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LVAD Outflow Graft Angle and Thrombosis Risk. ASAIO J 2017 Jan/Feb;63(1):14-23

Date

12/30/2016

Pubmed ID

28033200

Pubmed Central ID

PMC5201113

DOI

10.1097/MAT.0000000000000443

Scopus ID

2-s2.0-85008473978   26 Citations

Abstract

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 C

Author

Guilherme Garcia PhD Assistant Professor in the Biomedical Engineering department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adult
Heart Failure
Heart-Assist Devices
Humans
Hydrodynamics
Male
Risk
Thrombosis
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