Dual-Pump Support in the Inferior and Superior Vena Cavae of a Patient-Specific Fontan Physiology

作者：Throckmorton Amy L^*; Lopez Isaza Sergio; Moskowitz William

来源：Artificial Organs, 2013, 37(6): 513-522.

DOI：10.1111/aor.12039

• Single ventricle physiology
• Cavopulmonary assist device
• Fontan physiology
• Blood pump
• Artificial right ventricle
• Pediatric circulatory support
• Mechanical cavopulmonary assist
• Computational fluid dynamics
• Total cavopulmonary connection

The implementation of simultaneous mechanical cavopulmonary assistance having blood pumps located in both of the vena cavae is investigated as an approach to treating patients with an ailing Fontan physiology. Identical intravascular blood pumps are employed to model the hemodynamic support of a patient-specific Fontan. Pressure flow characteristics, energy gain calculations, and blood damage analyses are assessed for each model. The performance of the dual-support scenario is compared to conditions of mechanical support in the inferior vena cava only and to a nonsupported cavopulmonary circuit. The blood pump in the superior vena cava generates pressures ranging from 1 to 22mmHg for flow rates of 1-4L/min at operating speeds of 1250-2500rpm. The blood pump in the inferior vena cava produces pressures at levels approximately 20% lower. The blood pumps positively augment the hydraulic energy in the total cavopulmonary connection circuit as a function of flow rate and rotational speed. Scalar stress levels and fluid residence times are at acceptable levels. Damage indices for the dual-support case, however, are elevated slightly above 3.5%. These results suggest that concurrent, mechanical assistance of the inferior vena cava and superior vena cava in Fontan patients has the potential to be beneficial, but additional studies are needed to further explore this approach.

• 出版日期2013-6