Affiliations: [a] School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, PA, USA | [b] Pediatric Cardiology, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA | [c] St. Christopher's Hospital for Children, Tenet Healthcare Corporation, Philadelphia, PA, USA | [d] Departments of Cardiothoracic Surgery and Medicine, College of Medicine, Drexel University, Philadelphia, PA, USA
Correspondence:
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Corresponding author: Amy Throckmorton, School of Biomedical Engineering, Science and Health Systems, Drexel University, Bossone Research Enterprise Center, 3141 Chestnut Street, Rm. 718, Philadelphia, PA 19104, USA. Tel.: +1 757 646 3790; Fax: +1 215 895 4983; E-mail:[email protected]
Abstract: Surgical optimization of the cavopulmonary connection and pharmacological
therapy for dysfunctional Fontan physiology continue to advance, but these treatment approaches only
slow the progression of decline to end-stage heart failure. The development
of a mechanical cavopulmonary assist device will provide a viable
therapeutic option in the bridging of patients to transplant or to
stabilization. We hypothesize that rotational blood flow, delivered by an
implantable axial flow blood pump, could effectively assist the venous
circulation in Fontan patients by mimicking vortical blood flow patterns in
the cardiovascular system. This study investigated seven new models of
mechanical cavopulmonary assistance (single and dual-pump assist), created
combinations of pump designs that deliver counter rotating vortical flow
conditions, and analyzed pump performance, velocity streamlines, swirling
strength, and energy augmentation in the cavopulmonary circuit for each
support scenario. The model having an axial clockwise-oriented impeller in
the inferior vena cava and an axial counterclockwise-oriented impeller
rotating in the superior vena cava outperformed all of the support scenarios
by enhancing the energy of the cavopulmonary circulation an average of
10.3% over the entire flow range and a maximum of 27.4% at %the
higher
flow rates. This research will guide the development of axial flow blood
pumps for Fontan patients and demonstrated the high probability of %a
cardiovascular benefit using counter rotating pumps in a dual support
scenario, but found that this is dependent upon the patient-specific cavopulmonary
anatomy.
