Specklin Mathieu, Marcel Louis, Abbasnezhad Navideh, Bakir Farid, Kouidri Smaine, Danial Pichoy
Cnam, Arts et Metiers Institute of Technology, LIFSE, Paris, France.
Arts et Metiers Institute of Technology, Cnam, LIFSE, F-75013, Paris, France.
Artif Organs. 2025 Feb;49(2):310-321. doi: 10.1111/aor.14899. Epub 2024 Nov 6.
An innovative solution has been recently proposed for the treatment of heart failure with preserved ejection fraction (HFpEF), using a centrifugal mechanical circulatory support (MCS) device. We sought firstly to assess the hemocompatibility of the proposed device. HFpEF treatment requires the blood pump to operate at low blood flow rate (0.05-0.5 L/min). Given high blood trauma expected in these conditions, we sought secondly to investigate design improvements in order to reduce this risk.
Computational fluid dynamics was used to analyze the blood fluid filled within the centrifugal pump and to estimate the blood trauma due to its operation. This assessment is based on the computation of integrated quantities such as the hemolysis index and the turbulent dissipation energy.
The hemolysis index associated with the present device is comparable to the figures from HVAD. With the proposed pump, for instance, an index of 0.0036 is obtained at 1 L/min and 3000 rpm. Using thinner blades for the impeller allows a 12% reduction of the hemolysis index in average, while reducing its diameter leads to an index 2.8 folds lower at 0.5 L/min.
The present investigation shows the promising hemocompatibility of our centrifugal pump. Concerns about very high hemolysis generated at low flow rates could be overcome by reducing the impeller diameter. Experimental validations are planned to support our findings.
最近有人提出了一种创新的解决方案,用于治疗射血分数保留的心力衰竭(HFpEF),即使用离心式机械循环支持(MCS)装置。我们首先试图评估该装置的血液相容性。HFpEF的治疗要求血泵在低血流速率(0.05 - 0.5升/分钟)下运行。鉴于在这些条件下预计会有较高的血液损伤,我们其次试图研究设计改进措施以降低这种风险。
使用计算流体动力学来分析离心泵内填充的血液流体,并估计其运行导致的血液损伤。该评估基于溶血指数和湍流耗散能量等积分量的计算。
与当前装置相关的溶血指数与HVAD的数值相当。例如,对于所提出的泵,在1升/分钟和3000转/分钟时获得的指数为0.0036。使用更薄的叶轮叶片平均可使溶血指数降低12%,而减小其直径会使在0.5升/分钟时的指数降低至原来的2.8分之一。
本研究表明我们的离心泵具有良好的血液相容性。通过减小叶轮直径可以克服对低流速下产生极高溶血的担忧。计划进行实验验证以支持我们的发现。