Energetics of blood flow in Fontan circulation under VAD support

• Published in: Artificial organs Vol. 44; no. 1; pp. 50 - 57
• Main Authors: Telyshev, Dmitry, Denisov, Maxim, Markov, Aleksandr, Fresiello, Libera, Verbelen, Tom, Selishchev, Sergey
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01-01-2020
• Subjects: Bioelectricity; Blood circulation; Blood flow; Blood Flow Velocity; Blood Pressure; Computer Simulation; Configurations; Equipment Design; flow hemodynamics; Flow velocity; Fluid dynamics; Fontan Procedure - instrumentation; Heart; Heart surgery; Heart transplantation; Heart-Assist Devices; Human body; Humans; Hydrodynamics; Implantation; Kinetic energy; Kinetic energy distribution; Kinetics; Models, Cardiovascular; Morbidity; Power loss; scalar shear stress; Shear stress; Stress concentration; total cavopulmonary connection; Transplantation; Turbulent flow; Ventricle; ventricular assist device; ventricular assist device; kinetic energy distribution; scalar shear stress; total cavopulmonary connection; flow hemodynamics
• ISSN: 0160-564X; 1525-1594
• DOI: 10.1111/aor.13564

The need to simulate the normal operating conditions of the human body is the key factor in every study and engineering process of bioelectronic devices designed for implantation. The Fontan procedure is an example of such a process aimed to support the human body function. It is a standard treatment method for patients with a functionally univentricular heart. However, it has significant drawbacks such as overload of the only functional heart ventricle that often leads to the necessity of the heart transplantation. In this study, we analyze the total cavopulmonary connection (TCPC) influence on the blood with and without connected auxiliary blood circulation pump. We investigate four different types of TCPC configurations, analyze blood pressure and different flow rate, study the turbulent kinetic energy distribution, and evaluate hydraulic and power losses for various cases. Finally, we calculate volumetric scalar shear stresses distribution and demonstrate the high potential of TCPC configuration with connected rotary pump as a tool for the load redistribution in the functional heart ventricle. This work is particularly relevant for improving existing TCPCs’ quality that can extend the life of Fontan patients. Moreover, it also applies to the reduction of morbidity and mortality of the patients waiting for the heart transplantation.