Med Biol Eng Comput - Continuous flow left ventricular pump support and its effect on regional left ventricular wall stress: finite element analysis study.

Tópicos

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Resumo

Left ventricular assist device (LVAD) support unloads left ventricular (LV) pressure and volume and decreases wall stress. This study investigated the effect of systematic LVAD unloading on the 3-dimensional myocardial wall stress by employing finite element models containing layered fiber structure, active contractility, and passive stiffness. The HeartMate II(?) (Thoratec, Inc., Pleasanton, CA) was used for LV unloading. The model geometries and hemodynamic conditions for baseline (BL) and LVAD support (LVsupport) were acquired from the Penn State mock circulatory cardiac simulator. Myocardial wall stress of BL was compared with that of LVsupport at 8,000, 9,000, 10,000 RPM, providing mean pump flow (Q(mean)) of 2.6, 3.2, and 3.7 l/min, respectively. LVAD support was more effective at unloading during diastole as compared to systole. Approximately 40, 50, and 60% of end-diastolic wall stress reduction were achieved at Q(mean) of 2.6, 3.2, and 3.7 l/min, respectively, as compared to only a 10% reduction of end-systolic wall stress at Q(mean) of 3.7 l/min. In addition, there was a stress concentration during systole at the apex due to the cannulation and reduced boundary motion. This modeling study can be used to further understand optimal unloading, pump control, patient management, and cannula design.

Resumo Limpo

left ventricular assist devic lvad support unload left ventricular lv pressur volum decreas wall stress studi investig effect systemat lvad unload dimension myocardi wall stress employ finit element model contain layer fiber structur activ contractil passiv stiff heartmat ii thoratec inc pleasanton ca use lv unload model geometri hemodynam condit baselin bl lvad support lvsupport acquir penn state mock circulatori cardiac simul myocardi wall stress bl compar lvsupport rpm provid mean pump flow qmean lmin respect lvad support effect unload diastol compar systol approxim enddiastol wall stress reduct achiev qmean lmin respect compar reduct endsystol wall stress qmean lmin addit stress concentr systol apex due cannul reduc boundari motion model studi can use understand optim unload pump control patient manag cannula design

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