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Virtual Fitting and Hemodynamic Simulation of the EVAHEART 2 Left Ventricular Assist Device and Double-Cuff Tipless Inflow Cannula

Authors: Simon Johannes, Sonntag; Erin, Lipinski; Michael, Neidlin; Kristin, Hugenroth; Robert, Benkowski; Tadashi, Motomura; Tim Arne Simon, Kaufmann;

Virtual Fitting and Hemodynamic Simulation of the EVAHEART 2 Left Ventricular Assist Device and Double-Cuff Tipless Inflow Cannula

Abstract

Inflow malposition during surgery, postoperative pump migration, inflow obstruction, and right ventricular compression are major contributors to low flow and adverse events in patients with ventricular assist devices (VADs). These position abnormalities can lead to adverse events including ischemic stroke. To address these problems, we conducted a virtual anatomical fitting study and hemodynamic simulation on iterative cannula designs, resulting in the EVAHEART 2 with the novel double-cuff tipless (DCT) inflow cannula and smaller pump design. Anatomical fitting was based on computed tomography scans of six patients with heart failure, and a fluid-structure-integration (FSI) model of the left ventricle with a lumped parameter model of the entire cardiovascular system during VAD support was created. Using this model, the hemodynamics of three inflow cannula insertion lengths for two patient-specific ventricles were calculated for both full and partial VAD support. The DCT cannula with the smaller pump housing proved resistant to obstruction even when the pump housing was adjusted. The complete system also had a smaller pump pocket size than the other designs and avoided position abnormalities that commonly lead to adverse events. Compared with conventional cadaver studies, virtual fitting and numerical simulations are more beneficial and economical for iteratively designing medical devices.

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Keywords

Aged, 80 and over, Heart Failure, Male, Heart Ventricles, Hemodynamics, Thrombosis, Equipment Design, Middle Aged, Cannula, Humans, Computer Simulation, Female, Heart-Assist Devices, Shear Strength, Aged

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
14
Top 10%
Top 10%
Top 10%
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