Effects of Pulsatile Frequency of Left Ventricular Assist Device (LVAD) on Coronary Perfusion: A Numerical Simulation Study
Yuanfei Zhu, Ming Yang, Yan Zhang, Fan Meng, Tianyue Yang, Zhiwei Fang
Department of Instrument Science and Engineering, Shanghai Jiao Tong University, Shanghai, China (mainland)
Med Sci Monit 2020; 26:e925367
Available online: 2020-07-23
Left ventricular assist devices (LVADs) with counter-pulsation mode have been widely used to support left ventricular function and improve coronary circulation. However, the frequency characteristics of the coronary system have not been considered. The aim of this study was to investigate the effects of pulsatile frequency of LVADs on coronary perfusion.
MATERIAL AND METHODS: First, a lumped parameter (LP) model incorporating coronary circulation, systemic circulation, left heart, and LVAD was established to simulate the cardiovascular system. Then, the frequency characteristics of the coronary system were analyzed and the calculation results showed that the pulsatile frequency of the LVAD has a substantial effect on coronary blood flow. To verify the accuracy of the theoretical analysis, the hemodynamic effects of the LVAD on the coronary artery were compared under 4 support modes: co-pulsation mode, and counter-pulsation modes in synchronization ratios of 1: 1, 2: 1, and 3: 1.
RESULTS: We found that the coronary flow increased by 5% when the working mode changed from co-pulsation to counter-pulsation in a synchronization ratio of 1: 1, and by an additional 6% when the working mode changed from counter-pulsation in a synchronization ratio of 1: 1 to counter-pulsation in a synchronization ratio of 3: 1.
CONCLUSIONS: This work provides a useful method to increase coronary perfusion and may be beneficial for improving myocardial function in patients with end-stage heart failure, especially those with ischemic cardiomyopathy (ICM).
Keywords: Coronary Vessels, Heart-Assist Devices, Myocardial Reperfusion, Pulsatile Flow