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In Vitro Investigation of the Effect of Left Ventricular Assist Device Speed and Pulsatility Mode on Intraventricular Hemodynamics

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Abstract

Stroke has become the main cause of mortality and morbidity in patients treated with Left Ventricular Assist Devices (LVADs). The hemodynamics of the left ventricle are altered by the implantation of an LVAD, with the increase of thrombogenic flow patterns, such as stagnation regions. Time-resolved stereo particle image velocimetry (Stereo-PIV) measurements of the flow inside a patient-specific model of the left ventricle (LV) implanted with an LVAD were performed. The effects of LVAD speed, peripheral resistance and afterload were investigated. The impact of activating the LVAD pulsatility mode (periodic speed modulation) was also evaluated. Analysis of the velocity measurements in two orthogonal planes revealed stagnation zones which may be favorable to thrombus formation. Increasing LVAD speed, despite increasing the flow rate through the inflow cannula, does not automatically result in smaller stagnation regions. These results demonstrated the strong interdependence of peripheral resistance, afterload and flow through the LVAD. As a consequence, the pulsatility mode showed very limited effect on overall flow rate. However, it did reduce the size of high stagnation areas. This study showed how LVAD speed, peripheral resistance and afterload impact the complex intraventricular flow patterns in a ventricle implanted with an LVAD and quantify their thrombogenic risk.

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Acknowledgments

This work has been financially supported by the Locke Trust through a gift to the Division of Cardiology of the University of Washington and the American Heart Association via a Postdoctoral fellowship (19POST34450082).

Conflict of interest

Dr. Claudius Mahr: Consultant/Investigator: Abbott, Medtronic, Abiomed, Syncardia; Jennifer Beckman: Consultant: Abbott, Medtronic, Abiomed, Syncardia.

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Authors and Affiliations

  1. Mechanical Engineering, University of Washington, Seattle, WA, USA

    Fanette Chassagne, Marissa Miramontes & Alberto Aliseda

  2. Biomedical and Chemical Engineering and Sciences, Florida Institute of Technology, Melbourne, FL, USA

    Venkat Keshav Chivukula

  3. Division of Cardiology, University of Washington, Seattle, WA, USA

    Song Li, Jennifer A. Beckman & Claudius Mahr

Authors
  1. Fanette Chassagne
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  2. Marissa Miramontes
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Correspondence to Fanette Chassagne.

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Associate Editor Ender A. Finol oversaw the review of this article.

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Chassagne, F., Miramontes, M., Chivukula, V.K. et al. In Vitro Investigation of the Effect of Left Ventricular Assist Device Speed and Pulsatility Mode on Intraventricular Hemodynamics. Ann Biomed Eng 49, 1318–1332 (2021). https://doi.org/10.1007/s10439-020-02669-9

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