Left to right: Jay K. Bhama, MD, Gurjap Singh, MS, and Albert Ratner, PhD
Central Message
Computation fluid dynamics is emerging as a unique engineering methodology to “see” what our other investigatory tools cannot.
See Article page e205.
Computational fluid/flow dynamics (CFD) is a unique branch of mechanical engineering that uses numerical analysis and data structures to analyze and solve problems involving fluid flows. CFD is applied to research and engineering problems across a broad swath of industrial and investigational fields. Its potential use in biomedical investigations is growing, especially as our field advances in the areas of percutaneous intravascular interventions and mechanical circulatory support. The benefits of CFD have largely to do with its ability to clarify the characteristics of blood flow in vascular structures that are otherwise invisible to standard experimental measurements.
Yoshida and colleagues
1
utilize CFD using a novel 3-dimensional computational model to visualize turbulent flow in the aortic root of a patient under continuous-flow left ventricular assist device (LVAD) support. Their analysis identifies retrograde spiral turbulence in the aortic root and allows for qualitative comparison of shear stress at the level of the aortic valve and its components. The authors point out the potential utility of this type of advanced patient-specific computational modeling to understand how LVAD implantation may influence the development of aortic insufficiency in patients with chronic LVAD support.Indeed, Yoshida and colleagues
1
are not alone in having an interest in how CFD may be used to study clinically relevant problems in the continuous flow LVAD realm. Chivukula and colleagues2
from the University of Washington recently utilized CFD analysis to determine the influence of inflow cannula angulation on hemodynamic and thrombogenic performance in a continuous flow-LVAD model. Using this technology, they were able to identify inflow cannula angles that would adversely influence both platelet functionality and intraventricular hemodynamic parameters. Our group at the Bhama-Ratner Artificial Heart & Mechanical Circulatory Sciences Advancement Lab has a similar interest in utilizing CFD to help understand the effect of artificial pulse generation (using a novel pulse-generating device) on the flow characteristics of continuous flow LVADs.3
Bhama-Ratner Artificial Heart & Mechanical Circulatory Sciences Advancement (B.R.A.H.M.A.) Lab homepage.
https://brahma.lab.uiowa.edu/article/designing-next-generation-heart-pumps
Date accessed: May 3, 2019
Yoshida and colleagues
1
are to be commended for their efforts to utilize this novel technology to help answer clinical questions regarding continuous flow LVAD technology. This study provides important insight into the tremendous value of multidisciplinary collaboration among clinicians and engineers. As technology advancements allow us to use advanced computational modeling to “see” what our other investigatory tools cannot, this type of cross-pollination of ideas will be imperative to maximizing the potential of our biomedical research endeavors. There is no doubt that when it comes to understanding what we cannot easily see, it makes sense to go with the flow…dynamics!References
- Computational fluid dynamics visualizes turbulent flow in the aortic root of a patient under continuous-flow left ventricular assist device support.J Thorac Cardiovasc Surg. 2020; 159: e205-e207
- Left ventricular assist device inflow cannula angle and thrombosis risk.Circ Heart Fail. 2018; 11: e004325
- Bhama-Ratner Artificial Heart & Mechanical Circulatory Sciences Advancement (B.R.A.H.M.A.) Lab homepage.(Available at:)https://brahma.lab.uiowa.edu/article/designing-next-generation-heart-pumpsDate accessed: May 3, 2019
Article info
Publication history
Published online: April 24, 2019
Accepted:
April 2,
2019
Received:
April 2,
2019
Footnotes
Disclosures: Authors have nothing to disclose with regard to commercial support.
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© 2019 by The American Association for Thoracic Surgery
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- Computational fluid dynamics visualizes turbulent flow in the aortic root of a patient under continuous-flow left ventricular assist device supportThe Journal of Thoracic and Cardiovascular SurgeryVol. 159Issue 3
- PreviewAortic insufficiency (AI) developed during continuous-flow left ventricular assist device (CF-LVAD) use occurs in 25% of patients within 1 year of CF-LVAD implantation.1,2 Nonphysiologic retrograde flow in the ascending aorta and shear stress in the aortic valve have been suggested to induce valve-leaflet thinning, consequently, AI and its progression.3,4 Although blood flow analysis using vector flow mapping with 2-dimensional echocardiographic images or computational fluid dynamics (CFD) using the aortic mold without aortic root has been reported, blood flow and shear stress in the 3-dimensional aortic root with its complex anatomy are unknown.
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