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Computational analysis of aortic hemodynamics during total and partial extra-corporeal membrane oxygenation and intra-aortic balloon pump support

Caruzo M. V., Gramigna V., Renzulli A., Fragomeni G.

Acta of Bioengineering and Biomechanics

2016

Vol. 18, no. 3

3--9

Purpose: The extracorporeal membrane oxygenation (ECMO) is a temporary, but prolonged circulatory support for cardiopulmonary failure. Clinical evidence suggests that pulsed flow is healthier than non pulsatile perfusion. The aim of this study was to computationally evaluate the effects of total and partial ECMO assistance and pulsed flow on hemodynamics in a patient-specific aorta model. Methods: The pulsatility was obtained by means of the intra-aortic balloon pump (IABP), and two different cases were investigated, considering a cardiac output (CO) of 5 L/min: Case A – total assistance – the whole flow delivered through the ECMO arterial cannula; Case B – partial assistance – flow delivered half through the cannula and half through the aorta. Computational fluid dynamic (CFD) analysis was carried out using the multiscale approach to couple the 3D aorta model with the lumped parameter model (resistance boundary condition). Results: In case A pulsatility followed the balloon radius change, while in case B it was mostly influenced by the cardiac one. Furthermore, during total assistance, a blood stagnation occurred in the ascending aorta; in the case of partial assistance, the flow was orderly when the IABP was on and was chaotic when the balloon was off. Moreover, the mean arterial pressure (MAP) was higher in case B. The wall shear stress was worse in ascending aorta in case A. Conclusions: Partial support is hemodynamically advisable.

Vacuum powered tubular pump for ventricular assist

Del Canizo J. F., Desco M. M., Rodriguez-Martinez D.

Biocybernetics and Biomedical Engineering

2003

Vol. 23, no. 2

43-50

A new vacuum powered tubular pump for mechanical circulatory support has been developed. The blood chamber is a tube made of highly elastic biocompatible polyurethane and placed into a rigid chamber. The filling of the blood chamber is achieved by means of vacuum avoiding the possibility of air embolism and stagnation points. Mechanical valves have been replaced by clip valves placed over the input and output cannulae of the device. The final cost of the disposable parts of the device is very low and allows its use in other applications like extra corporeal circulation or haemodialysis.