医学
心脏病学
心室
心室辅助装置
收缩性
粒子图像测速
后负荷
内科学
生物医学工程
材料科学
心力衰竭
机械
物理
湍流
作者
Fanette Chassagne,Jennifer A. Beckman,Song Li,Claudius Mahr,Alberto Aliseda
出处
期刊:Asaio Journal
[Ovid Technologies (Wolters Kluwer)]
日期:2023-03-07
卷期号:Publish Ahead of Print
标识
DOI:10.1097/mat.0000000000001893
摘要
Thromboembolic events remain a common complication for left ventricular assist device (LVAD) patients. To prevent in-pump thrombosis, third-generation LVADs use speed modulation, which is not synchronized with the native left ventricle (LV) contractility. This study aims to investigate the effect of speed modulation on intraventricular flow patterns, and specifically, the impact of timing relative to pressure variations in the LV. Stereo-particle image velocimetry measurements were performed in a patient-derived LV implanted with an LVAD, for different timings of the speed modulation and speed. Speed modulation has a strong effect on instantaneous afterload and flowrate (-16% and +20%). The different timings of the speed modulation resulted in different flowrate waveforms, exhibiting different maxima (5.3-5.9 L/min, at constant average flowrate). Moreover, the timing of the speed modulation was found to strongly influence intraventricular flow patterns, specifically, stagnation areas within the LV. These experiments highlight, once more, the complex relationship between LVAD speed, hemodynamic resistance, and intraventricular pressure. Overall, this study demonstrates the importance of considering native LV contractility in future LVAD controls, to improve hemocompatibility and reduce the risk of thromboembolic complications.
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