Exploratory Simulation of Thrombosis in a Temporary LVAD Catheter Pump within a Virtual In-vivo Left Heart Environment

TL;DR

This study uses computational fluid dynamics to explore thrombosis risks associated with a temporary LVAD catheter pump within a simulated in-vivo left heart, aiming to better understand device-host interactions in realistic conditions.

Contribution

It presents an exploratory CFD simulation of thrombosis in a catheter pump within a virtual in-vivo left heart, addressing the gap in understanding device-hemodynamics interactions.

Findings

Thrombosis risk factors identified in simulated conditions

Hemodynamics influenced by pulsatile native heart activity

Insights into device design for improved hemocompatibility

Abstract

Percutaneous catheter pumps are intraventricular temporary mechanical circulatory support (MCS) devices that are positioned across the aortic valve into the left ventricle (LV) and provide continuous antegrade blood flow from the LV into the ascending aorta (AA). MCS devices are most often computationally evaluated as isolated devices subject to idealized steady-state blood flow conditions. In clinical practice, MCS devices operate connected to or within diseased pulsatile native hearts and are often complicated by hemocompatibility related adverse events such as stroke, bleeding, and thrombosis. Whereas aspects of the human circulation are increasingly being simulated via computational methods, the precise interplay of pulsatile LV hemodynamics with MCS pump hemocompatibility remains mostly unknown and not well characterized. Technologies are rapidly converging such that next-generation MCS devices will soon be evaluated in virtual physiological environments that increasingly mimic clinical settings. The purpose of this brief communication is to report results and lessons learned from an exploratory CFD simulation of hemodynamics and thrombosis for a catheter pump situated within a virtual in-vivo left heart environment.