Dual-Propeller Cavopulmonary Pump for Assisting Patients with Hypoplastic Right Ventricle

Area of Science:

• Biomedical Engineering
• Cardiovascular Physiology
• Medical Devices

Background:

• Single ventricle physiology presents complex surgical challenges, often requiring staged palliation like the Fontan procedure.
• The total cavopulmonary connection (TCPC) in Fontan patients can lead to nonphysiologic flow, causing venous hypertension and reduced cardiac output.
• A modest pressure increase in the TCPC could optimize hemodynamics, potentially delaying or preventing heart transplantation.

Purpose of the Study:

• To introduce and evaluate a novel conceptual design for a dual-propeller pump integrated within a flared TCPC.
• To assess the hydraulic performance, blood flow patterns, and hemolysis potential of this dual-propeller TCPC system using computational fluid dynamics (CFD).
• To determine the optimal axial separation distance between the two propellers for improved efficiency and reduced blood damage.

Main Methods:

• Computational fluid dynamics (CFD) simulations were employed to analyze the dual-propeller pump within a flared TCPC model.
• Hydraulic performance, including pressure rise and energy loss, was evaluated under various flow rates and rotational speeds.
• Blood flow patterns and the potential for hemolysis were assessed to understand the biocompatibility and efficacy of the design.

Main Results:

• The dual-propeller pump, with propellers in the inferior vena cava (IVC) and superior vena cava (SVC) pathways, generated a pressure rise of 1-20 mm Hg.
• Optimal performance regarding flow interference, energy loss, and reduced hemolysis potential was observed with a larger separation distance between propellers.
• The system operated effectively at flow rates of 0.4-7 lpm and speeds of 6,000-12,000 rpm.

Conclusions:

• The proposed dual-propeller micropump design offers a potential solution to augment cavopulmonary flow in Fontan patients.
• This technology could help normalize flow dynamics, mimicking biventricular circulation and improving long-term outcomes.
• Further research and development could lead to a device that mitigates complications associated with TCPC and reduces the need for heart transplantation.