Left Ventricular Assist Device Flow Pattern Analysis Using Computational Fluid Dynamics at the Time of Invasive Hemodynamic Ramp Study: Using Patient-Specific Data to Optimize the Ramp Study

PurposeInvasive hemodynamic ramp studies have been shown to decrease the rates of left ventricular assist device (LVAD) complications however hemocompatibility related adverse events (HRAE) still remain unacceptably high. Computational fluid dynamics (CFD) allows for a more thorough analysis shear rate (SR) and stress (SS) which influences endothelial function thrombotic potential.MethodsAn invasive study was performed on patient with HeartMate 3 (HM3). An anatomical model reconstructed from computed tomography (CT) images, LVAD outflow cannula used as inflow boundary. The flow calculated separately using lumped-parameter-model (LPM) circulation. Ventricular volumes were CT patient's tracings. contribution HM3 implemented in LPM via published H-Q curves. CFD simulations then carried out over entire clinical operating condition 4600 6400 RPM. SS SR quantified cannula, ascending aorta, aortic arch cerebral circulation.ResultsAs speed increased 5500, RPM, blood volume exposed greater than 500 s−1 increased, respectively, by 1.46 fold 2.18 (2.00 2.93 4.37 cm3). Increase 1.37 1.74 (1.88 2.56 3.26 Pa), aorta 1.44 1.92 (0.60 0.86 1.14 circulation 1.40 1.88 (0.46 0.65 0.87 Pa).ConclusionHemodynamic optimization during needs be balanced that occur incremental increases. when applied can provide additive patient-specific information may further mitigate HRAE. Invasive potential. As Pa). Hemodynamic