Summary
This computational model predicts cardiovascular performance to support individuals with a Left Ventricular Assist Device (LVAD).
Inventors
Jonathan Grinstein, MD
Hector Garcia-Garcia, MD, PhD
Christos Bourantas, MD, PhD
Ryo Torii, PhD
What is it? What does it do?
The LVAD is a durable mechanical pump that moves blood from the left ventricle to the aorta in patients with advanced heart failure. Because an LVAD profoundly alters the blood flow through the heart and aorta, a system is needed to predict and measure the impact on the cardiovascular system and postoperative complications such as pump thrombosis, stroke, aortic insufficiency, and heart failure readmissions.
Unlike the rest of the beating heart, an LVAD provides constant blood flow to the aorta. Current Computational Fluid Dynamics (CFD) models simulate blood flow from a non-beating heart. This CFD model is unique in that it integrates the pulsatile contributions from the heartbeat and the patient’s own anatomy by combining blood flow measurements in the heart with various imaging technologies (i.e., gated Computed Tomography, or CT). This dynamic model allows for a more accurate assessment of periodic deviations in flow patterns or momentary LVAD blockage during phases of the cardiac cycle. As a result, this model can be used to match the ideal pump to the patient prior to implantation, optimize the placement of the LVAD at the left ventricle and aorta, and program the pump settings post-implant to mitigate adverse outcomes for patients while maximizing LVAD performance.
Why is it better?
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Unlike other computational models, this CFD model is the first fully pulsatile model that integrates systolic and diastolic pressure variation within the left ventricle and includes the entire left ventricle, LVAD system (inflow cannula, pump, and outflow cannula), and the aorta, allowing for a more complete, natural representation of cardiac-LVAD performance.
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The model can also approximate the pressure-volume relationship in the various cardiac chambers under different LVAD settings, giving providers the ability to predict cardiac events.
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After LVAD implantation, the model can be used virtually to optimize LVAD settings at rest or even during simulated exercise.
What is its current status?
The novel, computational model was developed using an electrical circuit analogy to represent a model of circulation and 3D CFD to estimate the physiologic response to LVAD operation and provide a detailed depiction of flow patterns and hemodynamic indicators. Detailed anatomical information using high-resolution 4D CT images with pulmonary capillary wedge pressure tracings from a right heart catheterization were introduced to the model. Patient-specific variables such as blood pressure and heart rate were incorporated to calibrate the model.
Most recently, the MedStar Inventor Services team filed for a U.S. patent which is currently pending. U.S. Patent Application 20220044825 A1, “Modeling of flow through a left ventricular assist device (lvad).”
The MedStar Inventor Services team is now seeking a licensing/collaboration partner to develop and commercialize this technology. Please contact us at invent@medstar.net.
Publications
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Grinstein et al. (2021). Left Ventricular Assist Device Flow Pattern Analysis Using a Novel Model Incorporating Left Ventricular Pulsatility. ASAIO journal (American Society for Artificial Internal Organs : 1992), 67(7), 724–732.
https://pubmed.ncbi.nlm.nih.gov/33528162/