Alternative heart assistance pump

2021 Spring.Includes bibliographical references.On average, the human heart beats around 115,000, and pumps around 2,000 gallons of blood daily. This essential organ may undergo systolic or diastolic dysfunction in which the heart cannot properly contract or relax, respectively. To help hearts pump effectively should these types of failures occur, ventricular assist devices (VAD) are implemented as a temporary or permanent solution. The most common VAD is the left ventricular assist device (LVAD) which supports the left ventricle in pumping the oxygen-rich blood from the heart to the aorta, and ultimately to the rest of the body. Although current VADs are an important treatment for advanced heart failure, generally VADS come with many complications and issues after implantation. These complications include incidents of hemolysis (tearing of the blood cells), thrombosis (clotting of the blood), bleeding (especially in the gastrointestinal tract), and infection at the driveline site. Specifically, the current continuous flow pumps are associated with a much higher incidence of gastrointestinal bleeding, myocardial perfusion, kidney problems, among others, compared with the earlier generation pulsatile pumps. However, the presence of several moving mechanical components made the pulsatile pumps less durable, bulky, and prone to malfunction, ultimately leading to favor toward continuous flow designs. The goal of the present study is to develop a novel heart assist pump, overcoming drawbacks to current commercially available pumps, by improving hemodynamic (blood flow) performance, pulsatility, and eliminating bleeding disorders. Our design will overcome the current pumps which suffer from non-physiological flow, and blood damage. The impact of this work goes beyond heart assist devices and would be applicable to other blood pumps. The fundamental biological and physical principles of designing a blood pump will be reviewed in chapter one. In addition, recent studies on current LVADs and the motivation behind these studies will also be discussed. Then, the idea of using a contractive tubular heart as an alternative pump will be presented in chapter two. To understand the pumping mechanism of the tubular heart, a detailed study on the embryonic heart is presented in this chapter. Subsequently, the effect of flow forces on blood cells will be studied in chapter 3. Moreover, the relation between flow regime and bleeding disorders have been studied in the same chapter. A discussion of our design, including the pump design, testing set up, experimental results will be presented in chapter 4. Finally, the limitations of the present study and future work will be presented in chapter 5

A geometric framework for immersogeometric analysis

The purpose of this dissertation is to develop a geometric framework for immersogeometric analysis that directly uses the boundary representations (B-reps) of a complex computer-aided design (CAD) model and immerses it into a locally refined, non-boundary-fitted discretization of the fluid domain. Using the non-boundary-fitted mesh which does not need to conform to the shape of the object can alleviate the challenge of mesh generation for complex geometries. This also reduces the labor-intensive and time-consuming work of geometry cleanup for the purpose of obtaining watertight CAD models in order to perform boundary-fitted mesh generation. The Dirichlet boundary conditions in the fluid domain are enforced weakly over the immersed object surface in the intersected elements. The surface quadrature points for the immersed object are generated on the parametric and analytic surfaces of the B-rep models. In the case of trimmed surfaces, adaptive quadrature rule is considered to improve the accuracy of the surface integral. For the non-boundary-fitted mesh, a sub-cell-based adaptive quadrature rule based on the recursive splitting of quadrature elements is used to faithfully capture the geometry in intersected elements. The point membership classification for identifying quadrature points in the fluid domain is based on a voxel-based approach implemented on GPUs. A variety of computational fluid dynamics (CFD) simulations are performed using the proposed method to assess its accuracy and efficiency. Finally, a fluid--structure interaction (FSI) simulation of a deforming left ventricle coupled with the heart valves shows the potential advantages of the developed geometric framework for the immersogeomtric analysis with complex moving domains

Proceedings of the 4th bwHPC Symposium

The bwHPC Symposium 2017 took place on October 4th, 2017, Alte Aula, Tübingen. It focused on the presentation of scientific computing projects as well as on the progress and the success stories of the bwHPC realization concept. The event offered a unique opportunity to engage in an active dialogue between scientific users, operators of bwHPC sites, and the bwHPC support team

A Rapid and Computationally Inexpensive Method to Virtually Implant Current and Next-Generation Stents into Subject-Specific Computational Fluid Dynamics Models

Computational modeling is often used to quantify hemodynamic alterations induced by stenting, but frequently uses simplified device or vascular representations. Based on a series of Boolean operations, we developed an efficient and robust method for assessing the influence of current and next-generation stents on local hemodynamics and vascular biomechanics quantified by computational fluid dynamics. Stent designs were parameterized to allow easy control over design features including the number, width and circumferential or longitudinal spacing of struts, as well as the implantation diameter and overall length. The approach allowed stents to be automatically regenerated for rapid analysis of the contribution of design features to resulting hemodynamic alterations. The applicability of the method was demonstrated with patient-specific models of a stented coronary artery bifurcation and basilar trunk aneurysm constructed from medical imaging data. In the coronary bifurcation, we analyzed the hemodynamic difference between closed-cell and open-cell stent geometries. We investigated the impact of decreased strut size in stents with a constant porosity for increasing flow stasis within the stented basilar aneurysm model. These examples demonstrate the current method can be used to investigate differences in stent performance in complex vascular beds for a variety of stenting procedures and clinical scenarios

Numerical simulation and experimentation of pulsatile flows in axisymmetric arterial models

ABSTRACT NUMERICAL SIMULATION AND EXPERIMENTATION OF PULSATILE FLOWS IN AXISYMMETRIC ARTERIAL MODELS by TADESSE GEBREEGZIABHER December 2011 Co-advisors: 1. Dr. Emmanuel Ayorinde 2. Dr. Trilochan Singh Major: Mechanical Engineering Degree: Doctor of Philosophy The primary motivation for this dissertation is the fluid flow and structural response to unsteady blood flow in the human body. The research work is a synergistic merging of numerical simulation and experimentation. For the experiments, an all-encompassing, highly flexible experimental apparatus was designed and fabricated to facilitate a wide range of operating conditions, the range of which was chosen to accommodate mammalian cardiovascular system for both human and animal species. The parameters that were varied during the course of the experimentation include the frequency of the flow pulsation, tubular materials having various structural properties, and blockages of the tube cross sections to simulate the presence of plaque in arteries. The main outcome of the experimentation was a connection between the amplitude and frequency of the pulsations and the volumetric flow rate of the flowing fluid. Of equal importance is the extent of the response of the wall to the nature of the pulsating flow which was detected, located and characterized using a non-invasive acoustic emission equipment. The simulations that were performed represent a major advance over prior attempts to simulate pulsating flows in flexible- and rigid-walled tubes. That advance was embodied in the model that was used to characterize the flow. In most of prior studies, a particular flow regime was selected and used throughout the entire solution domain. This selection ignored the fact that flowing fluids passing through variable cross sections undergo changes of flow regime. In particular, a flow initiated in a relatively large upstream cross section may be laminar based on inlet conditions. However, as the fluid travels downstream and enters a constricted cross section, the laminar regime may undergo a transition and subsequently experience turbulence. The capability to accommodate all these flow regimes by a single model was first accomplished in this research. Of special relevance is that the capability to simulate the proper flow regime enabled a more realistic response of the bounding wall of the tube to the imposed pulsations. Comparisons were made between the experimental results and the predictions of the simulations for two purposes. One was to establish the ranges of applicability of the simulation model. The other established a body of archival-quality information based on confirming experimental and simulated results. Another unique contribution of this research is the determination of the presence of flow-induced acoustic emissions. The motivation for this part of this work is the development of a diagnostic tool to detect, locate, and characterize blockages in arterial models

Multiscale Fluid-Structure Interaction Models Development and Applications to the 3D Elements of a Human Cardiovascular System

Cardiovascular diseases (CVD) are the number one cause of death of humans in the United States and worldwide. Accurate, non-invasive, and cheaper diagnosis methods have always been on demand as cardiovascular monitoring increase in prevalence. The primary causes of the various forms of these CVDs are atherosclerosis and aneurysms in the blood vessels. Current noninvasive methods (i.e., statistical/medical) permit fairly accurate detection of the disease once clinical symptoms are suggestive of the existence of hemodynamic disorders. Therefore, the recent surge of hemodynamics models facilitated the prediction of cardiovascular conditions. The hemodynamic modeling of a human circulatory system involves varying levels of complexity which must be accounted for and resolved. Pulse-wave propagation effects and high aspect-ratio segments of the vasculature are represented using a quasi-one-dimensional (1D), non-steady, averaged over the cross-section models. However, these reduced 1D models do not account for the blood flow patterns (recirculation zones), vessel wall shear stresses and quantification of repetitive mechanical stresses which helps to predict a vessel life. Even a whole three-dimensional (3D) modeling of the vasculature is computationally intensive and do not fit the timeline of practical use. Thus the intertwining of a quasi 1D global vasculature model with a specific/risk-prone 3D local vessel ones is imperative. This research forms part of a multiphysics project that aims to improve the detailed understanding of the hemodynamics by investigating a computational model of fluid-structure interaction (FSI) of in vivo blood flow. First idealized computational a 3D FSI artery model is configured and executed in ANSYS Workbench, forming an implicit coupling of the blood flow and vessel walls. Then the thesis focuses on an approach developed to employ commercial tools rather than in-house mathematical models in achieving multiscale simulations. A robust algorithm is constructed to combine stabilization techniques to simultaneously overcome the added-mass effect in 3D FSI simulation and mathematical difficulties such as the assignment of boundary conditions at the interface between the 3D-1D coupling. Applications can be of numerical examples evaluating the change of hemodynamic parameters and diagnosis of an abdominal aneurysm, deep vein thrombosis, and bifurcation areas

Vascular Hemodynamics CFD Modeling

Three dimensional pulsatile blood flow CFD simulations in geometrically genuine normal and non-normal (aneurysm) human neck-head vascular systems nominally spanning the aortic arch to the circle of Willis has been performed and studied. CT scans of the human aortic arch and the carotid arteries were interpreted to obtain geometric data defining the boundary for a vascular CFD simulation. This was accomplished by reconstructing the surface from the anatomical slices and by imposing pertinent boundary conditions at the various artery termini. Following automated formation of a non-conformal CFD mesh, steady and unsteady laminar and low turbulent simulations were performed both for the normal and aneurysm models. Atherosclerosis and atherosclerotic induced aneurysms can occur in the ascending aorta. The results showed marked differences in the flow dynamics for the two models. Secondary flow is induced in both of the models due to the curvature of the aortic arch which is distorted in three dimensions. Counter clockwise rotating vortex formation was seen at the aneurysm segment in the ascending aorta for the aneurysm model which was absent for the normal case. The effect of the aneurysm bulge was seen in regions proximal to it at peak reverse flow causing secondary flow. These secondary aortic blood flows are though to have an effect on the wall shear stress distribution. Maximum pressure regions for the aneurysm were observed at regions distal to it indicating the possible location for rupture. Wall shear force (WSF) values for the normal case at the aortic bend were low indicating the possible reason for the formation of the aneurysm in the first place. The WSF values at the aneurysm segment for the aneurysm case were also low supporting the low shear stress induced atherosclerotic aneurysms theory. These results may act as a precursor for a multiscale Large eddy simulation model (LES) for pulsatile blood flow eliminating the need for a priori definition of the flow as laminar or turbulent

Computational fluid dynamics indicators to improve cardiovascular pathologies

In recent years, the study of computational hemodynamics within anatomically complex vascular regions has generated great interest among clinicians. The progress in computational fluid dynamics, image processing and high-performance computing haveallowed us to identify the candidate vascular regions for the appearance of cardiovascular diseases and to predict how this disease may evolve. Medicine currently uses a paradigm called diagnosis. In this thesis we attempt to introduce into medicine the predictive paradigm that has been used in engineering for many years. The objective of this thesis is therefore to develop predictive models based on diagnostic indicators for cardiovascular pathologies. We try to predict the evolution of aortic abdominal aneurysm, aortic coarctation and coronary artery disease in a personalized way for each patient. To understand how the cardiovascular pathology will evolve and when it will become a health risk, it is necessary to develop new technologies by merging medical imaging and computational science. We propose diagnostic indicators that can improve the diagnosis and predict the evolution of the disease more efficiently than the methods used until now. In particular, a new methodology for computing diagnostic indicators based on computational hemodynamics and medical imaging is proposed. We have worked with data of anonymous patients to create real predictive technology that will allow us to continue advancing in personalized medicine and generate more sustainable health systems. However, our final aim is to achieve an impact at a clinical level. Several groups have tried to create predictive models for cardiovascular pathologies, but they have not yet begun to use them in clinical practice. Our objective is to go further and obtain predictive variables to be used practically in the clinical field. It is to be hoped that in the future extremely precise databases of all of our anatomy and physiology will be available to doctors. These data can be used for predictive models to improve diagnosis or to improve therapies or personalized treatments.En els últims anys, l'estudi de l'hemodinàmica computacional en regions vasculars anatòmicament complexes ha generat un gran interès entre els clínics. El progrés obtingut en la dinàmica de fluids computacional, en el processament d'imatges i en la computació d'alt rendiment ha permès identificar regions vasculars on poden aparèixer malalties cardiovasculars, així com predir-ne l'evolució. Actualment, la medicina utilitza un paradigma anomenat diagnòstic. En aquesta tesi s'intenta introduir en la medicina el paradigma predictiu utilitzat des de fa molts anys en l'enginyeria. Per tant, aquesta tesi té com a objectiu desenvolupar models predictius basats en indicadors de diagnòstic de patologies cardiovasculars. Tractem de predir l'evolució de l'aneurisma d'aorta abdominal, la coartació aòrtica i la malaltia coronària de forma personalitzada per a cada pacient. Per entendre com la patologia cardiovascular evolucionarà i quan suposarà un risc per a la salut, cal desenvolupar noves tecnologies mitjançant la combinació de les imatges mèdiques i la ciència computacional. Proposem uns indicadors que poden millorar el diagnòstic i predir l'evolució de la malaltia de manera més eficient que els mètodes utilitzats fins ara. En particular, es proposa una nova metodologia per al càlcul dels indicadors de diagnòstic basada en l'hemodinàmica computacional i les imatges mèdiques. Hem treballat amb dades de pacients anònims per crear una tecnologia predictiva real que ens permetrà seguir avançant en la medicina personalitzada i generar sistemes de salut més sostenibles. Però el nostre objectiu final és aconseguir un impacte en l¿àmbit clínic. Diversos grups han tractat de crear models predictius per a les patologies cardiovasculars, però encara no han començat a utilitzar-les en la pràctica clínica. El nostre objectiu és anar més enllà i obtenir variables predictives que es puguin utilitzar de forma pràctica en el camp clínic. Es pot preveure que en el futur tots els metges disposaran de bases de dades molt precises de tota la nostra anatomia i fisiologia. Aquestes dades es poden utilitzar en els models predictius per millorar el diagnòstic o per millorar teràpies o tractaments personalitzats.Postprint (published version

Computational analysis of blood flow and stress patterns in the aorta of patients with Marfan syndrome

Personalised external aortic root support (PEARS) was designed to prevent progressive aortic dilatation, and the associated risk of aortic dissection, in patients with Marfan syndrome by providing an additional support to the aorta. The objective of this thesis was to understand the biomechanical implications of PEARS surgery as well as to investigate the altered haemodynamics associated with the disease and its treatment. Finite element (FE) models were developed using patient-specific aortic geometries reconstructed from pre and post-PEARS magnetic resonance (MR) images of three Marfan patients. The wall and PEARS materials were assumed to be isotropic, incompressible and linearly elastic. A static load on the inner wall corresponding to the patients’ pulse pressure was applied with a zero-displacement constraint at all boundaries. Results showed that peak aortic stresses and displacements before PEARS were located at the sinuses of Valsalva but following PEARS surgery, they were shifted to the aortic arch, at the intersection between the supported and unsupported aorta. The zero-displacement constraint at the aortic root was subsequently removed and replaced with downward motion measured from in vivo images. This revealed significant increases in the longitudinal wall stress, especially in the pre-PEARS models. Computational fluid dynamics (CFD) models were developed to evaluate flow characteristics. The correlation-based transitional Shear Stress Transport (SST-Tran) model was adopted to simulate potential transitional and turbulence flow during part of the cardiac cycle and flow waveforms derived from phase-contrast MR images were imposed at the inlets. Qualitative patterns of the haemodynamics were similar pre- and post-PEARS with variations in mean helicity flow index (HFI) of -10%, 35% and 20% in the post-PEARS aortas of the three patients. A fluid-structure interaction (FSI) model was developed for one patient, pre- and post-PEARS in order to examine the effect of wall compliance on aortic flow as well as the effect of pulsatile flow on wall stress. This model excluded the sinuses and was based on the laminar flow assumption. The results were similar to those obtained using the rigid wall and static structural models, with minor quantitative differences. Considering the higher computational cost of FSI simulations and the relatively small differences observed in peak wall stress, it is reasonable to suggest that static structural models would be sufficient for wall stress prediction. Additionally, aortic root motion had a more profound effect on wall stress than wall compliance. Further studies are required to assess the statistical significance of the findings outlined in this thesis. Recommendations for future work were also highlighted, with emphasis on model assumptions including material properties, residual stress and boundary conditions.Open Acces