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Experimental measurement and numerical modelling of dye washout for investigation of blood residence time in ventricular assist devices

Alessandra Molteni, Zubair PH Masri, Kenny WQ Low, Haitham Yousef Orcid Logo, Johann Sienz Orcid Logo, Katharine H Fraser

The International Journal of Artificial Organs, Volume: 41, Issue: 4, Pages: 201 - 212

Swansea University Authors: Haitham Yousef Orcid Logo, Johann Sienz Orcid Logo

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DOI (Published version): 10.1177/0391398817752877

Abstract

Ventricular assist devices have become the standard therapy for end-stage heart failure. However, their use is still associated with severe adverse events related to the damage done to the blood by fluid dynamic stresses. This damage relates to both the stress magnitude and the length of time the bl...

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Published in: The International Journal of Artificial Organs
ISSN: 0391-3988 1724-6040
Published: 2018
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URI: https://cronfa.swan.ac.uk/Record/cronfa39471
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spelling 2018-08-20T13:05:08.0615011 v2 39471 2018-04-18 Experimental measurement and numerical modelling of dye washout for investigation of blood residence time in ventricular assist devices f7e1da01dad6e24cfa51e7b7d036fbba 0000-0002-4589-7881 Haitham Yousef Haitham Yousef true false 17bf1dd287bff2cb01b53d98ceb28a31 0000-0003-3136-5718 Johann Sienz Johann Sienz true false 2018-04-18 AERO Ventricular assist devices have become the standard therapy for end-stage heart failure. However, their use is still associated with severe adverse events related to the damage done to the blood by fluid dynamic stresses. This damage relates to both the stress magnitude and the length of time the blood is exposed to that stress. We created a dye washout technique which combines experimental and numerical approaches to measure the washout times of ventricular assist devices. The technique was used to investigate washout characteristics of three commercially available and clinically used ventricular assist devices: the CentriMag, HVAD and HeartMate II. The time taken to reach 5% dye concentration at the outlet (T05) was used as an indicator of the total residence time. At a typical level of cardiac support, 5 L/min and 100 mmHg, T05 was 0.93, 0.28 and 0.16 s for CentriMag, HVAD and HeartMate II, respectively, and increased to 5.06, 1.64 and 0.96 s for reduced cardiac support of 1 L/min. Regional variations in washout characteristics are described in this article. While the volume of the flow domain plays a large role in the differences in T05 between the ventricular assist devices, after standardising for ventricular assist device volume, the secondary flow path was found to increase T05 by 35%. The results explain quantitatively, for the first time, why the CentriMag, which exerts low shear stress magnitude, has still been found to cause acquired von Willebrand Syndrome in patients. Journal Article The International Journal of Artificial Organs 41 4 201 212 0391-3988 1724-6040 Ventricular assist devices, residence time, blood damage, shear stress, washout 1 4 2018 2018-04-01 10.1177/0391398817752877 COLLEGE NANME Aerospace Engineering COLLEGE CODE AERO Swansea University 2018-08-20T13:05:08.0615011 2018-04-18T14:18:24.6903441 Faculty of Science and Engineering School of Engineering and Applied Sciences - Uncategorised Alessandra Molteni 1 Zubair PH Masri 2 Kenny WQ Low 3 Haitham Yousef 0000-0002-4589-7881 4 Johann Sienz 0000-0003-3136-5718 5 Katharine H Fraser 6 0039471-19042018130214.pdf molteni2018.pdf 2018-04-19T13:02:14.7770000 Output 1366410 application/pdf Accepted Manuscript true 2018-04-19T00:00:00.0000000 true eng
title Experimental measurement and numerical modelling of dye washout for investigation of blood residence time in ventricular assist devices
spellingShingle Experimental measurement and numerical modelling of dye washout for investigation of blood residence time in ventricular assist devices
Haitham Yousef
Johann Sienz
title_short Experimental measurement and numerical modelling of dye washout for investigation of blood residence time in ventricular assist devices
title_full Experimental measurement and numerical modelling of dye washout for investigation of blood residence time in ventricular assist devices
title_fullStr Experimental measurement and numerical modelling of dye washout for investigation of blood residence time in ventricular assist devices
title_full_unstemmed Experimental measurement and numerical modelling of dye washout for investigation of blood residence time in ventricular assist devices
title_sort Experimental measurement and numerical modelling of dye washout for investigation of blood residence time in ventricular assist devices
author_id_str_mv f7e1da01dad6e24cfa51e7b7d036fbba
17bf1dd287bff2cb01b53d98ceb28a31
author_id_fullname_str_mv f7e1da01dad6e24cfa51e7b7d036fbba_***_Haitham Yousef
17bf1dd287bff2cb01b53d98ceb28a31_***_Johann Sienz
author Haitham Yousef
Johann Sienz
author2 Alessandra Molteni
Zubair PH Masri
Kenny WQ Low
Haitham Yousef
Johann Sienz
Katharine H Fraser
format Journal article
container_title The International Journal of Artificial Organs
container_volume 41
container_issue 4
container_start_page 201
publishDate 2018
institution Swansea University
issn 0391-3988
1724-6040
doi_str_mv 10.1177/0391398817752877
college_str Faculty of Science and Engineering
hierarchytype
hierarchy_top_id facultyofscienceandengineering
hierarchy_top_title Faculty of Science and Engineering
hierarchy_parent_id facultyofscienceandengineering
hierarchy_parent_title Faculty of Science and Engineering
department_str School of Engineering and Applied Sciences - Uncategorised{{{_:::_}}}Faculty of Science and Engineering{{{_:::_}}}School of Engineering and Applied Sciences - Uncategorised
document_store_str 1
active_str 0
description Ventricular assist devices have become the standard therapy for end-stage heart failure. However, their use is still associated with severe adverse events related to the damage done to the blood by fluid dynamic stresses. This damage relates to both the stress magnitude and the length of time the blood is exposed to that stress. We created a dye washout technique which combines experimental and numerical approaches to measure the washout times of ventricular assist devices. The technique was used to investigate washout characteristics of three commercially available and clinically used ventricular assist devices: the CentriMag, HVAD and HeartMate II. The time taken to reach 5% dye concentration at the outlet (T05) was used as an indicator of the total residence time. At a typical level of cardiac support, 5 L/min and 100 mmHg, T05 was 0.93, 0.28 and 0.16 s for CentriMag, HVAD and HeartMate II, respectively, and increased to 5.06, 1.64 and 0.96 s for reduced cardiac support of 1 L/min. Regional variations in washout characteristics are described in this article. While the volume of the flow domain plays a large role in the differences in T05 between the ventricular assist devices, after standardising for ventricular assist device volume, the secondary flow path was found to increase T05 by 35%. The results explain quantitatively, for the first time, why the CentriMag, which exerts low shear stress magnitude, has still been found to cause acquired von Willebrand Syndrome in patients.
published_date 2018-04-01T03:50:07Z
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