BACKGROUND & AIMS:
:This numerical study examined the performance of an intravascular axial flow blood pump for mechanical hemodynamic support of patients in the setting of Fontan failure, which presently has few treatment options. Three anatomically accurate geometries of the total cavopulmonary connection (TCPC) were generated using patients' magnetic resonance imaging data. These patient-specific geometries, as well as an idealized version with cylindrical vessels, were computationally analyzed with and without a pump in the inferior vena cava. Pressure flow characteristics, energy gain calculations, and blood damage analyses were performed for each model. The pump produced pressures of 1-14 mm Hg for 1500-4000 revolutions per minute, flow rates of 1-4 L/min, and pulmonary artery pressures of 8-24 mm Hg. Comparison of pump performance among the four models showed minimal intermodel differences (<5% deviation) in the pressure rise generated by the pump, the IVC pressure, and the energy imparted to the system by the pump. Blood damage analysis showed maximum fluid scalar stress values of 372 Pa or less, and the blood damage index was less than 2% in all of the models. These results suggest that this axial flow blood pump performs consistently in a variety of TCPC vessel geometries with low risk of blood trauma.
背景与目标:
:这项数值研究检查了在Fontan衰竭的情况下血管内轴流式血液泵对患者进行机械血流动力学支持的性能,目前尚无治疗选择。使用患者的磁共振成像数据生成了总腔肺连接(TCPC)的三个解剖学精确的几何形状。在下腔静脉中有无泵的情况下,对这些特定于患者的几何形状以及带有圆柱形血管的理想版本进行了计算分析。对每个模型进行压力流量特性,能量获取计算和血液损伤分析。泵以每分钟1500-4000转的速度产生1-14 mm Hg的压力,1-4 L / min的流速以及8-24 mm Hg的肺动脉压力。四个模型之间的泵性能比较显示,泵产生的压力上升,IVC压力和泵传递给系统的能量之间存在最小的模型间差异(偏差小于5%)。血液损伤分析显示所有模型的最大液体标量应力值为372 Pa或更低,血液损伤指数小于2%。这些结果表明,这种轴流式血泵在各种TCPC血管几何形状中均具有一致的性能,且血液外伤的风险较低。