The Use of Fluid Mechanics to Predict Regions of Microscopic Thrombus Formation in Pulsatile VADs.

We compare the velocity and shear obtained from particle image velocimetry (PIV) and computational fluid dynamics (CFD) in a pulsatile ventricular assist device (VAD) to further test our thrombus predictive methodology using microscopy data from an explanted VAD. To mimic physiological conditions in vitro, a mock circulatory loop is used with a blood analog that matched blood's viscoelastic behavior at 40% hematocrit. Under normal physiologic pressures and for a heart rate of 75 bpm, PIV data is acquired and wall shear maps are produced. The resolution of the PIV shear rate calculations are tested using the CFD and found to be in the same range. A bovine study, using a model of the 50 cc Penn State V-2 VAD, for 30 days at a constant beat rate of 75 beats per minute (bpm) provides the microscopic data whereby after the 30 days, the device is explanted and the sac surface analyzed using scanning electron microscopy (SEM) and, after immunofluorescent labeling for platelets and fibrin, confocal microscopy. Areas are examined based on PIV measurements and CFD, with special attention to low shear regions where platelet and fibrin deposition are most likely to occur. Data collected within the outlet port in a direction normal to the front wall of the VAD shows that some regions experience wall shear rates less than 500 s-1, which increases the likelihood of platelet and fibrin deposition. Despite only one animal study, correlations between PIV, CFD, and in vivo data show promise. Deposition probability is quantified by the thrombus susceptibility potential, a calculation to correlate low shear and time of shear with deposition.

Computational fluid dynamics design and analysis of a passively suspended Tesla pump left ventricular assist device.

This article summarizes the use of computational fluid dynamics (CFD) to design a novel suspended Tesla left ventricular assist device. Several design variants were analyzed to study the parameters affecting device performance. CFD was performed at pump speeds of 6500, 6750, and 7000 rpm and at flow rates varying from 3 to 7 liters per minute (LPM). The CFD showed that shortening the plates nearest the pump inlet reduced the separations formed beneath the upper plate leading edges and provided a more uniform flow distribution through the rotor gaps, both of which positively affected the device hydrodynamic performance. The final pump design was found to produce a head rise of 77 mm Hg with a hydraulic efficiency of 16% at the design conditions of 6 LPM through flow and a 6750 rpm rotation rate. To assess the device hemodynamics the strain rate fields were evaluated. The wall shear stresses demonstrated that the pump wall shear stresses were likely adequate to inhibit thrombus deposition. Finally, an integrated field hemolysis model was applied to the CFD results to assess the effects of design variation and operating conditions on the device hemolytic performance.

Multilaboratory particle image velocimetry analysis of the FDA benchmark nozzle model to support validation of computational fluid dynamics simulations.

This study is part of a FDA-sponsored project to evaluate the use and limitations of computational fluid dynamics (CFD) in assessing blood flow parameters related to medical device safety. In an interlaboratory study, fluid velocities and pressures were measured in a nozzle model to provide experimental validation for a companion round-robin CFD study. The simple benchmark nozzle model, which mimicked the flow fields in several medical devices, consisted of a gradual flow constriction, a narrow throat region, and a sudden expansion region where a fluid jet exited the center of the nozzle with recirculation zones near the model walls. Measurements of mean velocity and turbulent flow quantities were made in the benchmark device at three independent laboratories using particle image velocimetry (PIV). Flow measurements were performed over a range of nozzle throat Reynolds numbers (Re(throat)) from 500 to 6500, covering the laminar, transitional, and turbulent flow regimes. A standard operating procedure was developed for performing experiments under controlled temperature and flow conditions and for minimizing systematic errors during PIV image acquisition and processing. For laminar (Re(throat)=500) and turbulent flow conditions (Re(throat)≥3500), the velocities measured by the three laboratories were similar with an interlaboratory uncertainty of ∼10% at most of the locations. However, for the transitional flow case (Re(throat)=2000), the uncertainty in the size and the velocity of the jet at the nozzle exit increased to ∼60% and was very sensitive to the flow conditions. An error analysis showed that by minimizing the variability in the experimental parameters such as flow rate and fluid viscosity to less than 5% and by matching the inlet turbulence level between the laboratories, the uncertainties in the velocities of the transitional flow case could be reduced to ∼15%. The experimental procedure and flow results from this interlaboratory study (available at http://fdacfd.nci.nih.gov) will be useful in validating CFD simulations of the benchmark nozzle model and in performing PIV studies on other medical device models.

Hemodynamics of an end-to-side anastomotic graft for a pulsatile pediatric ventricular assist device.

Numerical simulations are performed to investigate the flow within the end-to-side proximal anastomosis of a pulsatile pediatric ventricular assist device (PVAD) to an aorta. The anastomotic model is constructed from a patient-specific pediatric aorta. The three great vessels originating from the aortic arch--brachiocephalic (innominate), left common carotid, and left subclavian arteries--are included. An implicit large eddy simulation method based on a finite volume approach is used to study the resulting turbulent flow. A resistance boundary condition is applied at each branch outlet to study flow splitting. The PVAD anastomosis is found to alter the aortic flow dramatically. More flow is diverted into the great vessels with the PVAD support. Turbulence is found in the jet impingement area at peak systole for 100% bypass, and a maximum principal normal Reynolds stress of 7081 dyn/cm(2) is estimated based on ten flow cycles. This may be high enough to cause hemolysis and platelet activation. Regions prone to intimal hyperplasia are identified by combining the time-averaged wall shear stress and oscillatory shear index. These regions are found to vary, depending on the percentage of the flow bypass.

The fluid dynamics of canine olfaction: unique nasal airflow patterns as an explanation of macrosmia.

The canine nasal cavity contains hundreds of millions of sensory neurons, located in the olfactory epithelium that lines convoluted nasal turbinates recessed in the rear of the nose. Traditional explanations for canine olfactory acuity, which include large sensory organ size and receptor gene repertoire, overlook the fluid dynamics of odorant transport during sniffing. But odorant transport to the sensory part of the nose is the first critical step in olfaction. Here we report new experimental data on canine sniffing and demonstrate allometric scaling of sniff frequency, inspiratory airflow rate and tidal volume with body mass. Next, a computational fluid dynamics simulation of airflow in an anatomically accurate three-dimensional model of the canine nasal cavity, reconstructed from high-resolution magnetic resonance imaging scans, reveals that, during sniffing, spatially separate odour samples are acquired by each nostril that may be used for bilateral stimulus intensity comparison and odour source localization. Inside the nose, the computation shows that a unique nasal airflow pattern develops during sniffing, which is optimized for odorant transport to the olfactory part of the nose. These results contrast sharply with nasal airflow in the human. We propose that mammalian olfactory function and acuity may largely depend on odorant transport by nasal airflow patterns resulting from either the presence of a highly developed olfactory recess (in macrosmats such as the canine) or the lack of one (in microsmats including humans).

Comparative Study of Continuous and Pulsatile Left Ventricular Assist Devices on Hemodynamics of a Pediatric End-to-Side Anastomotic Graft.

Although there are many studies that focus on understanding the consequence of pumping mode (continuous vs. pulsatile) associated with ventricular assist devices (VADs) on pediatric vascular pulsatility, the impact on local hemodynamics has been largely ignored. Hence, we compare not only the hemodynamic parameters indicative of pulsatility but also the local flow fields in the aorta and the great vessels originating from the aortic arch. A physiologic graft anastomotic model is constructed based on a pediatric, patient specific, aorta with a graft attached on the ascending aorta. The flow is simulated using a previously validated second-order accurate Navier-Stokes flow solver based upon a finite volume approach. The major findings are: (1) pulsatile support provides a greater degree of vascular pulsatility when compared to continuous support, which, however, is still 20% less than pulsatility in the healthy aorta; (2) pulsatile support increases the flow in the great vessels, while continuous support decreases it; (3) complete VAD support results in turbulence in the aorta, with maximum principal Reynolds stresses for pulsatile support and continuous support of 7081 and 249 dyn/cm2, respectively; (4) complete pulsatile support results in a significant increase in predicted hemolysis in the aorta; and (5) pulsatile support causes both higher time-averaged wall shear stresses (WSS) and oscillatory shear indices (OSI) in the aorta than does continuous support. These findings will help to identify the risk of graft failure for pediatric patients with pulsatile and continuous VADs.

Development and verification of a high-fidelity computational fluid dynamics model of canine nasal airflow.

The canine nasal cavity contains a complex airway labyrinth, dedicated to respiratory air conditioning, filtering of inspired contaminants, and olfaction. The small and contorted anatomical structure of the nasal turbinates has, to date, precluded a proper study of nasal airflow in the dog. This study describes the development of a high-fidelity computational fluid dynamics (CFD) model of the canine nasal airway from a three-dimensional reconstruction of high-resolution magnetic resonance imaging scans of the canine anatomy. Unstructured hexahedral grids are generated, with large grid sizes ((10-100) x 10(6) computational cells) required to capture the details of the nasal airways. High-fidelity CFD solutions of the nasal airflow for steady inspiration and expiration are computed over a range of physiological airflow rates. A rigorous grid refinement study is performed, which also illustrates a methodology for verification of CFD calculations on complex unstructured grids in tortuous airways. In general, the qualitative characteristics of the computed solutions for the different grid resolutions are fairly well preserved. However, quantitative results such as the overall pressure drop and even the regional distribution of airflow in the nasal cavity are moderately grid dependent. These quantities tend to converge monotonically with grid refinement. Lastly, transient computations of canine sniffing were carried out as part of a time-step study, demonstrating that high temporal accuracy is achievable using small time steps consisting of 160 steps per sniff period. Here we demonstrate that acceptable numerical accuracy (between approximately 1% and 15%) is achievable with practical levels of grid resolution (approximately 100 x 10(6) computational cells). Given the popularity of CFD as a tool for studying flow in the upper airways of humans and animals, based on this work we recommend the necessity of a grid dependence study and quantification of numerical error when presenting CFD results in complicated airways.

A passively suspended Tesla pump left ventricular assist device.

The design and initial test results of a new passively suspended Tesla type left ventricular assist device blood pump are described. Computational fluid dynamics (CFD) analysis was used in the design of the pump. Overall size of the prototype device is 50 mm in diameter and 75 mm in length. The pump rotor has a density lower than that of blood and when spinning inside the stator in blood it creates a buoyant centering force that suspends the rotor in the radial direction. The axial magnetic force between the rotor and stator restrain the rotor in the axial direction. The pump is capable of pumping up to 10 L/min at a 70 mm Hg head rise at 8,000 revolutions per minute (RPM). The pump has demonstrated a normalized index of hemolysis level below 0.02 mg/dL for flows between 2 and 9.7 L/min. An inlet pressure sensor has also been incorporated into the inlet cannula wall and will be used for control purposes. One initial in vivo study showed an encouraging result. Further CFD modeling refinements are planned and endurance testing of the device.

Numerical study of blood flow at the end-to-side anastomosis of a left ventricular assist device for adult patients.

We use an implicit large eddy simulation (ILES) method based on a finite volume approach to capture the turbulence in the anastomoses of a left ventricular assist device (LVAD) to the aorta. The order-of-accuracy of the numerical schemes is computed using a two-dimensional decaying Taylor-Green vortex. The ILES method is carefully validated by comparing to documented results for a fully developed turbulent channel flow at Re(tau)=395. Two different anastomotic flows (proximal and distal) are simulated for 50% and 100% LVAD supports and the results are compared with a healthy aortic flow. All the analyses are based on a planar aortic model under steady inflow conditions for simplification. Our results reveal that the outflow cannulae induce high exit jet flows in the aorta, resulting in turbulent flow. The distal configuration causes more turbulence in the aorta than the proximal configuration. The turbulence, however, may not cause any hemolysis due to low Reynolds stresses and relatively large Kolmogorov length scales compared with red blood cells. The LVAD support causes an acute increase in flow splitting in the major branch vessels for both anastomotic configurations, although its long-term effect on the flow splitting remains unknown. A large increase in wall shear stress is found near the cannulation sites during the LVAD support. This work builds a foundation for more physiologically realistic simulations under pulsatile flow conditions.

Validation of a CFD methodology for positive displacement LVAD analysis using PIV data.

Computational fluid dynamics (CFD) is used to asses the hydrodynamic performance of a positive displacement left ventricular assist device. The computational model uses implicit large eddy simulation direct resolution of the chamber compression and modeled valve closure to reproduce the in vitro results. The computations are validated through comparisons with experimental particle image velocimetry (PIV) data. Qualitative comparisons of flow patterns, velocity fields, and wall-shear rates demonstrate a high level of agreement between the computations and experiments. Quantitatively, the PIV and CFD show similar probed velocity histories, closely matching jet velocities and comparable wall-strain rates. Overall, it has been shown that CFD can provide detailed flow field and wall-strain rate data, which is important in evaluating blood pump performance.

Reconstruction and morphometric analysis of the nasal airway of the dog (Canis familiaris) and implications regarding olfactory airflow.

The canine nasal airway is an impressively complex anatomical structure, having many functional roles. The complicated branching and intricate scrollwork of the nasal conchae provide large surface area for heat, moisture, and odorant transfer. Of the previous anatomical studies of the canine nasal airway, none have included a detailed rendering of the maxilloturbinate and ethmoidal regions of the nose. Here, we present a high-resolution view of the nasal airway of a large dog, using magnetic resonance imaging scans. Representative airway sections are shown, and a three-dimensional surface model of the airway is reconstructed from the image data. The resulting anatomic structure and detailed morphometric data of the airway provide insight into the functional nature of canine olfaction. A complex airway network is revealed, wherein the branched maxilloturbinate and ethmoturbinate scrolls appear structurally distinct. This is quantitatively confirmed by considering the fractal dimension of each airway, which shows that the maxilloturbinate airways are more highly contorted than the ethmoidal airways. Furthermore, surface areas of the maxilloturbinate and ethmoidal airways are shown to be much different, despite having analogous physiological functions. Functionally, the dorsal meatus of the canine nasal airway is shown to be a bypass for odorant-bearing inspired air around the complicated maxilloturbinate during sniffing for olfaction. Finally, nondimensional analysis is used to show that the airflow within both the maxilloturbinate and ethmoturbinate regions must be laminar. This work has direct relevance to biomimetic sniffer design, chemical trace detector development, intranasal drug delivery, and inhalation toxicology.

Development and validation of a computational fluid dynamics methodology for simulation of pulsatile left ventricular assist devices.

An unsteady computational fluid dynamic methodology was developed so that design analyses could be undertaken for devices such as the 50cc Penn State positive-displacement left ventricular assist device (LVAD). The piston motion observed in vitro was modeled, yielding the physiologic flow waveform observed during pulsatile experiments. Valve closure was modeled numerically by locally increasing fluid viscosity during the closed phase. Computational geometry contained Bjork-Shiley Monostrut mechanical heart valves in mitral and aortic positions. Cases for computational analysis included LVAD operation under steady-flow and pulsatile-flow conditions. Computations were validated by comparing simulation results with previously obtained in vitro particle image velocimetry (PIV) measurements. The steady portion of the analysis studied effects of mitral valve orientation, comparing the computational results with in vitro data obtained from mock circulatory loop experiments. The velocity field showed good qualitative agreement with the in vitro PIV data. The pulsatile flow simulations modeled the unsteady flow phenomena associated with a positive-displacement LVAD operating through several beat cycles. Flow velocity gradients allowed computation of the scalar wall strain rate, an important factor for determining hemodynamics of the device. Velocity magnitude contours compared well with PIV data throughout the cycle. Computational wall shear rates over the pulsatile cycle were found to be in the same range as wall shear rates observed in vitro.