Performance evaluation of a pediatric viscous impeller pump for Fontan cavopulmonary assist

Guruprasad A. Giridharan, Steven C. Koenig, Jeffrey Kennington, Michael A. Sobieski, Jun Chen, Steven H. Frankel, Mark Rodefeld

Research output: Contribution to journalArticle

40 Citations (Scopus)

Abstract

Objective: The anatomic and physiologic constraints for pediatric cavopulmonary assist differ markedly from adult Fontan circulations owing to smaller vessel sizes and risk of elevated pulmonary resistance. In this study, hemodynamic and hemolysis performance of a catheter-based viscous impeller pump (VIP) to power the Fontan circulation is assessed at a pediatric scale (∼15 kg) and performance range (0-30 mm Hg). Methods: Computer simulation and mock circulation studies were conducted to assess the hydraulic performance, acute hemodynamic response to different levels VIP support, and the potential for vena caval collapse. Computational fluid dynamics simulations were used to estimate VIP hydraulic performance, shear rates, and potential for hemolysis. Hemolysis was quantified in a mock loop with fresh bovine blood. Results: A VIP augmented 4-way total cavopulmonary connection flow at pediatric scales and restored systemic pressures and flows to biventricular values, without causing flow obstruction or suction. VIP generated flows up to 4.1 L/min and pressure heads of up to 38 mm Hg at 11,000 rpm. Maximal shear rate was 160 Pa, predicting low hemolysis risk. Observed hemolysis was low with plasma free hemoglobin of 11.4 mg·dL-1·h-1. Conclusions: A VIP will augment Fontan cavopulmonary flow in the proper pressure and flow ranges, with low hemolysis risk under more stringent pediatric scale and physiology compared with adult scale. This technology may be developed to simultaneously reduce systemic venous pressure and improve cardiac output after stage 2 or 3 Fontan repair. It may serve to compress surgical staging, lessening the pathophysiologic burden of repair.

Original languageEnglish
Pages (from-to)249-257
Number of pages9
JournalJournal of Thoracic and Cardiovascular Surgery
Volume145
Issue number1
DOIs
StatePublished - Jan 2013

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Hemolysis
Pediatrics
Pressure
Hemodynamics
Venae Cavae
Venous Pressure
Suction
Hydrodynamics
Cardiac Output
Computer Simulation
Hemoglobins
Catheters
Technology
Lung

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine

Cite this

Performance evaluation of a pediatric viscous impeller pump for Fontan cavopulmonary assist. / Giridharan, Guruprasad A.; Koenig, Steven C.; Kennington, Jeffrey; Sobieski, Michael A.; Chen, Jun; Frankel, Steven H.; Rodefeld, Mark.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 145, No. 1, 01.2013, p. 249-257.

Research output: Contribution to journalArticle

Giridharan, Guruprasad A. ; Koenig, Steven C. ; Kennington, Jeffrey ; Sobieski, Michael A. ; Chen, Jun ; Frankel, Steven H. ; Rodefeld, Mark. / Performance evaluation of a pediatric viscous impeller pump for Fontan cavopulmonary assist. In: Journal of Thoracic and Cardiovascular Surgery. 2013 ; Vol. 145, No. 1. pp. 249-257.
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