دورية أكاديمية
In Silico Evaluation of a Self-powered Venous Ejector Pump for Fontan Patients.
العنوان: | In Silico Evaluation of a Self-powered Venous Ejector Pump for Fontan Patients. |
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المؤلفون: | Rasooli, Reza, Giljarhus, Knut Erik Teigen, Hiorth, Aksel, Jolma, Ingunn Westvik, Vinningland, Jan Ludvig, de Lange, Charlotte, 1963, Brun, Henrik, Holmstrom, Henrik |
المساهمون: | Göteborgs universitet, Sahlgrenska akademin, Institutionen för kliniska vetenskaper, Avdelningen för radiologi, Gothenburg University, Sahlgrenska Academy, Institute of Clinical Sciences, Department of Radiology |
المصدر: | Cardiovascular engineering and technology. 14(3):428-446 |
مصطلحات موضوعية: | Kardiologi, Cardiac and Cardiovascular Systems, Pediatrik, Pediatrics, Humans, Fontan Procedure, adverse effects, Pulmonary Artery, surgery, Hemodynamics, Vena Cava, Inferior, Heart Ventricles, Heart-Assist Devices, Models, Cardiovascular, Heart Defects, Congenital |
الوصف: | The Fontan circulation carries a dismal prognosis in the long term due to its peculiar physiology and lack of a subpulmonic ventricle. Although it is multifactorial, elevated IVC pressure is accepted to be the primary cause of Fontan's high mortality and morbidity. This study presents a self-powered venous ejector pump (VEP) that can be used to lower the high IVC venous pressure in single-ventricle patients.A self-powered venous assist device that exploits the high-energy aortic flow to lower IVC pressure is designed. The proposed design is clinically feasible, simple in structure, and is powered intracorporeally. The device's performance in reducing IVC pressure is assessed by conducting comprehensive computational fluid dynamics simulations in idealized total cavopulmonary connections with different offsets. The device was finally applied to complex 3D reconstructed patient-specific TCPC models to validate its performance.The assist device provided a significant IVC pressure drop of more than 3.2 mm Hg in both idealized and patient-specific geometries, while maintaining a high systemic oxygen saturation of more than 90%. The simulations revealed no significant caval pressure rise (< 0.1 mm Hg) and sufficient systemic oxygen saturation (> 84%) in the event of device failure, demonstrating its fail-safe feature.A self-powered venous assist with promising in silico performance in improving Fontan hemodynamics is proposed. Due to its passive nature, the device has the potential to provide palliation for the growing population of patients with failing Fontan. |
URL الوصول: | https://gup.ub.gu.se/publication/331908 |
قاعدة البيانات: | SwePub |
تدمد: | 1869408X 18694098 |
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DOI: | 10.1007/s13239-023-00663-5 |