In Silico Evaluation of a Self-powered Venous Ejector Pump for Fontan Patients.

IF 1.6 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Reza Rasooli, Knut Erik Teigen Giljarhus, Aksel Hiorth, Ingunn Westvik Jolma, Jan Ludvig Vinningland, Charlotte de Lange, Henrik Brun, Henrik Holmstrom
{"title":"In Silico Evaluation of a Self-powered Venous Ejector Pump for Fontan Patients.","authors":"Reza Rasooli,&nbsp;Knut Erik Teigen Giljarhus,&nbsp;Aksel Hiorth,&nbsp;Ingunn Westvik Jolma,&nbsp;Jan Ludvig Vinningland,&nbsp;Charlotte de Lange,&nbsp;Henrik Brun,&nbsp;Henrik Holmstrom","doi":"10.1007/s13239-023-00663-5","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>The Fontan circulation carries a dismal prognosis in the long term due to its peculiar physiology and lack of a subpulmonic ventricle. Although it is multifactorial, elevated IVC pressure is accepted to be the primary cause of Fontan's high mortality and morbidity. This study presents a self-powered venous ejector pump (VEP) that can be used to lower the high IVC venous pressure in single-ventricle patients.</p><p><strong>Methods: </strong>A self-powered venous assist device that exploits the high-energy aortic flow to lower IVC pressure is designed. The proposed design is clinically feasible, simple in structure, and is powered intracorporeally. The device's performance in reducing IVC pressure is assessed by conducting comprehensive computational fluid dynamics simulations in idealized total cavopulmonary connections with different offsets. The device was finally applied to complex 3D reconstructed patient-specific TCPC models to validate its performance.</p><p><strong>Results: </strong>The assist device provided a significant IVC pressure drop of more than 3.2 mm Hg in both idealized and patient-specific geometries, while maintaining a high systemic oxygen saturation of more than 90%. The simulations revealed no significant caval pressure rise (< 0.1 mm Hg) and sufficient systemic oxygen saturation (> 84%) in the event of device failure, demonstrating its fail-safe feature.</p><p><strong>Conclusions: </strong>A self-powered venous assist with promising in silico performance in improving Fontan hemodynamics is proposed. Due to its passive nature, the device has the potential to provide palliation for the growing population of patients with failing Fontan.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":null,"pages":null},"PeriodicalIF":1.6000,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10412470/pdf/","citationCount":"1","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cardiovascular Engineering and Technology","FirstCategoryId":"5","ListUrlMain":"https://doi.org/10.1007/s13239-023-00663-5","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 1

Abstract

Purpose: The Fontan circulation carries a dismal prognosis in the long term due to its peculiar physiology and lack of a subpulmonic ventricle. Although it is multifactorial, elevated IVC pressure is accepted to be the primary cause of Fontan's high mortality and morbidity. This study presents a self-powered venous ejector pump (VEP) that can be used to lower the high IVC venous pressure in single-ventricle patients.

Methods: A self-powered venous assist device that exploits the high-energy aortic flow to lower IVC pressure is designed. The proposed design is clinically feasible, simple in structure, and is powered intracorporeally. The device's performance in reducing IVC pressure is assessed by conducting comprehensive computational fluid dynamics simulations in idealized total cavopulmonary connections with different offsets. The device was finally applied to complex 3D reconstructed patient-specific TCPC models to validate its performance.

Results: The assist device provided a significant IVC pressure drop of more than 3.2 mm Hg in both idealized and patient-specific geometries, while maintaining a high systemic oxygen saturation of more than 90%. The simulations revealed no significant caval pressure rise (< 0.1 mm Hg) and sufficient systemic oxygen saturation (> 84%) in the event of device failure, demonstrating its fail-safe feature.

Conclusions: A self-powered venous assist with promising in silico performance in improving Fontan hemodynamics is proposed. Due to its passive nature, the device has the potential to provide palliation for the growing population of patients with failing Fontan.

Abstract Image

Abstract Image

Abstract Image

自供电静脉射血泵对Fontan患者的计算机评价。
目的:Fontan循环由于其特殊的生理和缺乏肺下心室,长期预后不佳。虽然它是多因素的,但下腔静脉压力升高被认为是Fontan高死亡率和发病率的主要原因。本研究提出了一种自供电静脉射血泵(VEP),可用于降低单心室患者的高下腔静脉压。方法:设计一种利用高能量主动脉血流降低下腔压力的自供电静脉辅助装置。所提出的设计在临床上是可行的,结构简单,并在体内供电。通过在不同偏移量的理想全腔室肺连接中进行全面的计算流体动力学模拟,评估该设备在降低IVC压力方面的性能。最后将该设备应用于复杂的3D重建患者特异性TCPC模型以验证其性能。结果:辅助装置提供了一个显著的下腔静脉压降超过3.2毫米汞柱,在理想和患者特定的几何形状,同时保持高全身氧饱和度超过90%。模拟显示,在设备发生故障时,腔静脉压力没有明显上升(84%),证明了其故障安全特性。结论:提出了一种有希望改善Fontan血流动力学的自供电静脉辅助装置。由于其被动性质,该设备有可能为越来越多的Fontan患者提供缓解。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Cardiovascular Engineering and Technology
Cardiovascular Engineering and Technology Engineering-Biomedical Engineering
CiteScore
4.00
自引率
0.00%
发文量
51
期刊介绍: Cardiovascular Engineering and Technology is a journal publishing the spectrum of basic to translational research in all aspects of cardiovascular physiology and medical treatment. It is the forum for academic and industrial investigators to disseminate research that utilizes engineering principles and methods to advance fundamental knowledge and technological solutions related to the cardiovascular system. Manuscripts spanning from subcellular to systems level topics are invited, including but not limited to implantable medical devices, hemodynamics and tissue biomechanics, functional imaging, surgical devices, electrophysiology, tissue engineering and regenerative medicine, diagnostic instruments, transport and delivery of biologics, and sensors. In addition to manuscripts describing the original publication of research, manuscripts reviewing developments in these topics or their state-of-art are also invited.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信