Impact of heart failure severity on ventricular assist device haemodynamics: a computational study

From Springer Nature via Jisc Publications RouterHistory: received 2020-04-17, registration 2020-08-24, accepted 2020-08-24, pub-electronic 2020-08-29, online 2020-08-29, pub-print 2020-12Publication status: PublishedFunder: University of ManchesterAbstract: Purpose: This computational fluid dynamics study investigates the necessity of incorporating heart failure severity in the preoperative planning of left ventricular assist device (LVAD) configurations, as it is often omitted from studies on LVAD performance. Methods: A parametric study was conducted examining a common range of LVAD to aortic root flow ratios (LVAD/AR-FR). A normal aortic root waveform was scaled by 5–30% in increments of 5% to represent the common range of flow pumped by the left ventricle for different levels of heart failure. A constant flow rate from the cannula compensated for the severity of heart failure in order to maintain normal total aortic flow rate. Results: The results show that LVAD/AR-FR can have a significant but irregular impact on the perfusion and shear stress-related haemodynamic parameters of the subclavian and carotid arteries. Furthermore, it is found that a larger portion of the flow is directed towards the thoracic aorta at the expense of the carotid and subclavian arteries, regardless of LVAD/AR-FR. Conclusion: The irregular behaviour found in the subclavian and carotid arteries highlights the necessity of including the LVAD/AR-FR in the preoperative planning of an LVAD configuration, in order to accurately improve the effects on the cardiovascular system post implantation