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Fluid Dynamics in the HeartMate 3: Influence of the Artificial Pulse Feature and Residual Cardiac Pulsation

Lena Wiegmann1, Bente Thamsen2,3,4, Diane de Zélicourt1,3

  • 1The Interface Group, Institute of Physiology, University of Zurich, Zurich, Switzerland.

Artificial Organs
|August 22, 2018
PubMed

Insights

The HeartMate 3 ventricular assist device (VAD) shows good flow, but its artificial pulse increases turbulence and total stresses. This may explain hemocompatibility issues despite low pump thrombosis rates.

Area of Science:

  • Biomedical Engineering
  • Fluid Dynamics
  • Cardiovascular Science

Background:

  • Ventricular assist devices (VADs) are crucial for end-stage heart failure patients.
  • The HeartMate 3 (HM3) VAD features an artificial pulse to mitigate thrombosis.
  • Stroke and bleeding complications persist despite VAD advancements.

Purpose of the Study:

  • To investigate the impact of HM3's artificial pulse on internal flow dynamics.
  • To analyze flow fields and stresses under various operational modes.
  • To correlate flow characteristics with clinical complications like hemocompatibility issues.

Main Methods:

  • High-resolution computational fluid dynamics (CFD) simulations were employed.
  • Eulerian and Lagrangian flow features were compared.
  • Simulations included constant speed, artificial pulse, and native cardiac cycle effects.

Main Results:

  • Good scalar washout was observed across all tested conditions, correlating with low pump thrombosis.
  • The artificial pulse did not improve scalar washout but increased velocity and gradient variations.
  • Viscous stresses were lower than in other VADs, but the pulse significantly increased turbulence and total stresses.

Conclusions:

  • The HM3 VAD demonstrates effective washout, potentially explaining low thrombosis rates.
  • The artificial pulse's impact on turbulence and stresses may be linked to hemocompatibility issues.
  • Further research is needed to fully understand the clinical implications of HM3's flow dynamics.

Keywords:
Artificial pulseCardiac cycleComputational fluid dynamicsHeartMate 3HemocompatibilityVentricular assist devices

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