Investigating Aortic Root Hemodynamics With EVAHEART2 Pump Speed Modulation.

Abstract

Left ventricular assist device (LVAD) therapy often reduces the chances of aortic valve opening (AVO), increasing the risk of blood stagnation and thrombus formation. The EVAHEART2 (EVA2) pump speed modulation (PSM) can be leveraged to mitigate these risks by encouraging AVO. Study aims to i) investigate how PSM impacts aortic root hemodynamics, ii) quantify how much transaortic valve flow is needed to washout the aortic root, and iii) evaluate how PSM may alter pulsatility in LVAD flow. Computational fluid dynamics simulations were used to quantify aortic root washout, washout progression, and perform platelet tracking to evaluate thrombogenic potential. Results showed that when the aortic valve (AV) was closed, only 60% of blood was washed out after 4 seconds, whereas AVO significantly increased washout efficiency, clearing over 80% of blood within 3 seconds. Platelet tracking revealed that platelets were up to 60% more likely to stagnate for a nonfunctional AV compared with transaortic flow scenarios. Higher transaortic flow had the lowest thrombogenic potential score. These findings demonstrate that transaortic valve flow is the primary factor driving aortic root washout. Using EVA2 PSM settings to enhance transaortic valve flow can improve aortic root washout. This study emphasizes the importance of strategies that enable LVAD patients to have a functional AV.