Ventricular Flow Dynamics With an Intra-Ventricular Balloon Pump: An In Vitro Analysis

Area of Science:

• Biomedical Engineering
• Cardiovascular Physiology
• Medical Device Development

Background:

• Durable ventricular assist devices are costly for short-term heart failure support.
• Intra-ventricular balloon pumps (IVBP) are a potential low-cost alternative.
• Evaluating IVBP impact on intraventricular flow dynamics is critical to prevent thrombus formation.

Purpose of the Study:

• To assess left ventricle pulsatility and flow patterns with IVBP support in a simulated severe heart failure model.
• To compare IVBP co-pulsation and counter-pulsation timings against a baseline severe heart failure condition.
• To determine if IVBP actuation timing can prevent flow stasis and promote blood washout.

Main Methods:

• Particle image velocimetry (PIV) was employed to analyze flow dynamics.
• Simulated severe heart failure left ventricle model was used.
• Two IVBP inflation timings (co-pulsation and counter-pulsation) were evaluated against baseline.

Main Results:

• IVBP co-pulsation showed reduced velocity range but increased peak systolic velocity and cardiac output compared to baseline.
• IVBP counter-pulsation increased peak systolic velocity but disrupted vortex flow and induced diastolic pulsing and ventricular dilation.
• Neither IVBP timing reduced overall intraventricular pulsatility, suggesting potential for improved blood washout.

Conclusions:

• IVBP co-pulsation timing demonstrates potential for enhancing systolic energy and cardiac output in severe heart failure.
• IVBP counter-pulsation timing negatively impacts natural flow dynamics and may cause adverse effects.
• Optimizing IVBP actuation timing is key to achieving effective blood washout and preventing thrombus formation in heart failure patients.