PIV measurements of flow in a centrifugal blood pump: steady flow

Magnetically suspended left ventricular assist devices have only one moving part, the impeller. The impeller has absolutely no contact with any of the fixed parts, thus greatly reducing the regions of stagnant or high shear stress that surround a mechanical or fluid bearing. Measurements of the mean flow patterns as well as viscous and turbulent stresses were made in a shaft-driven prototype of a magnetically suspended centrifugal blood pump at several constant flow rates (3-9 L/min) using particle image velocimetry (PIV). The chosen range of flow rates is representative of the range over which the pump may operate while implanted. Measurements on a three-dimensional measurement grid within several regions of the pump, including the inlet, blade passage, exit volute, and diffuser are reported. The measurements are used to identify regions of potential blood damage due to high shear stress and/or stagnation of the blood, both of which have been associated with blood damage within artificial heart valves and diaphragm-type pumps. Levels of turbulence intensity and Reynolds stresses that are comparable to those in artificial heart valves are reported. At the design flow rate (6 L/min), the flow is generally well behaved (no recirculation or stagnant flow) and stress levels are below levels that would be expected to contribute to hemolysis or thrombosis. The flow at both high (9 L/min) and low (3 L/min) flow rates introduces anomalies into the flow, such as recirculation, stagnation, and high stress regions. Levels of viscous and Reynolds shear stresses everywhere within the pump are below reported threshold values for damage to red cells over the entire range of flow rates investigated; however, at both high and low flow rate conditions, the flow field may promote activation of the clotting cascade due to regions of elevated shear stress adjacent to separated or stagnant flow.     

Computational Fluid Dynamics (CFD) study of the 4th generation prototype of a continuous flow Ventricular Assist Device (VAD)

The continuous flow ventricular assist device (VAD) is a miniature centrifugal pump, fully suspended by magnetic bearings, which is being developed for implantation in humans. The CF4 model is the first actual prototype of the final design product. The overall performances of blood flow in CF4 have been simulated using computational fluid dynamics (CFD) software: CFX, which is commercially available from ANSYS Inc. The flow regions modeled in CF4 include the inlet elbow, the five-blade impeller, the clearance gap below the impeller, and the exit volute. According to different needs from patients, a wide range of flow rates and revolutions per minute (RPM) have been studied. The flow rate-pressure curves are given. The streamlines in the flow field are drawn to detect stagnation points and vortices that could lead to thrombosis. The stress is calculated in the fluid field to estimate potential hemolysis. The stress is elevated to the decreased size of the blood flow paths through the smaller pump, but is still within the safe range. The thermal study on the pump, the blood and the surrounding tissue shows the temperature rise due to magnetoelectric heat sources and thermal dissipation is insignificant. CFD simulation proved valuable to demonstrate and to improve the performance of fluid flow in the design of a small size pump.     

Numerical simulation and comparative analysis of flow field in axial blood pumps

The objective study was to estimate the rheological properties and physiological compatibility of the blood pump by simulating the internal flow field of the blood pump. In this study we use computational fluid dynamics method to simulate and analyse two models of axial blood pumps with a three-blade diffuser and a six-blade diffuser, named pump I and pump II, respectively, and to compare the flow patterns of these two kinds of blood pumps while both of them satisfy the conditions of the normal human blood differential pressure and blood flow. Results indicate that (i) the high shear force occurs between the diffuser and the rotor in which the crucial place leads to haemolysis and (ii) under the condition of 100 mmHg pressure head and 5 l/min flow rate, the difference between the two kinds of blood pumps, as far as the haemolytic performance is concerned, is notable. The haemolysis index of the two pumps is 0.32% and 0.2%. In conclusion, the performance of the blood pump is influenced by the diffusers' blade number. Pump II performed better than pump I, which can be the basic model for blood pump option.     

Low haemolysis pulsatile impeller pump: design concepts and experimental results

A pulsatile fully implantable impeller pump with low haemolysis has been produced by developing a pulsatile impeller for a nonpulsatile pump also developed in this laboratory. The impeller was designed according to the 3-dimensional theory of fluid dynamics. The impeller shroud retains the same parabolic form and the vane has a form compacted by a radial logarithmic spiral and an axial helical spiral so that the absolute vibration velocity of the blood in a peripheral direction is a minimum as the impellar changes its speed periodically to generate a physiological pulsatile blood flow. Thus the Reynolds shear and the Newton shear are a minimum for the required pulse pressure. The mean volume and mean pressure are controlled by adjusting the voltage. The shape of the pressure pulse is determined by a square was of vollage and the systole/diastole ratio. In order to abolish regurgitation of the pump, a 40 per cent systole period and a 5 V voltage pulse are desirable for 40 mmHg pulse pressure (80–120 mmHg mean pressure). The pulse frequency has almost no effect on pump output. The pump can delivery 4 l/min mean volume and 100 mmHg mean pressure (40 mmHg pulse pressure), and these conditions result in an index of heamolysis (IH) for porcine blood of 0.020—only slighly more than the nonpulsatile pump (0.016). When the pulsatile impeller was used under nonpulsatile conditions its IH was almost doubled, but when the nonpulsatile impeller was used under pulsatile conditions the IH reached 0.13. The power consumption is approximately equal to that for the nonpulsatile pump: 3 W for 4 l/min and 100 mmHg output. The pump weights 240 g (including 190 g for the motor) and, because a commercial motor has been used, costs only a few hundred US dollars.     

Numerical simulation of cardiovascular dynamics with different types of VAD assistance

A variety of methods by which mechanical circulatory support (MCS) can be provided have been described. However, the haemodynamic benefits of the different methods have not been adequately quantified. The aim of this paper is to compare the haemodynamic effects of six forms of MCS by numerical simulation. Three types of ventricular assist device (VAD) are studied: positive displacement; impeller and a novel reciprocating-valve design. Similarly, three pumping modes are modelled: constant flow; counterpulsation and copulsation. The cardiovascular system is modelled using an approach developed previously, using the concentrated parameter method by considering flow resistance, vessel elasticity and inertial effects of blood in individual conduit segments. The dynamic modelling of displacement and impeller pumps is represented by VAD inlet/outlet flow-rate changes. The dynamics of the reciprocating-valve pump is modelled with a specified displacement profile. Results show that in each simulation, the physiological variables of mean arterial pressure and systemic flow are adequately maintained. Modulation of the impeller pump flow profile produces a small (5 mmHg) oscillatory component to arterial pressure, whereas the displacement and reciprocating-valve pumps generate substantial arterial pressure and flow pulsatility. The impeller pump requires the least power input, the reciprocating valve pump slightly more, and the displacement pump the most. The in parallel configuration of the impeller and displacement pump designs with respect to the left ventricle provides near complete unloading and can cause the aortic valve to remain closed throughout the entire cardiac cycle with the attendant risk of aortic valve leaflet fusion following prolonged support. The in series configuration of the reciprocating-valve pump avoids this shortcoming but activation must be carefully synchronized to the cardiac cycle to allow adequate coronary perfusion. The reciprocating-valve pump is associated with haemodynamic advantages and a favourable power consumption.     

Initial hydrodynamic study on a new intraaortic axial flow pump: Dynamic aortic valve

Rotary blood pumps have been researched as implantable ventricular assist devices for years. To further reduce the complex of implanted axial pumps, the authors proposed a new concept of intraaortic axial pump, termed previously as "dynamic aortic valve (DAV)". Instead of being driven by an intraaortic micro-electric motor, it was powered by a magnetic field from outside of body. To ensure the perfusion of coronary artery, the axial flow pump is to be implanted in the position of aortic valve. It could serve as either a blood pump or a mechanical valve depending on the power input. This research tested the feasibility of the new concept in model study. A column, made from permanent magnet, is jointed to an impeller in a concentric way to form a "rotor-impeller". Supported by a hanging shaft cantilevered in the center of a rigid cage, the rotor-impeller can be turned by the magnetic field in the surrounding space. In the present prototype, the rotor is 8 mm in diameter and 15 mm in length, the impeller ha     

PIV measurements of flow in a centrifugal blood pump: time-varying flow

Measurements of the time-varying flow in a centrifugal blood pump operating as a left ventricular assist device (LVAD) are presented. This includes changes in both the pump flow rate as a function of the left ventricle contraction and the interaction of the rotating impeller and fixed exit volute. When operating with a pulsing ventricle, the flow rate through the LVAD varies from 0-11 L/min during each cycle of the heartbeat. Phase-averaged measurements of mean velocity and some turbulence statistics within several regions of the pump, including the inlet, blade passage, exit volute, and diffuser, are reported at 20 phases of the cardiac cycle. The transient flow fields are compared to the constant flow rate condition that was reported previously in order to investigate the transient effects within the pump. It is shown that the quasi-steady assumption is a fair treatment of the time varying flow field in all regions of this representative pump, which greatly simplifies the comprehension and modeling of this flow field. The measurements are further interpreted to identify the effects that the transient nature of the flow field will have on blood damage. Although regions of recirculation and stagnant flow exist at some phases of the cardiac cycle, there is no location where flow is stagnant during the entire heartbeat.     

Initial hydrodynamic study on a new intraaortic axial flow pump: Dynamic aortic valve

Rotary blood pumps have been researched as implantable ventricular assist devices for years. To further reduce the complex of implanted axial pumps, the authors proposed a new concept of intraaortic axial pump, termed previously as “dynamic aortic valve (DAV)”. Instead of being driven by an intraaortic micro-electric motor, it was powered by a magnetic field from outside of body. To ensure the perfusion of coronary artery, the axial flow pump is to be implanted in the position of aortic valve. It could serve as either a blood pump or a mechanical valve depending on the power input. This research tested the feasibility of the new concept in model study. A column, made from permanent magnet, is jointed to an impeller in a concentric way to form a “rotor-impeller”. Supported by a hanging shaft cantilevered in the center of a rigid cage, the rotor-impeller can be turned by the magnetic field in the surrounding space. In the present prototype, the rotor is 8 mm in diameter and 15 mm in length, the impeller has 3 vanes with an outer diameter of 18 mm. The supporting cage is 22 mm in outer diameter and 20 mm in length. When tested, the DAV prototype is inserted into the tube of a mock circuit. The alternative magnetic field is produced by a rotating magnet placed side by side with the rotor-impeller at a distance of 30 mm. Once the alternative magnetic field is presented in the surrounding space, the DAV starts to turn, leading to a pressure difference and liquid flow in the tube. The flow rate or pressure difference is proportioned to rotary speed. At the maximal output of hydraulic power, the flow rate reached 5 L/min against an afterload of 100 mmHg. The maximal pressure difference generated by DAV at a rotation rate of 12600 r/min was 147 mmHg. The preliminary results demonstrated the feasibility of “DAV”, further research on this concept is justifiable.     

A compact centrifugal blood pump for extracorporeal circulation: design and performance

A new compact centrifugal blood pump driven by a miniature DC servomotor has been designed for use for short-term extra corporeal and cardiac-assisted circulation. The impeller of the pump was connected directly to the motor by using a simple-gear coupling. The shaft for the impeller was sealed from blood by both a V-ring and a seal bearing. Either pulsatile or nonpusatile flow was produced by controlling the current supply to the motor. The pump characteristics and the degree of hemolysis were evaluated with regard to the configuration of the impeller with a 38-mm outer diameter in vitro tests; the impeller having the blade angles at the inlet of 20 deg and at the outlet of 50 deg was the most appropriate as a blood pump. The performance in an operation, hemolysis and thrombus formation in the pump were assessed by a left ventricular bypass experiment in dogs. It was suggested by this study that this prototype pump appears promising for use not only in animal experiments but also in clinical application.     

Towards a concept of thrombosis in accelerated flow: rheology, fluid dynamics, and biochemistry

The predilection sites of arterial thrombosis are characterized by local increase in wall shear stress, flow separation with eddy formation and stagnation point flow. The defenders of high shear, as well as those of low shear theory of thrombogenesis, point to correlations of predilection sites and the respective flow abnormalities. Experimental evidence is provided, that high shear rates can damage both red cells and platelets, that lysed red cells constitute a potent platelet stimulant, due to their content of adenine nucleotides, and that platelets do not adhere to surfaces unless transported onto them by convective motion, the effectiveness of the platelet-wall interaction being enhanced by platelet activation. Based on these facts, a resolution of the contrast between high and low shear theory of thrombosis is attempted in a way, that the different flow regimens, with blood cells sequentially passing them, are each considered important and interdependent steps on the way to thrombosis.     

Effect of the action of anodal direct current on venous blood characteristics in vitro

Intravasal application of anodic direct current usually results in the development of a separate thrombosis. Thrombotic occlusion made successively by means of direct current will lead to an acceleration of the second thrombosis. Significant alterations of the examined parameters in the sense of an increased readiness to coagulation and acidosis could be proved after the impact of anodic direct current on the blood in vitro. The development of coagulation thrombosis and obstruction of microcirculation in the supply area are could be observed when the blood which in vitro had been exposed to the effect of the anodic direct current was transfused into the arterial blood circulation.     

21毫米人造心脏瓣膜泵的设计及研制

为了研究能够长期置入主动脉瓣环的左心室辅助装置,研制出直径21毫米重27克可植入的主动脉瓣膜泵.装置包括一个转子和一个定子.转子由驱动磁钢和叶轮组成;定子装有带铁心的电机线圈和出口导叶.装置被置於主动脉瓣位置,所以不占用额外的解剖空间.血泵能像自然心脏一样直接将血液由心室输送到主动脉,不需要连接管道和旁路,因此对自然生理循环的干扰可以减到最低.血泵流量由最大到零周期变化.血液动力学测试表明,当血泵转速为17500转/分钟时,可以产生流量5升/分钟、压力增益50毫米汞柱的血流;同一转速下,当流量为零时,血泵能保持主动脉舒张压为80毫米汞柱.     

Velocity gradients and turbulence around macrophyte stands in streams

1. Submerged macrophytes strongly modify water flow in small lowland streams. The present study investigated turbulence and vertical velocity gradients using small hot-wire anemometers in the vicinity and within the canopies of four macrophyte species with the objective of evaluating: (a) how plant canopies influence velocity gradients and shear force on the surfaces of the plants and the stream bed; and (b) how the presence and morphology of plants influence the intensity of turbulence. 2. Water velocity was often relatively constant with water depth both outside and inside the plant canopies, but the velocity declined steeply immediately above the unvegetated stream bed. Steep vertical velocity profiles were also observed in the transition to the surface of the macrophyte canopy of three of the plant species forming a dense shielding structure of high biomass. Less steep vertical profiles were observed at the open canopy surface of the fourth plant species, growing from a basal meristem and having the biomass more homogeneously distributed with depth. The complex distribution of hydraulic roughness between the stream bed, the banks and the plants resulted in velocity profiles which often fitted better to a linear than to a logarithmic function of distance above the sediment and canopy surfaces. 3. Turbulence increased in proportion to the mean flow velocity, but the slope of the relationships differed in a predictable manner among positions outside and inside the canopies of the different species, suggesting that their morphology and movements influenced the intensity of turbulence. Turbulence was maintained in the attenuated flow inside the plant canopies, despite estimates of low Reynolds numbers, demonstrating that reliable evaluation of flow patterns requires direct measurements. The mean velocity inside plant canopies mostly exceeded 2 cm s^??1 and turbulence intensity remained above 0.2 cm s^??1, which should be sufficient to prevent carbon limitation of photosynthesis in CO₂-rich streams, while plant growth may benefit from the reduced physical disturbance and the retention of nutrient-rich sediment particles. 4. Flow patterns were highly reproducible within canopies of the individual species despite differences in stand size and location among streams. We propose that individual plant stands are suitable functional units for analysing the influence of submerged macrophytes on flow patterns, retention of particles and biological communities in lowland streams.     

Flow in tubes and arteries--a comparison

The cardiovascular circulatory system of the human body can be compared with a network of tubes. It consists of a pump and a system of branched vessels. The arteries transport the blood to the periphery in a manner similar to that of a water supply network. It is important to know what kind of forces act upon "fittings", bends and bifurcations. It is also essential to assess whether the flow is laminar or turbulent, attached or separated. The flow should be optimized in such a manner as to minimize the drop in pressure. This means that no additional pressure loss due to separation or turbulence should occur, since such losses increase the pump power requirements. The loss appears in heating and acoustic energy. The necessary understanding of blood flow in human vessels is also of great interest to physicians since it is believed that the local flow behavior of blood determines the formation of atherosclerotic plaques. As in tubing systems, deposits in blood vessels are found close to bends and bifurcations. These deposits lead to impaired cerebral circulation and to myocardial infarction. A partial review of recent research into the details of flow behavior (like separation, stagnation and reattachment points) in bends and bifurcations of arterial models is presented. Studies involving steady and pulsatile flow conditions in rigid and elastic models with Newtonian and non-Newtonian fluids are shown here. The most important differences between blood vessels and tubes are discussed. This modern biofluidmechanical approach of detailed flow examination is compared with the more classical hemodynamic approach considering only gross features such as pressure loss coefficients.     

Turbulence characteristics downstream of bileaflet aortic valve prostheses

This study was focused on a series of in vitro tests on the turbulent flow characteristics of three bileaflet aortic valves: St. Jude Medical (SJM), CarboMedics (CM), and Edwards Tekna (modified Duromedics, DM). The flow fields of the valves were measured in a pulsatile flow model with a laser-Doppler anemometer (LDA) at the aortic sinus area downstream of the valves. The heart rate was set at 70 beats per minute, the cardiac output was maintained at 5 liters per minute, and the aortic pressure wave forms were kept within the physiological range. Cycle-resolved analysis was applied to obtain turbulence data, including mean velocity, Reynolds stresses, autocorrelation coefficients, energy spectral density functions, and turbulence scales. The Reynolds shear stresses of all three valves induced only minor damage to red blood cells, but directly damaged the platelets, increasing the possibility of thrombosis. The smallest turbulence length scale, which offers a more reliable estimate of the effects of turbulence on blood cell damage, was three times the size of red blood cells and five times the size of platelets. This suggests that there is more direct interaction with the blood cells, thus causing more damage.     

Ventricular flow dynamics with varying LVAD inflow cannula lengths: In-silico evaluation in a multiscale model

Left ventricular assist devices are associated with thromboembolic events, which are potentially caused by altered intraventricular flow. Due to patient variability, differences in apical wall thickness affects cannula insertion lengths, potentially promoting unfavourable intraventricular flow patterns which are thought to be correlated to the risk of thrombosis. This study aimed to present a 3D multiscale computational fluid dynamic model of the left ventricle (LV) developed using a commercial software, Ansys, and evaluate the risk of thrombosis with varying inflow cannula insertion lengths in a severely dilated LV. Based on a HeartWare HVAD inflow cannula, insertion lengths of 5, 19, 24 and 50 mm represented cases of apical hypertrophy, typical ranges of apical thicknesses and an experimental length, respectively. The risk of thrombosis was evaluated based on blood washout, residence time, instantaneous blood stagnation and a pulsatility index. By introducing fresh blood to displace pre-existing blood in the LV, after 5 cardiac cycles, 46.7%, 45.7%, 45.1% and 41.8% of pre-existing blood remained for insertion lengths of 5, 19, 24 and 50 mm, respectively. Compared to the 50 mm insertion, blood residence time was at least 9%, 7% and 6% higher with the 5, 19 and 24 mm insertion lengths, respectively. No instantaneous stagnation at the apex was observed directly after the E-wave. Pulsatility indices adjacent to the cannula increased with shorter insertion lengths. For the specific scenario studied, a longer insertion length, relative to LV size, may be advantageous to minimise thrombosis by increasing LV washout and reducing blood residence time.     

Nonclinical aspects of venous thrombosis in pregnancy

Pregnancy is a hypercoagulable state which carries an excess risk of maternal venous thrombosis. Endothelial injury, alterations in blood flow and activation of the coagulation pathway are proposed to contribute to the hypercoagulability. The risk for thrombosis may be accentuated by certain drugs and device implants that directly or indirectly affect the coagulation pathway. To help ensure that these interventions do not result in adverse maternal or fetal outcomes during pregnancy, gravid experimental animals can be exposed to such treatments at various stages of gestation and over a dosage range that would identify hazards and inform risk assessment. Circulating soluble biomarkers can also be evaluated for enhancing the assessment of any increased risk of venous thrombosis during pregnancy. In addition to traditional in vivo animal testing, efforts are under way to incorporate reliable non‐animal methods in the assessment of embryofetal toxicity and thrombogenic effects. This review summarizes hemostatic balance during pregnancy in animal species, embryofetal development, biomarkers of venous thrombosis, and alterations caused by drug‐induced venous thrombosis. Birth Defects Research (Part C) 105:190–200, 2015. © 2015 Wiley Periodicals, Inc.     

Haemolysis,a tool to evaluate mechanical stress to cells in bioprocess equipment

Summary Suspensions of fragile sheep erythrocytes were used to compare the levels of mechanical stress in two different crossflow filter units of small pilot scale. The recycling pumps were identified as the critical components mainly responsible for haemolysis. The level of cell damage was largely determined by the pump type and the backpressure applied to increase the transmembrane pressure in the filter.     

Blood flow augmentation by intrinsic venular contraction in vivo

Venomotion, spontaneous cyclic contractions of venules, was first observed in the bat wing 160 years ago. Of all the functional roles proposed since then, propulsion of blood by venomotion remains the most controversial. Common animal models that require anesthesia and surgery have failed to provide evidence for venular pumping of blood. To determine whether venomotion actively pumps blood in a minimally invasive, unanesthetized animal model, we reintroduced the batwing model. We evaluated the temporal and functional relationship between the venous contraction cycle and blood flow and luminal pressure. Furthermore, we determined the effect of inhibiting venomotion on blood flow. We found that the active venous contractions produced an increase in the blood flow and exhibited temporal vessel diameter-blood velocity and pressure relationships characteristic of a peristaltic pump. The presence of valves, a characteristic of reciprocating pumps, enhances the efficiency of the venular peristaltic pump by preventing retrograde flow. Instead of increasing blood flow by decreasing passive resistance, venular dilation with locally applied sodium nitroprusside decreased blood flow. Taken together, these observations provide evidence for active venular pumping of blood. Although strong venomotion may be unique to bats, venomotion has also been inferred from venous pressure oscillations in other animal models. The conventional paradigm of microvascular pressure and flow regulation assumes venules only act as passive resistors, a proposition that must be reevaluated in the presence of significant venomotion.     

Vortex shedding as a mechanism for free emboli formation in mechanical heart valves

The high incidence of thromboembolic complications of mechanical heart valves (MHV) limits their success as permanent implants. The thrombogenicity of all MHV is primarily due to platelet activation by contact with foreign surfaces and by nonphysiological flow patterns. The latter include elevated flow stresses and regions of recirculation of blood that are induced by valve design characteristics. A numerical simulation of unsteady turbulent flow through a bileaflet MHV was conducted, using the Wilcox k-omega turbulence model for internal low-Reynolds-number flows, and compared to quantitative flow visualization performed in a pulse duplicator system using Digital Particle Image Velocimetry (DPIV). The wake of the valve leaflet during the deceleration phase revealed an intricate pattern of interacting shed vortices. Particle paths showed that platelets that were exposed to the highest flow stresses around the leaflets were entrapped within the shed vortices. Potentially activated, such platelets may tend to aggregate and form free emboli. Once formed, such free emboli would be convected downstream by the shed vortices, increasing the risk of systemic emboli.