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A New Mathematical Model for Assessment of Bleeding and Thrombotic Risk in Three Different Types of Clinical Ventricular Assist Devices

  • Conference paper
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12th Asian-Pacific Conference on Medical and Biological Engineering (APCMBE 2023)

Part of the book series: IFMBE Proceedings ((IFMBE,volume 104))

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Abstract

In this study, our new shear-induced thrombosis and bleeding mathematical model (integrates variations in platelet and vWF morphology, function, and binding ability) was utilized to identify regions at high risk of induced blood damage and assess the bleeding and thrombosis risk in three different types of clinical ventricular assist devices (VADs) (HVAD, CentriMag and HeartMate II). It was found that extracorporeal VADs require a higher pressure head to overcome body and pipeline resistance compared to intracorporeal VADs. Centrifugal VADs have a better work ability compared to axial VADs. In vitro VADs are more highly blood damaged than in vivo VADs. For bleeding probability, CentriMag > HVAD > HeartMate II. Narrow regions of the VAD (such as the hydrodynamic clearance in HVAD, the side clearance in CentriMag and the blade tip clearance in HeartMate II) contribute significantly to device-induced bleeding. For thrombotic potential, CentriMag > HeartMate II > HVAD. The distribution of regions of high thrombotic potential in VADs is similar to the distribution of long residence time regions (such as the clearance between rotor and guide cone in HVAD, the back clearance and impeller eye in CentriMag, and the straightener and rotor inlet in HeartMate II). Flow separation regions in VADs resulting in residence time and shear stress pairs also contributed to the risk of bleeding and thrombosis. Further studies found that the hemocompatibility of VADs was strongly negatively correlated with efficiency (r < −0.80). This study found that CentriMag > HVAD > HeartMate II in terms of bleeding probability and CentriMag > HeartMate II > HVAD in terms of thrombosis potential. Narrow regions and flow separation regions in VADs contribute to blood damage. The efficiency of VADs is highly negatively correlated with hemocompatibility.

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References

  1. Benjamin, E.J., et al.: Heart disease and stroke statistics-2017 update: a report from the American heart association. Circulation 135(10), e146–e603 (2017)

    Article  Google Scholar 

  2. Slaughter, M.S., et al.: Advanced heart failure treated with continuous-flow left ventricular assist device. N. Engl. J. Med. 361(23), 2241–2251 (2009)

    Article  Google Scholar 

  3. Xi, Y., et al.: The impact of ECMO lower limb cannulation on the aortic flow features under differential blood perfusion conditions. Med. Novel Technol. Dev. 16 (2022)

    Google Scholar 

  4. Najjar, S.S., et al.: An analysis of pump thrombus events in patients in the HeartWare Advance bridge to transplant and continued access protocol trial. J. Heart Lung. Transp. 33(1), 23–34 (2014)

    Article  Google Scholar 

  5. Starling, R.C., et al.: Results of the post-U.S. Food and Drug Administration-approval study with a continuous flow left ventricular assist device as a bridge to heart transplantation: a prospective study using the INTERMACS (Interagency Registry for Mechanically Assisted Circulatory Support). J. Am. Coll. Cardiol. 57(19), 1890–1898 (2011)

    Google Scholar 

  6. Chen, Z., et al.: Flow features and device-induced blood trauma in CF-VADs under a pulsatile blood flow condition: a CFD comparative study. Int. J. Numer Method Biomed. Eng. 34(2) (2018)

    Google Scholar 

  7. Wu, P., et al.: On the optimization of a centrifugal maglev blood pump through design variations. Front. Physiol. 12, 699891 (2021)

    Article  Google Scholar 

  8. Lansink-Hartgring, A.O., et al.: Changes in red blood cell properties and platelet function during extracorporeal membrane oxygenation. J. Clin. Med. 9(4) (2020)

    Google Scholar 

  9. Chandler, W.L.: Platelet, red cell, and endothelial activation and injury during extracorporeal membrane oxygenation. ASAIO J. 67(8), 935–942 (2021)

    Article  Google Scholar 

  10. Li, Y., et al.: The impact of a new arterial intravascular pump on aorta hemodynamic surrounding: a numerical study. Bioengineering (Basel) 9(10) (2022)

    Google Scholar 

  11. Valladolid, C., Yee, A., Cruz, M.A.: Von Willebrand factor, free Hemoglobin and Thrombosis in ECMO. Front. Med. (Lausanne) 5, 228 (2018)

    Article  Google Scholar 

  12. Mazzeffi, M., et al.: Von Willebrand factor concentrate administration for acquired Von Willebrand syndrome-related bleeding during adult extracorporeal membrane oxygenation. J. Cardiothorac. Vasc. Anesth. 35(3), 882–887 (2021)

    Article  Google Scholar 

  13. Meyer, A.D., et al.: Effect of blood flow on platelets, leukocytes, and extracellular vesicles in thrombosis of simulated neonatal extracorporeal circulation. J. Thromb. Haemost. 18(2), 399–410 (2020)

    Article  Google Scholar 

  14. Ki, K.K., et al.: Current understanding of leukocyte phenotypic and functional modulation during extracorporeal membrane oxygenation: a narrative review. Front. Immunol. 11, 600684 (2020)

    Article  Google Scholar 

  15. Birschmann, I., et al.: Ambient hemolysis and activation of coagulation is different between HeartMate II and HeartWare left ventricular assist devices. J. Heart Lung. Transp. 33(1), 80–87 (2014)

    Article  Google Scholar 

  16. Thamsen, B., et al.: Numerical analysis of blood damage potential of the HeartMate II and HeartWare HVAD rotary blood pumps. Artif. Organs. 39(8), 651–659 (2015)

    Article  Google Scholar 

  17. Fraser, K.H., et al.: A quantitative comparison of mechanical blood damage parameters in rotary ventricular assist devices: shear stress, exposure time and hemolysis index. J. Biomech. Eng. 134(8), 081002 (2012)

    Article  Google Scholar 

  18. Heuser, G., Opitz, R.: A Couette viscometer for short time shearing of blood. Biorheology 17(1–2), 17–24 (1980)

    Article  Google Scholar 

  19. Zhang, T., et al.: Study of flow-induced hemolysis using novel Couette-type blood-shearing devices. Artif. Organs. 35(12), 1180–1186 (2011)

    Article  Google Scholar 

  20. Song, X., et al.: Computational fluid dynamics prediction of blood damage in a centrifugal pump. Artif. Organs. 27(10), 938–941 (2003)

    Article  Google Scholar 

  21. Li, Y., et al.: Investigation of the influence of blade configuration on the hemodynamic performance and blood damage of the centrifugal blood pump. Artif. Organs. 46(9), 1817–1832 (2022)

    Article  MathSciNet  Google Scholar 

  22. Li, Y., et al.: A new way to evaluate thrombotic risk in failure heart and ventricular assist devices. Med. Novel Technol. Dev. 16 (2022)

    Google Scholar 

  23. Sorensen, E.N., et al.: Computational simulation of platelet deposition and activation: II. Results for Poiseuille flow over collagen. Ann. Biomed. Eng. 27(4), 449–458 (1999)

    Google Scholar 

  24. Wu, W.T., et al.: Multi-constituent simulation of thrombus deposition. Sci. Rep. 7, 42720 (2017)

    Article  Google Scholar 

  25. Wu, W.T., et al.: Simulation of thrombosis in a stenotic microchannel: The effects of vWF-enhanced shear activation of platelets. Int. J. Eng. Sci. 147 (2020)

    Google Scholar 

  26. Zhussupbekov, M., et al.: Influence of shear rate and surface chemistry on thrombus formation in micro-crevice. J. Biomech. 121, 110397 (2021)

    Article  Google Scholar 

  27. Taskin, M.E., et al.: Evaluation of Eulerian and Lagrangian models for hemolysis estimation. ASAIO J 58(4), 363–372 (2012)

    Article  Google Scholar 

  28. Menichini, C., Xu, X.Y.: Mathematical modeling of thrombus formation in idealized models of aortic dissection: initial findings and potential applications. J. Math. Biol. 73(5), 1205–1226 (2016)

    Article  MathSciNet  Google Scholar 

  29. Li, Y., et al.: A mathematical model for assessing shear induced bleeding risk. Comput. Methods Programs Biomed. 231, 107390 (2023)

    Article  Google Scholar 

  30. Cho, S.M., Moazami, N., Frontera, J.A.: Stroke and Intracranial Hemorrhage in HeartMate II and HeartWare left ventricular assist devices: a systematic review. Neurocrit. Care. 27(1), 17–25 (2017)

    Article  Google Scholar 

  31. Suarez-Pierre, A., et al.: Early outcomes after heart transplantation in recipients bridged with a HeartMate 3 device. Ann. Thorac. Surg. 108(2), 467–473 (2019)

    Article  Google Scholar 

  32. Schalit, I., et al.: Accelerometer detects pump thrombosis and thromboembolic events in an in vitro HVAD circuit. ASAIO J. 64(5), 601–609 (2018)

    Article  Google Scholar 

  33. Rowlands, G.W., Antaki, J.F.: High-speed visualization of ingested, ejected, adherent, and disintegrated thrombus in contemporary ventricular assist devices. Artif. Organs. 44(11), E459–E469 (2020)

    Article  Google Scholar 

  34. Koliopoulou, A., et al.: Bleeding and thrombosis in chronic ventricular assist device therapy: focus on platelets. Curr. Opin. Cardiol. 31(3), 299–307 (2016)

    Article  Google Scholar 

Download references

Acknowledgment

This work was supported by the National Key R&D Program of China (Grant no. 2020YFC0862900, 2020YFC0862902, 2020YFC0862904 and 2020YFC0122203), the Beijing Municipal Science and Technology Project (Grant no. Z201100007920003), and the Fundamental Research Funds for the Central Universities and the National Natural Science Foundation of China (Grant no. 32071311).

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Authors and Affiliations

  1. Key Laboratory of Biomechanics and Mechanobiology (Beihang University), Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100083, China

    Yuan Li & Zengsheng Chen

Authors
  1. Yuan Li
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  2. Zengsheng Chen
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Correspondence to Zengsheng Chen .

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Editors and Affiliations

  1. Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China

    Guangzhi Wang

  2. School of Life Science and Technology, University of Electronic Science and Technology, Chengdu, China

    Dezhong Yao

  3. State Key Laboratory of Bioelectronics, School of Biological Science and Medical Engineering, Southeast University, Nanjing, China

    Zhongze Gu

  4. Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China

    Yi Peng

  5. School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China

    Shanbao Tong

  6. State Key Laboratory of Bioelectronics, School of Instrument Science and Engineering, Southeast University, Nanjing, China

    Chengyu Liu

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Li, Y., Chen, Z. (2024). A New Mathematical Model for Assessment of Bleeding and Thrombotic Risk in Three Different Types of Clinical Ventricular Assist Devices. In: Wang, G., Yao, D., Gu, Z., Peng, Y., Tong, S., Liu, C. (eds) 12th Asian-Pacific Conference on Medical and Biological Engineering. APCMBE 2023. IFMBE Proceedings, vol 104. Springer, Cham. https://doi.org/10.1007/978-3-031-51485-2_17

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  • DOI: https://doi.org/10.1007/978-3-031-51485-2_17

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-51484-5

  • Online ISBN: 978-3-031-51485-2

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