Whereas left ventricular assist device (LVAD) is the gold-standard therapy for patients with heart failure, gastrointestinal bleeding is one of the most common complications. LVAD implantation may remarkably impact aortic hemodynamics so that experimental and computational flow analyses can be used to study the disease mechanisms. Here we present an experimentally-calibrated computational model of the celiac trunk hemodynamic of a LVAD-supported patient who experienced bleeding after device implantation. Specifically, both particle image velocimetry (PIV) and echocardiography were used to measure and compare flow distributions in each branch of a phantom model of the patient abdominal aorta. Then, the distribution of wall shear stress (WSS) was estimated by computational flow analysis. At a cardiac output of 5 L/min, the highest flow division was found in the mesenteric artery (13.6% for PIV and 14.6% for echocardiography), while the left renal artery exhibited the lowest amount in the celiac trunk model (2.6% for PIV and 2.4% for echocardiography). Bland–Altman analysis demonstrated a high agreement between echocardiographic and PIV-related flow measurements, while computational flow analysis revealed that WSS was high in the LVAD graft anastomosis site and just after the ostia of both the celiac trunk and mesenteric artery. This altered shear stress distribution in the celiac trunk may lead to a flow-mediated mechanism of adverse remodeling of the von Willebrand factor and ultimately to gastrointestinal bleeding as seen clinically in this patient.

Scardulla, F., Bellavia, D., D'Acquisto, L., Raffa, G., Pasta, S. (2017). Particle image velocimetry study of the celiac trunk hemodynamic induced by continuous-flow left ventricular assist device. MEDICAL ENGINEERING & PHYSICS, 47, 47-54 [10.1016/j.medengphy.2017.06.029].

Particle image velocimetry study of the celiac trunk hemodynamic induced by continuous-flow left ventricular assist device

Scardulla, Francesco
;
Bellavia, Diego;D'Acquisto, Leonardo;Pasta, Salvatore;PASTA, Salvatore
2017-01-01

Abstract

Whereas left ventricular assist device (LVAD) is the gold-standard therapy for patients with heart failure, gastrointestinal bleeding is one of the most common complications. LVAD implantation may remarkably impact aortic hemodynamics so that experimental and computational flow analyses can be used to study the disease mechanisms. Here we present an experimentally-calibrated computational model of the celiac trunk hemodynamic of a LVAD-supported patient who experienced bleeding after device implantation. Specifically, both particle image velocimetry (PIV) and echocardiography were used to measure and compare flow distributions in each branch of a phantom model of the patient abdominal aorta. Then, the distribution of wall shear stress (WSS) was estimated by computational flow analysis. At a cardiac output of 5 L/min, the highest flow division was found in the mesenteric artery (13.6% for PIV and 14.6% for echocardiography), while the left renal artery exhibited the lowest amount in the celiac trunk model (2.6% for PIV and 2.4% for echocardiography). Bland–Altman analysis demonstrated a high agreement between echocardiographic and PIV-related flow measurements, while computational flow analysis revealed that WSS was high in the LVAD graft anastomosis site and just after the ostia of both the celiac trunk and mesenteric artery. This altered shear stress distribution in the celiac trunk may lead to a flow-mediated mechanism of adverse remodeling of the von Willebrand factor and ultimately to gastrointestinal bleeding as seen clinically in this patient.
2017
Settore ING-IND/12 - Misure Meccaniche E Termiche
Scardulla, F., Bellavia, D., D'Acquisto, L., Raffa, G., Pasta, S. (2017). Particle image velocimetry study of the celiac trunk hemodynamic induced by continuous-flow left ventricular assist device. MEDICAL ENGINEERING & PHYSICS, 47, 47-54 [10.1016/j.medengphy.2017.06.029].
File in questo prodotto:
File Dimensione Formato  
Particle image velocimetry study of the celiac trunk hemodynamic induced by continuous-flow left ventricular assist device.pdf

Solo gestori archvio

Descrizione: Articolo - Particle image velocimetry study of the celiac trunk hemodynamic induced by continuous-flow left ventricular assist device
Tipologia: Versione Editoriale
Dimensione 2.07 MB
Formato Adobe PDF
2.07 MB Adobe PDF   Visualizza/Apri   Richiedi una copia

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10447/250574
Citazioni
  • ???jsp.display-item.citation.pmc??? 4
  • Scopus 15
  • ???jsp.display-item.citation.isi??? 14
social impact