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Dual‐Pump Support in the Inferior and Superior Vena Cavae of a Patient‐Specific F ontan Physiology
Author(s) -
Throckmorton Amy L.,
LopezIsaza Sergio,
Moskowitz William
Publication year - 2013
Publication title -
artificial organs
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 76
eISSN - 1525-1594
pISSN - 0160-564X
DOI - 10.1111/aor.12039
Subject(s) - inferior vena cava , superior vena cava , hemodynamics , blood flow , vena cava , medicine , venae cavae , cardiology , anesthesia
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 F ontan physiology. Identical intravascular blood pumps are employed to model the hemodynamic support of a patient‐specific F ontan. 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 22 mm H g for flow rates of 1–4 L/min at operating speeds of 1250–2500 rpm. 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 F ontan patients has the potential to be beneficial, but additional studies are needed to further explore this approach.