临床建议。