Inflow from a Cardiopulmonary Assist System to the Pulmonary Artery and Its Implications for Local Hemodynamics-a Computational Fluid Dynamics Study.
Artificial lung
CFD simulation
ECMO
Graft connection
In silico
Lung perfusion
Retrograde flow
Journal
Journal of cardiovascular translational research
ISSN: 1937-5395
Titre abrégé: J Cardiovasc Transl Res
Pays: United States
ID NLM: 101468585
Informations de publication
Date de publication:
08 2023
08 2023
Historique:
received:
31
05
2022
accepted:
19
12
2022
medline:
6
9
2023
pubmed:
21
1
2023
entrez:
20
1
2023
Statut:
ppublish
Résumé
When returning blood to the pulmonary artery (PA), the inflow jet interferes with local hemodynamics. We investigated the consequences for several connection scenarios using transient computational fluid dynamics simulations. The PA was derived from CT data. Three aspects were varied: graft flow rate, anastomosis location, and inflow jet path length from anastomosis site to impingement on the PA wall. Lateral anastomosis locations caused abnormal flow distribution between the left and right PA. The central location provided near-physiological distribution but induced higher wall shear stress (WSS). All effects were most pronounced at high graft flows. A central location is beneficial regarding flow distribution, but the resulting high WSS might promote detachment of local thromboembolisms or influence the autonomic nervous innervation. Lateral locations, depending on jet path length, result in lower WSS at the cost of an unfavorable flow distribution that could promote pulmonary vasculature changes. Case-specific decisions and further research are necessary.
Identifiants
pubmed: 36662482
doi: 10.1007/s12265-022-10349-3
pii: 10.1007/s12265-022-10349-3
pmc: PMC10480287
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
842-851Informations de copyright
© 2023. The Author(s).
Références
Stulak JM, Dearani JA, Burkhart HM, Barnes RD, Scott PD, Schears GJ. ECMO cannulation controversies and complications. Sem Cardiothorac Vasc Anesth. 2009;13(3):176–82. https://doi.org/10.1177/1089253209347943 .
doi: 10.1177/1089253209347943
Pavlushkov E, Berman M, Valchanov K. Cannulation techniques for extracorporeal life support. Ann Transl Med. 2017;5(4):70. https://doi.org/10.21037/atm.2016.11.47 .
doi: 10.21037/atm.2016.11.47
pubmed: 28275615
pmcid: 5337209
Biscotti M, Gannon WD, Agerstrand C, Abrams D, Sonett J, Brodie D, et al. Awake extracorporeal membrane oxygenation as bridge to lung transplantation: a 9-year experience. Ann Thorac Surg. 2017;104(2):412–9. https://doi.org/10.1016/j.athoracsur.2016.11.056 .
doi: 10.1016/j.athoracsur.2016.11.056
pubmed: 28242078
Abrams D, Javidfar J, Farrand E, Mongero LB, Agerstrand CL, Ryan P, et al. Early mobilization of patients receiving extracorporeal membrane oxygenation: a retrospective cohort study. Crit Care (London, England). 2014;18(1):R38. https://doi.org/10.1186/cc13746 .
doi: 10.1186/cc13746
Lehr CJ, Zaas DW, Cheifetz IM, Turner DA. Ambulatory extracorporeal membrane oxygenation as a bridge to lung transplantation: walking while waiting. Chest. 2015;147(5):1213–8. https://doi.org/10.1378/chest.14-2188 .
doi: 10.1378/chest.14-2188
pubmed: 25940249
Saxena P, Marasco SF. Tunneling a pulmonary artery graft: a simplified way to insert and remove a temporary right ventricular assist device. Texas Heart Inst J. 2015;42(6):540–2. https://doi.org/10.14503/THIJ-14-4855 .
doi: 10.14503/THIJ-14-4855
Loforte A, Gliozzi G, Mariani C, Cavalli GG, Martin-Suarez S, Pacini D. Ventricular assist devices implantation: surgical assessment and technical strategies. Cardiovasc Diagn Ther. 2021;11(1):277–91. https://doi.org/10.21037/cdt-20-325 .
doi: 10.21037/cdt-20-325
pubmed: 33708499
pmcid: 7944211
Broman LM, Taccone FS, Lorusso R, Malfertheiner MV, Pappalardo F, Di Nardo M, et al. The ELSO Maastricht Treaty for ECLS Nomenclature: abbreviations for cannulation configuration in extracorporeal life support - a position paper of the Extracorporeal Life Support Organization. Crit Care (London, England). 2019;23(1):36. https://doi.org/10.1186/s13054-019-2334-8 .
doi: 10.1186/s13054-019-2334-8
Padalino MA, Pittarello DG, Vida VL, and Stellin G. Minimally invasive approach in surgery for congenital heart disease. In A. Montalto, A. Loforte, & C. Amarelli (Eds.), Cardiac surgery procedures: IntechOpen. 2020. https://doi.org/10.5772/intechopen.87136
Benim AC, Nahavandi A, Assmann A, Schubert D, Feindt P, Suh SH. Simulation of blood flow in human aorta with emphasis on outlet boundary conditions. Appl Math Model. 2011;35(7):3175–88. https://doi.org/10.1016/j.apm.2010.12.022 .
doi: 10.1016/j.apm.2010.12.022
Kaufmann TAS, Neidlin M, Büsen M, Sonntag SJ, Steinseifer U. Implementation of intrinsic lumped parameter modeling into computational fluid dynamics studies of cardiopulmonary bypass. J Biomech. 2014;47(3):729–35. https://doi.org/10.1016/j.jbiomech.2013.11.005 .
doi: 10.1016/j.jbiomech.2013.11.005
pubmed: 24365093
Assemat P, Siu KK, Armitage JA, Hokke SN, Dart A, Chin-Dusting J, et al. Haemodynamical stress in mouse aortic arch with atherosclerotic plaques: preliminary study of plaque progression. Comput Struct Biotechnol J. 2014;10(17):98–106. https://doi.org/10.1016/j.csbj.2014.07.004 .
doi: 10.1016/j.csbj.2014.07.004
pubmed: 25349678
pmcid: 4204426
Vignon-Clementel IE, Figueroa CA, Jansen KE, Taylor CA. Outflow boundary conditions for 3D simulations of non-periodic blood flow and pressure fields in deformable arteries. Comput Methods Biomech Biomed Engin. 2010;13(5):625–40. https://doi.org/10.1080/10255840903413565 .
doi: 10.1080/10255840903413565
pubmed: 20140798
Bordones AD, Leroux M, Kheyfets VO, Wu Y-A, Chen C-Y, Finol EA. Computational fluid dynamics modeling of the human pulmonary arteries with experimental validation. Ann Biomed Eng. 2018;46(9):1309–24. https://doi.org/10.1007/s10439-018-2047-1 .
doi: 10.1007/s10439-018-2047-1
pubmed: 29786774
pmcid: 6095803
Kong F, Kheyfets V, Finol E, Cai X-C. An efficient parallel simulation of unsteady blood flows in patient-specific pulmonary artery. Int J Numer Methods Biomed Eng. 2018;34(4):e2952. https://doi.org/10.1002/cnm.2952 .
doi: 10.1002/cnm.2952
Ku JP, Elkins CJ, Taylor CA. Comparison of CFD and MRI flow and velocities in an in vitro large artery bypass graft model. Ann Biomed Eng. 2005;33(3):257–69. https://doi.org/10.1007/s10439-005-1729-7 .
doi: 10.1007/s10439-005-1729-7
pubmed: 15868717
Ruiz-Soler A, Kabinejadian F, Slevin MA, Bartolo PJ, Keshmiri A. Optimisation of a novel spiral-inducing bypass graft using computational fluid dynamics. Sci Rep. 2017;7(1):1865. https://doi.org/10.1038/s41598-017-01930-x .
doi: 10.1038/s41598-017-01930-x
pubmed: 28500311
pmcid: 5431846
Steuer NB, Hugenroth K, Beck T, Spillner J, Kopp R, Reinartz S, et al. Long-term venovenous connection for extracorporeal carbon dioxide removal (ECCO2R)-numerical investigation of the connection to the common iliac veins. Cardiovasc Eng Technol. 2020;11(4):362–80. https://doi.org/10.1007/s13239-020-00466-y .
doi: 10.1007/s13239-020-00466-y
pubmed: 32405926
pmcid: 7385029
Neidlin M, Jansen S, Moritz A, Steinseifer U, Kaufmann TAS. Design modifications and computational fluid dynamic analysis of an outflow cannula for cardiopulmonary bypass. Ann Biomed Eng. 2014;42(10):2048–57. https://doi.org/10.1007/s10439-014-1064-y .
doi: 10.1007/s10439-014-1064-y
pubmed: 25015131
Jamil M, Rezaeimoghaddam M, Cakmak B, Yildiz Y, Rasooli R, Pekkan K, et al. Hemodynamics of neonatal double lumen cannula malposition. Perfusion. 2020;35(4):306–15. https://doi.org/10.1177/0267659119874697 .
doi: 10.1177/0267659119874697
pubmed: 31580212
Kaufmann TAS, Wong KC, Schmitz-Rode T, Steinseifer U. Mimicking of cerebral autoregulation by flow-dependent cerebrovascular resistance: a feasibility study. Artif Organs. 2012;36(4):E97-101. https://doi.org/10.1111/j.1525-1594.2011.01433.x .
doi: 10.1111/j.1525-1594.2011.01433.x
pubmed: 22372981
Eshtehardi P, Brown AJ, Bhargava A, Costopoulos C, Hung OY, Corban MT, et al. High wall shear stress and high-risk plaque: an emerging concept. Int J Cardiovasc Imaging. 2017;33(7):1089–99. https://doi.org/10.1007/s10554-016-1055-1 .
doi: 10.1007/s10554-016-1055-1
pubmed: 28074425
pmcid: 5496586
Kummer W. Pulmonary vascular innervation and its role in responses to hypoxia: size matters! Proc Am Thorac Soc. 2011;8(6):471–6. https://doi.org/10.1513/pats.201101-013MW .
doi: 10.1513/pats.201101-013MW
pubmed: 22052922
Rudenko B, Shanoyan A, Drapkina O, Gavrilova N, Beregovskaya S, Akhadova A, et al. Simplicity denervation system for pulmonary artery denervation in patients with residual pulmonary hypertension after pulmonary thromboembolism and surgical thrombectomy. Cardiol Cardiovasc Med. 2017;01(05):200–9. https://doi.org/10.26502/fccm.92920024 .
doi: 10.26502/fccm.92920024
Zhang H, Chen S-L. Pulmonary artery denervation: update on clinical studies. Curr Cardiol Rep. 2019;21(10):124. https://doi.org/10.1007/s11886-019-1203-z .
doi: 10.1007/s11886-019-1203-z
pubmed: 31486924
Huang Y, Liu Y-W, Pan H-Z, Zhang X-L, Li J, Xiang L, et al. Transthoracic pulmonary artery denervation for pulmonary arterial hypertension. Arterioscler Thromb Vasc Biol. 2019;39(4):704–18. https://doi.org/10.1161/ATVBAHA.118.311992 .
doi: 10.1161/ATVBAHA.118.311992
pubmed: 30816802
Lang I. Chronic thromboembolic pulmonary hypertension: a distinct disease entity. Eur Respir Rev : Off J Eur Respir Soc. 2015;24(136):246–52. https://doi.org/10.1183/16000617.00001115 .
doi: 10.1183/16000617.00001115
Carlson BE, Arciero JC, Secomb TW. Theoretical model of blood flow autoregulation: roles of myogenic, shear-dependent, and metabolic responses. Am J Physiol Heart Circ Physiol. 2008;295(4):1572–9. https://doi.org/10.1152/ajpheart.00262.2008 .
doi: 10.1152/ajpheart.00262.2008
Liu H, Lan L, Abrigo J, Ip HL, Soo Y, Zheng D, et al. Comparison of Newtonian and non-Newtonian fluid models in blood flow simulation in patients with intracranial arterial stenosis. Front Physiol. 2021;12:718540. https://doi.org/10.3389/fphys.2021.718540 .
doi: 10.3389/fphys.2021.718540
pubmed: 34552505
pmcid: 8450390