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

Francesco Scardulla, Diego Bellavia, Leonardo D'Acquisto, Giuseppe M. Raffa, Salvatore Pasta

Research output: Contribution to journalArticle

4 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)47-54
Number of pages8
JournalMedical Engineering and Physics
Volume47
DOIs
Publication statusPublished - Sep 1 2017

Fingerprint

Left ventricular assist devices
Heart-Assist Devices
Rheology
Hemodynamics
Echocardiography
Abdomen
Velocity measurement
Shear stress
Mesenteric Arteries
Hemorrhage
Celiac Artery
Abdominal Aorta
von Willebrand Factor
Renal Artery
Flow measurement
Grafts
Gold
Cardiac Output
Stress concentration
Heart Failure

Keywords

  • Abdominal aorta
  • Gastrointestinal bleeding
  • Left ventricular assist device (LVAD)
  • Particle image velocimetry (PIV)

ASJC Scopus subject areas

  • Biophysics
  • Biomedical Engineering

Cite this

Particle image velocimetry study of the celiac trunk hemodynamic induced by continuous-flow left ventricular assist device. / Scardulla, Francesco; Bellavia, Diego; D'Acquisto, Leonardo; Raffa, Giuseppe M.; Pasta, Salvatore.

In: Medical Engineering and Physics, Vol. 47, 01.09.2017, p. 47-54.

Research output: Contribution to journalArticle

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