Ventricular flow field visualization during mechanical circulatory support in the assisted isolated beating heart

Philipp Aigner, Martin Schweiger, Katharine Fraser, Young Choi, Frithjof Lemme, Nikola Cesarovic, Ulrich Kertzscher, Heinrich Schima, Michael Huebler, Marcus Granegger

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Abstract

Investigations of ventricular flow patterns during mechanical circulatory support are limited to in-vitro flow models or in-silico simulations, which cannot fully replicate the complex anatomy and contraction of the heart. Therefore, the feasibility of using echocardiographic particle image velocimetry (Echo-PIV) for physiological flow field characterization was evaluated in an isolated beating heart setup.
Porcine hearts were connected to the isolated heart setup and a left ventricular assist device (LVAD) was implanted. During different levels of LVAD support (unsupported, partial support, full support), microbubbles were injected and echocardiographic images were acquired. Iterative PIV algorithms were applied to calculate flow fields.
The isolated heart setup allowed different hemodynamic situations. In the unsupported heart, diastolic intra-ventricular blood flow was redirected at the heart’s apex towards the left ventricular outflow tract (LVOT). As the level of support was increased, vortex formation was diminished with the blood flow following a more direct path toward the pump cannula. The maximum velocities in the LVOT were significantly reduced with increasing support.
For the first time, cardiac blood flow patterns during LVAD support were visualized and quantified in an ex-vivo model using Echo-PIV. The results reveal potential regions of stagnation in the LVOT and, in future the methods might also beused in clinical routine to evaluate LVAD support.
Original languageEnglish
JournalAnnals of Biomedical Engineering
Early online date18 Nov 2019
DOIs
Publication statusE-pub ahead of print - 18 Nov 2019

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