Validation of Aortic Blood Flow Simulations During Extracorporeal Circulation Using Phase Contrast Magnetic Resonance...

Although extracorporeal circulation (ECC) is routinely used in invasive cardiovascular medicine and can cause severe complications, the impact of ECC on arterial blood flow is not yet fully understood. This study aims to reveal actual bloodflow profiles during different ECC scenarios.

Twenty-three New Zealand White rabbits underwent ECC by ante- (n = 7) or retro-grade (n = 9) or physiological perfusion (n = 7). Arterial blood flow profiles were assessed with a focus on cerebral and visceral perfusion. Numerical simulation models were tuned and validated based on magnetic resonance imaging (MRI).

Ante- and retrograde ECC resulted in completely divergent aortic blood flow patterns. Supraaortic and visceral perfusions were not impaired during ante- or retro grade ECC. Excellent correlation of volume flow rates was achieved between MRI and simulations (r = 0.98). Intima damage was observed in regions of high wall shear stress (WSS).

This is the first study assessing arterial blood flow during different ECC scenarios in a living organism, and additionally validating precise blood flow simulations by in vivo measurements. Retrograde ECC does not a priori impair cerebral perfusion. Individualized simulations may guide cannulation strategies aiming at minimization of ECC-related complications.