LVAD Outflow Graft Angle and Thrombosis Risk. ASAIO J 2017;63(1):14-23
Date
12/30/2016Pubmed ID
28033200Pubmed Central ID
PMC5201113DOI
10.1097/MAT.0000000000000443Scopus ID
2-s2.0-85008473978 (requires institutional sign-in at Scopus site) 61 CitationsAbstract
This study quantifies thrombogenic potential (TP) of a wide range of left ventricular assist device (LVAD) outflow graft anastomosis angles through state-of-the-art techniques: 3D imaged-based patient-specific models created via virtual surgery and unsteady computational fluid dynamics with Lagrangian particle tracking. This study aims at clarifying the influence of a single parameter (outflow graft angle) on the thrombogenesis associated with flow patterns in the aortic root after LVAD implantation. This is an important and poorly-understood aspect of LVAD therapy, because several studies have shown strong inter and intrapatient thrombogenic variability and current LVAD implantation strategies do not incorporate outflow graft angle optimization. Accurate platelet-level investigation, enabled by statistical treatment of outliers in Lagrangian particle tracking, demonstrates a strong influence of outflow graft anastomoses angle on thrombogenicity (platelet residence times and activation state characterized by shear stress accumulation) with significantly reduced TP for acutely-angled anastomosed outflow grafts. The methodology presented in this study provides a device-neutral platform for conducting comprehensive thrombogenicity evaluation of LVAD surgical configurations, empowering optimal patient-focused surgical strategies for long-term treatment and care for advanced heart failure patients.
Author List
Aliseda A, Chivukula VK, Mcgah P, Prisco AR, Beckman JA, Garcia GJ, Mokadam NA, Mahr CAuthor
Guilherme Garcia PhD Assistant Professor in the Biomedical Engineering department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultHeart Failure
Heart-Assist Devices
Humans
Hydrodynamics
Male
Risk
Thrombosis
