A new way to evaluate thrombotic risk in failure heart and ventricular assist devices

Li, Yuan; Xi, Yifeng; Wang, Hongyu; Sun, Anqiang; Deng, Xiaoyan; Chen, Zengsheng; Fan, Yubo

doi:10.1016/j.medntd.2022.100135

Cited by 16 publications

(10 citation statements)

References 44 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The use of certain pumps can lead to the degradation of red blood cells due to higher shear stress [ 35 ], which has been linked to blood dysfunction and hemolysis, presenting a major limitation for these devices. Threshold shear stress values have been identified to detect dysfunction [ 44 , 45 ], with values of 9, 50, and 150 Pa corresponding to degradation of Willebrand factor, platelet activation, and red blood cell rupture (hemolysis) [ 24 , 37 , 46 , 47 , 48 ]. To improve hemocompatibility and reduce dysfunction, designers have focused on the geometric parameters of pumps, such as the wrap angle, number of blades, blade thickness, impeller diameter, and gap size [ 49 , 50 , 51 , 52 , 53 , 54 ].…”

Section: Discussionmentioning

confidence: 99%

Hemodynamic Evaluation of a Centrifugal Left Atrial Decompression Pump for Heart Failure with Preserved Ejection Fraction

et al. 2023

View full text Add to dashboard Cite

This article discusses a new continuous flow mini pump that has been developed to improve symptoms and prognosis in patients with Heart Failure with Preserved Ejection Fraction (HFpEF), for which there are currently no established treatments. The pump is designed to discharge a reduced percentage of blood volume from the left atrium to the subclavian artery, clamped at the bifurcation with the aortic arch. The overall specifications, design parameters, and hemodynamics of this new device are discussed, along with data from in vitro circulation loop tests and numerical simulations. The article also compares the results for two configurations of the pump with respect to key indicators of hemocompatibility used in blood pump development.

show abstract

Section: Discussionmentioning

confidence: 99%

Hemodynamic Evaluation of a Centrifugal Left Atrial Decompression Pump for Heart Failure with Preserved Ejection Fraction

et al. 2023

View full text Add to dashboard Cite

show abstract

“…The presence of secondary flow passages leads to a large number of secondary flows, and the collision/mixing of these secondary flows with main flow can also lead to high NPSSS 19,21 . The level of NPSS in the blood pump usually exceeds 100 Pa, when blood moves through the blood pump, it will be subjected to NPSS 25,26 . The NPSS can cause damage to red blood cells (RBCs), 27‐29 resulting in release of hemoglobin into plasma(hemolysis) 30,31 .…”

Section: Introductionmentioning

confidence: 99%

“…19,21 The level of NPSS in the blood pump usually exceeds 100 Pa, when blood moves through the blood pump, it will be subjected to NPSS. 25,26 The NPSS can cause damage to red blood cells (RBCs), [27][28][29] resulting in release of hemoglobin into plasma(hemolysis). 30,31 In addition to the magnitude of shear stress, hemolysis is also associated with an increase in the duration of exposure to high shear stress.…”

Section: Introductionmentioning

confidence: 99%

Impact of volute design features on hemodynamic performance and hemocompatibility of centrifugal blood pumps used in ECMO

Wang

et al. 2022

Artificial Organs

Self Cite

View full text Add to dashboard Cite

Background The centrifugal blood pump volute has a significant impact on its hemodynamic performance hemocompatibility. Previous studies about the effect of volute design features on the performance of blood pumps are relatively few. Methods In the present study, the computational fluid dynamics (CFD) method was utilized to evaluate the impact of volute design factors, including spiral start position, volute tongue radius, inlet height, size, shape and diffuser pipe angle on the hemolysis index and thrombogenic potential of the centrifugal blood pump. Results Correlation analysis shows that flow losses affect the hemocompatibility of the blood pump by influencing shear stress and residence time. The closer the spiral start position of the volute, the better the hydraulic performance and hemocompatibility of the blood pump. Too large or too small volute inlet heights can worsen hydraulic performance and hemolysis, and higher volute inlet height can increase the thrombogenic potential. Small volute sizes exacerbate hemolysis and large volute sizes increase the thrombogenic risk, but volute size does not affect hydraulic performance. When the diffuser pipe is tangent to the base circle of the volute, the best hydraulic performance and hemolysis performance of the blood pump is achieved, but the thrombogenic potential is increased. The trapezoid volute has poor hydraulic performance and hemocompatibility. The round volute has the best hydraulic and hemolysis performance, but the thrombogenic potential is higher than that of the rectangle volute. Conclusion This study found that the hemolysis index shows a significant correlation with spiral start position, volute size, and diffuser pipe angle. Thrombogenic potential exhibits a good correlation with all the studied volute design features. The flow losses affect the hemocompatibility of the blood pump by influencing shear stress and residence time. The finding of this study can be used to guide the optimization of blood pump for improving the hemodynamic performance and hemocompatibility.

show abstract

“…8 As blood passes through the pump, it is easily affected by NPSS. [9][10][11] High NPSS induces hemolysis, that is, damage to RBCs, resulting in the release of hemoglobin into the plasma. [12][13][14] The formation of thrombus is also closely related to NPSS.…”

Section: Introductionmentioning

confidence: 99%

“…Turbulence is another important contributor for NPSS generation 8 . As blood passes through the pump, it is easily affected by NPSS 9–11 . High NPSS induces hemolysis, that is, damage to RBCs, resulting in the release of hemoglobin into the plasma 12–14 .…”

Section: Introductionmentioning

confidence: 99%

The impact of rotor configurations on hemodynamic features, hemocompatibility and dynamic balance of the centrifugal blood pump: A numerical study

Wang

et al. 2022

Numer Methods Biomed Eng

Self Cite

View full text Add to dashboard Cite

To investigate the effect of rotor design configuration on hemodynamic features, hemocompatibility and dynamic balance of blood pumps. Computational fluid dynamics was employed to investigate the effects of rotor type (closed impeller, semi‐open impeller), clearance height and back vanes on blood pump performance. In particular, the Eulerian hemolysis model based on a power‐law function and the Lagrangian thrombus model with integrated stress accumulation and residence time were applied to evaluate the hemocompatibility of the blood pump. This study shows that compared to the closed impeller, the semi‐open impeller can improve hemolysis at a slight sacrifice in head pressure, but increase the risk of thrombogenic potential and disrupt rotor dynamic balance. For the semi‐open impeller, the pressure head, hemolysis, and axial thrust of the blood pump decrease with increasing front clearance, and the risk of thrombosis increases first and then decreases with increasing front clearance. Variations in back clearance have little effect on pressure head, but larger on back clearance, worsens hemolysis, thrombogenic potential and rotor dynamic balance. The employment of back vanes has little effect on the pressure head. All back vanes configurations have an increased risk of hemolysis in the blood pump but are beneficial for the improvement of the rotor dynamic balance of the blood pump. Reasonable back vanes configuration (higher height, wider width, longer length and more number) decreases the flow separation, increases the velocity of blood in the back clearance, and reduces the risk of blood pooling and thrombosis. It was also found that hemolysis index (HI) was highly negatively correlated with pressure difference between the top and back clearances (r = −.87), and thrombogenic potential was positively correlated with pressure difference between the top and back clearances (r = .71). This study found that rotor type, clearance height, and back vanes significantly affect the hydraulic performance, hemocompatibility and rotor dynamic balance of centrifugal blood pumps through secondary flow. These parameters should be carefully selected when designing and optimizing centrifugal blood pumps for improving the blood pump clinical outcomes.

show abstract

A new way to evaluate thrombotic risk in failure heart and ventricular assist devices

Cited by 16 publications

References 44 publications

Hemodynamic Evaluation of a Centrifugal Left Atrial Decompression Pump for Heart Failure with Preserved Ejection Fraction

Hemodynamic Evaluation of a Centrifugal Left Atrial Decompression Pump for Heart Failure with Preserved Ejection Fraction

Impact of volute design features on hemodynamic performance and hemocompatibility of centrifugal blood pumps used in ECMO

The impact of rotor configurations on hemodynamic features, hemocompatibility and dynamic balance of the centrifugal blood pump: A numerical study

Contact Info

Product

Resources

About