Experimental Measurements of Energy Augmentation for Mechanical Circulatory Assistance in a Patient-Specific Fontan Model

A mechanical blood pump specifically designed to increase pressure in the great veins would improve hemodynamic stability in adolescent and adult Fontan patients having dysfunctional cavopulmonary circulation. This study investigates the impact of axial‐flow blood pumps on pressure, flow rate, and e...

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Bibliographic Details
Published in:Artificial organs 2014-09, Vol.38 (9), p.791-799
Main Authors: Chopski, Steven G., Rangus, Owen M., Moskowitz, William B., Throckmorton, Amy L.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Algorithms
Artificial right ventricle
Blood pump
Catheters
Cavopulmonary assist device
Equipment Design
Fontan conversion
Fontan Procedure - instrumentation
Heart-Assist Devices
Hemodynamics
Humans
Mechanical cavopulmonary assist
Pediatric circulatory support
Pulmonary Artery - surgery
Single-ventricle physiology
Vena Cava, Inferior - surgery
Vena Cava, Superior - surgery
Ventricular assist device
Young Adult
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Summary:A mechanical blood pump specifically designed to increase pressure in the great veins would improve hemodynamic stability in adolescent and adult Fontan patients having dysfunctional cavopulmonary circulation. This study investigates the impact of axial‐flow blood pumps on pressure, flow rate, and energy augmentation in the total cavopulmonary circulation (TCPC) using a patient‐specific Fontan model. The experiments were conducted for three mechanical support configurations, which included an axial‐flow impeller alone in the inferior vena cava (IVC) and an impeller with one of two different protective stent designs. All of the pump configurations led to an increase in pressure generation and flow in the Fontan circuit. The increase in IVC flow was found to augment pulmonary arterial flow, having only a small impact on the pressure and flow in the superior vena cava (SVC). Retrograde flow was neither observed nor measured from the TCPC junction into the SVC. All of the pump configurations enhanced the rate of power gain of the cavopulmonary circulation by adding energy and rotational force to the fluid flow. We measured an enhancement of forward flow into the TCPC junction, reduction in IVC pressure, and only minimally increased pulmonary arterial pressure under conditions of pump support.
ISSN:0160-564X
1525-1594
DOI:10.1111/aor.12255