Open AccessVascular Thrombosis During Support With Continuous Flow Ventricular Assist Devices: Correlation With Computerized Flow Simulations
Author(s) -
Kar Biswajit,
Delgado Reynolds M.,
Radovancevic Branislav,
Myers Timothy J.,
Wadia Yasmin,
Letsou George V.,
Riaz Imran,
Metcalfe Ralph,
Gregoric Igor,
Harting Matthew T.
Publication year - 2005
Publication title -
congestive heart failure
Language(s) - English
Resource type - Journals
eISSN - 1751-7133
pISSN - 1527-5299
DOI - 10.1111/j.1527-5299.2005.04474.x
Subject(s) - medicine , thrombosis , cardiology , flow (mathematics) , heart failure , ventricular assist device , continuous flow , mechanics , physics
Continuous flow pumps are increasingly used to treat severe heart failure. These pumps alter flow physiology by lowering pulsatility in the arterial circulation. In patients with peripheral stenosis, continuous flow pumps may lead to thrombosis of peripheral vessels, possibly predisposing to vascular thrombosis in areas of non‐flow‐limiting stenosis. The authors performed a computerized flow modeling simulation to analyze the effects of altered hemodynamics in a stenotic area. Drawing on previous clinical experience, we modeled a stenotic area in the common carotid artery. Computerized flow modeling revealed blood stagnation zones with low shear stress and velocity adjacent to the stenotic area during nonpulsatile flow. Such stagnation was not present during pulsatile flow. These results indicate a mechanism by which altered physiologic flow may accelerate occlusion of arterial conduits in patients with preexisting stenosis. This finding may be important for patients with continuous flow devices who have peripheral vascular disease; therefore, further study is warranted.