(966) Computational Fluid Dynamics as a Surgical Tool to Optimise the Positioning of the LVAD Outflow Graft for Reducing Aortic Regurgitation
نویسندگان
چکیده
PurposeThe HeartMate III (HMIII) has improved the survival rate of patients with LVAD to over 50% at five years. Despite this, some continuous flow develop significant aortic regurgitation (AR) which is associated adverse outcomes. The optimal surgical positioning outflow graft (OG) in ascending aorta (AA) for minimising risk developing AR not yet been investigated.MethodsA 3D model was created using MRI scan data. 14mm HMIII OG position on AA simulated and geometrical parameters including angle insertion, rotational (right-side front) distance from valve (AV) were modified. A computational fluid dynamics (CFD) simulation designed calculate obtain blood velocity, perfusion, wall shear stress (WSS) turbulent kinetic energy (TKE). pulsatile native cardiac cycle used as inlet boundaries Windkessel prescribed pressure outlets.ResultsBased this CFD simulation, reducing reverse flow, turbulence WSS around AV an 35-55°, attached right side 55mm. This also optional attaching front AA. However, resulted a 2-fold increase higher velocity carotid arteries. suggests that furthest possible without compromising future transplant may help reduce AR.ConclusionThe potentially implications patterns should be considered during implantation. Optimized could development following Further studies are required validate these simulations clinical practice. investigated. outlets. Based AR.
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15 صفحه اولA simple method of creating LVAD outflow tract aortic anastomosis.
Left ventricular assist device (LVAD) implantation is frequently complicated by intraoperative and postoperative bleeding, particularly at the aortic anastomosis site. Many modifications of the anastomosis have been attempted. We describe a simple method to anastomose the LVAD outflow tract to the ascending aorta with minimal bleeding and a short anastomosis time.
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ژورنال
عنوان ژورنال: Journal of Heart and Lung Transplantation
سال: 2023
ISSN: ['1053-2498', '1557-3117']
DOI: https://doi.org/10.1016/j.healun.2023.02.1077