Uniquely shaped cardiovascular stents enhance the pressure generation of intravascular blood pumps

Throckmorton, Amy L.; Carr, James; Moskowitz, William B.; Gangemi, James J.; Haggerty, Christopher M.; Yoganathan, Ajit P.

doi:10.1016/j.jtcvs.2011.12.061

Cited by 9 publications

(19 citation statements)

References 15 publications

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“…Figure illustrates the stent designs as investigated. The super‐diffuser has straight filaments with a set of diffuser blades on the stent at the outlet, whereas the against–with cage has filaments partially twisted in the opposite direction to the impeller blades and filaments partially twisted in the same direction as the diffuser blades . The two cages are the result of two separate design iterations incorporating hydraulic testing .…”

Section: Methodsmentioning

confidence: 99%

“…These surgical treatment strategies are limited in long-term benefit, and few therapeutic alternatives exist. The lack of therapeutic options for Fontan patients necessitates the development of new cavopulmonary assist doi: 10.1111/aor.12255 devices to address the need for alternative circulatory support for this growing cohort of patients (11)(12)(13)(14)(15)(16)(17). A mechanical blood pump specifically designed to increase pressure in the great veins would improve hemodynamic stability in adolescent and adult patients having dysfunctional cavopulmonary circulations.…”

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confidence: 99%

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Experimental Measurements of Energy Augmentation for Mechanical Circulatory Assistance in a Patient-Specific Fontan Model

et al. 2014

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A mechanical blood pump specifically designed to increase pressure in the great veins would improve hemodynamic stability in adolescent and adult Fontan patients having dysfunctional cavopulmonary circulation. This study investigates the impact of axial-flow blood pumps on pressure, flow rate, and energy augmentation in the total cavopulmonary circulation (TCPC) using a patient-specific Fontan model. The experiments were conducted for three mechanical support configurations, which included an axial-flow impeller alone in the inferior vena cava (IVC) and an impeller with one of two different protective stent designs. All of the pump configurations led to an increase in pressure generation and flow in the Fontan circuit. The increase in IVC flow was found to augment pulmonary arterial flow, having only a small impact on the pressure and flow in the superior vena cava (SVC). Retrograde flow was neither observed nor measured from the TCPC junction into the SVC. All of the pump configurations enhanced the rate of power gain of the cavopulmonary circulation by adding energy and rotational force to the fluid flow. We measured an enhancement of forward flow into the TCPC junction, reduction in IVC pressure, and only minimally increased pulmonary arterial pressure under conditions of pump support.

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Section: Methodsmentioning

confidence: 99%

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confidence: 99%

Experimental Measurements of Energy Augmentation for Mechanical Circulatory Assistance in a Patient-Specific Fontan Model

et al. 2014

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“…The performance achievements met the desired pressure-flow requirements to support a Fontan patient (3,(5)(6)(7)(8). All of the pump designs produced a pressure rise over the flow range evaluated and rotational speeds of 4000-7000 RPM.…”

Section: Discussionmentioning

confidence: 76%

“…Details about this flow loop and the methodology that was employed can be found in the literature (5,7). A shaft-driven configuration was utilized for testing.…”

Section: Experimental Testing Of Impeller Prototypementioning

confidence: 99%

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Design of Axial Blood Pumps for Patients With Dysfunctional Fontan Physiology: Computational Studies and Performance Testing

et al. 2015

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Limited treatment options for patients having dysfunctional single ventricle physiology motivate the necessity for alternative therapeutic options. To address this unmet need, we are developing a collapsible axial flow blood pump. This study investigated the impact of geometric simplicity to facilitate percutaneous placement and maintain optimal performance. Three new pump designs were numerically evaluated. A transient simulation explored the impact of respiration on blood flow conditions over the entire respiratory cycle. Prototype testing of the top performing pump design was completed. The top performing Rec design generated the highest pressure rise range of 2-38 mm Hg for flow rates of 1-4 L/min at 4000-7000 RPM, exceeding the performance of the other two configurations by more than 26%. The blood damage indices for the new pump designs were determined to be below 0.5% and predicted hemolysis levels remained low at less than 7 × 10(-5) g/100 L. Prototype testing of the Rec design confirmed numerical predictions to within an average of approximately 22%. These findings demonstrate that the pumps are reasonably versatile in operational ability, meet pressure-flow requirements to support Fontan patients, and are expected to have low levels of blood trauma.

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In Silico Evaluation of a Self-powered Venous Ejector Pump for Fontan Patients

Rasooli

Giljarhus

Hiorth

et al. 2023

Cardiovasc Eng Tech

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Purpose The Fontan circulation carries a dismal prognosis in the long term due to its peculiar physiology and lack of a subpulmonic ventricle. Although it is multifactorial, elevated IVC pressure is accepted to be the primary cause of Fontan's high mortality and morbidity. This study presents a self-powered venous ejector pump (VEP) that can be used to lower the high IVC venous pressure in single-ventricle patients. Methods A self-powered venous assist device that exploits the high-energy aortic flow to lower IVC pressure is designed. The proposed design is clinically feasible, simple in structure, and is powered intracorporeally. The device's performance in reducing IVC pressure is assessed by conducting comprehensive computational fluid dynamics simulations in idealized total cavopulmonary connections with different offsets. The device was finally applied to complex 3D reconstructed patient-specific TCPC models to validate its performance. Results The assist device provided a significant IVC pressure drop of more than 3.2 mm Hg in both idealized and patient-specific geometries, while maintaining a high systemic oxygen saturation of more than 90%. The simulations revealed no significant caval pressure rise (< 0.1 mm Hg) and sufficient systemic oxygen saturation (> 84%) in the event of device failure, demonstrating its fail-safe feature. Conclusions A self-powered venous assist with promising in silico performance in improving Fontan hemodynamics is proposed. Due to its passive nature, the device has the potential to provide palliation for the growing population of patients with failing Fontan.

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Uniquely shaped cardiovascular stents enhance the pressure generation of intravascular blood pumps

Abstract: The specialized design of the stents, which protect the vessel wall from the rotating components of the pump, proved to be advantageous by further augmenting the pressure generation of the pump, reducing the flow vorticity at the pump outlet, and enhancing flow control.

Cited by 9 publications

References 15 publications

Experimental Measurements of Energy Augmentation for Mechanical Circulatory Assistance in a Patient-Specific Fontan Model

Experimental Measurements of Energy Augmentation for Mechanical Circulatory Assistance in a Patient-Specific Fontan Model

Design of Axial Blood Pumps for Patients With Dysfunctional Fontan Physiology: Computational Studies and Performance Testing

In Silico Evaluation of a Self-powered Venous Ejector Pump for Fontan Patients

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