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Continuous and Pulsatile Pediatric Ventricular Assist Device Hemodynamics with a Viscoelastic Blood Model

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An Erratum to this article was published on 06 July 2016

Abstract

To investigate the effects of pulsatile and continuous pediatric ventricular assist (PVAD) flow and pediatric blood viscoelasticity on hemodynamics in a pediatric aortic graft model. Hemodynamic parameters of pulsatility, along with velocity and wall shear stress (WSS), are analyzed and compared between Newtonian and viscoelastic blood models at a range of physiological pediatric hematocrits using computational fluid dynamics. Both pulsatile and continuous PVAD flow lead to a decrease in pulsatility (surplus hemodynamic energy, ergs/cm3) compared to healthy aortic flow but with continuous PVAD pulsatility up to 2.4 times lower than pulsatile PVAD pulsatility at each aortic outlet. Significant differences are also seen between the two flow modes in velocity and WSS. The higher velocity jet during systole with pulsatile flow leads to higher WSSs at the anastomotic toe and at the aortic branch bifurcations. The lower velocity but continuous flow jet leads to a much different flow field and higher WSSs into diastole. Under a range of physiological pediatric hematocrit (20–60%), both velocity and WSS can vary significantly with the higher hematocrit blood model generally leading to higher peak WSSs but also lower WSSs in regions of flow separation. The large decrease in pulsatility seen from continuous PVAD flow could lead to complications in pediatric vascular development while the high WSSs during peak systole from pulsatile PVAD flow could lead to blood damage. Both flow modes lead to similar regions prone to intimal hyperplasia resulting from low time-averaged WSS and high oscillatory shear index.

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Acknowledgments

We would like to acknowledge the National Institutes of Health for their support of this project through NIH NHLBI HL108123. Bryan C Good, Steven Deutsch, and Keefe B. Manning declare that they have no conflict of interest. No human or animal studies were carried out by the authors for this article. We also thank Ajit Yoganathan, PhD and Christopher M. Haggerty, PhD from the Department of Biomedical Engineering at the Georgia Institute of Technology for providing the pediatric aortic model.

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Authors and Affiliations

  1. Department of Biomedical Engineering, The Pennsylvania State University, 205 Hallowell Building, University Park, PA, 16802, USA

    Bryan C. Good, Steven Deutsch & Keefe B. Manning

  2. Department of Surgery, Penn State Hershey Medical Center, Hershey, PA, 17033, USA

    Keefe B. Manning

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  1. Bryan C. Good
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Correspondence to Keefe B. Manning.

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Associate Editor Ajit P. Yoganathan oversaw the review of this article.

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Good, B.C., Deutsch, S. & Manning, K.B. Continuous and Pulsatile Pediatric Ventricular Assist Device Hemodynamics with a Viscoelastic Blood Model. Cardiovasc Eng Tech 7, 23–43 (2016). https://doi.org/10.1007/s13239-015-0252-8

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