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A long-term mechanical cavopulmonary support device for patients with Fontan circulation


Granegger, Marcus; Thamsen, Bente; Hubmann, Emanuel J; Choi, Young; Beck, Dominik; Valsangiacomo Buechel, Emanuela; Voutat, Michael; Schweiger, Martin; Meboldt, Mirko; Hübler, Michael (2019). A long-term mechanical cavopulmonary support device for patients with Fontan circulation. Medical Engineering & Physics, 70:9-18.

Abstract

In patients with a single ventricle, failure of the cardiovascular system may be prevented by substituting the missing sub-pulmonary ventricle with a pump. The aim of this study was to design and evaluate a device for long-term cavopulmonary support. A radial pump with two inlets and two outlets, a single impeller, mechanical bearings, and dual motor configuration was developed. Motor and fluid dynamic components were designed and simulated using computational methods including thermal effects. Hydraulic properties were determined in-vitro with 3D-printed prototypes. The pump design was virtually implanted in an MRI-derived total cavopulmonary connection (TCPC). Computational fluid dynamics (CFD) showed flow fields without regions of flow stagnation (velocity < 0.1 m/s) and only minor recirculations within the pump between 2-10 L/min against pressure heads of 0-50 mmHg at 2500-5000 rpm. The computed maximum temperature increase of blood due to motor heat was 1.3 K. Virtual implantation studies showed that the pump would introduce an additional volume of approximately 4 mL. Experimentally determined hydraulic performance results agreed well with CFD (deviation of <1.3 mmHg) and indicated pressure-sensitive characteristics (∼-2.6 mmHg/(L/min)) while balancing the two inlet pressures (∆P < 2.5 mmHg) under imbalanced inflow conditions. Through in-silico and in-vitro investigations, we demonstrated a promising pump design, which fulfills the basic requirements for long-term cavopulmonary support.

Abstract

In patients with a single ventricle, failure of the cardiovascular system may be prevented by substituting the missing sub-pulmonary ventricle with a pump. The aim of this study was to design and evaluate a device for long-term cavopulmonary support. A radial pump with two inlets and two outlets, a single impeller, mechanical bearings, and dual motor configuration was developed. Motor and fluid dynamic components were designed and simulated using computational methods including thermal effects. Hydraulic properties were determined in-vitro with 3D-printed prototypes. The pump design was virtually implanted in an MRI-derived total cavopulmonary connection (TCPC). Computational fluid dynamics (CFD) showed flow fields without regions of flow stagnation (velocity < 0.1 m/s) and only minor recirculations within the pump between 2-10 L/min against pressure heads of 0-50 mmHg at 2500-5000 rpm. The computed maximum temperature increase of blood due to motor heat was 1.3 K. Virtual implantation studies showed that the pump would introduce an additional volume of approximately 4 mL. Experimentally determined hydraulic performance results agreed well with CFD (deviation of <1.3 mmHg) and indicated pressure-sensitive characteristics (∼-2.6 mmHg/(L/min)) while balancing the two inlet pressures (∆P < 2.5 mmHg) under imbalanced inflow conditions. Through in-silico and in-vitro investigations, we demonstrated a promising pump design, which fulfills the basic requirements for long-term cavopulmonary support.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Children's Hospital Zurich > Medical Clinic
04 Faculty of Medicine > University Children's Hospital Zurich > Clinic for Surgery
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Life Sciences > Biophysics
Physical Sciences > Biomedical Engineering
Language:English
Date:August 2019
Deposited On:21 Jan 2020 16:13
Last Modified:29 Jul 2020 12:56
Publisher:Elsevier
ISSN:1350-4533
OA Status:Closed
Publisher DOI:https://doi.org/10.1016/j.medengphy.2019.06.017
PubMed ID:31266678

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