Comprehensive study on simulation, performance evaluation and optimization strategies for blood pumps

Figures & data

Figure 1. Blood pump simulation method, performance evaluation method and optimization strategy study

Figure 2. Clinical incidence and relationship between thrombosis, bleeding (gastrointestinal bleeding and hemorrhagic stroke), and ischemic stroke in the blood pump.

Figure 3. Shear stress-induced variation in platelet and vWF hemostatic function

Figure 4. Effect of steady state and transient RANS model and LES on the predicted results: (a) Flow field (vortex shown by Q criterion, Q = 6 × 10⁶ s⁻², Condition 3: 4.5L/min, 3500 rpm); (b) Pressure head; (c) Efficiency; (d) Power loss; (e) Hemolysis index.

Figure 5. Comparison of the hydraulic performance and non-physiological flow environment of blood pumps: (a) Efficiency of four blood pumps; (b) Power loss of four blood pumps; (c) Non-physiological flow environment in HeartMate 3 blood pump; (d) Non-physiological flow environment in HeartWare blood pump; (e) Non-physiological flow environment in HeartMate II blood pump; and (f) Non-physiological flow environment in Jarvik 2000 blood pump.

Figure 6. Comparison of blood damage indicators of four blood pumps: (a) Hemolysis; (b) Thrombosis; (c) bleeding; and (d) Ischemic Stroke.

Figure 7. Analysis of the causes of differences in blood damage: (a) Threshold shear stress and exposure time leading to cellular and protein damage (Data from the study by Paul et al. (2003), Zhang et al. (2011), Arwatz and Smits (2013), Boehning et al. (2014), Ding et al. (2015), Chen et al. (2016), Lu et al. (2013), Chan et al. (2022), Colace and Diamond (2013), Lippok et al. (2016), Schneider et al. (2007), Siedlecki et al. (1996); (b) High shear stress volume in HeartWare and HeartMate II blood pumps; (c) HeartWare and HeartMate II blood pumps leading to vWF damage risk prediction and experimental validation; and (d) HeartWare and HeartMate II blood pump-induced platelet GPIIb/IIIa receptor activation ratio prediction and experimental validation.

Figure 8. Blood pump-induced bleeding and hemolysis high-risk regions assessed: (a) HeartMate 3 blood pump-induced bleeding risk regions; (b) HeartWare blood pump-induced bleeding risk regions; (c) HeartMate II blood pump-induced bleeding risk regions; (d) Jarvik 2000 blood pump-induced bleeding risk regions; (e) HeartMate 3 blood pump-induced hemolysis risk regions; (f) HeartWare blood pump-induced hemolysis risk regions; (g) HeartMate II blood pump-induced hemolysis risk regions; and (h) Jarvik 2000 blood pump-induced hemolysis risk regions.

Figure 9. Blood pump-induced thrombosis and ischemic stroke high-risk regions assessed: (a) HeartMate 3 blood pump-induced thrombosis risk regions prediction and validation; (b) HeartWare blood pump-induced thrombosis risk regions prediction and validation; (c) HeartMate II blood pump-induced thrombosis risk regions prediction and validation; (d) Jarvik 2000 blood pump-induced thrombosis risk regions prediction and validation; (e) HeartWare blood pump-induced thrombosis risk regions validation; (f) HeartMate II blood pump-induced thrombosis risk regions validation; (g) Jarvik 2000 blood pump-induced thrombosis risk regions validation; (h) HeartMate 3 blood pump-induced ischemic stroke risk regions; (i) HeartWare blood pump-induced ischemic stroke risk regions; (j) HeartMate II blood pump-induced ischemic stroke risk regions; and (k) Jarvik 2000 blood pump-induced ischemic stroke risk regions.

Figure 10. The linkage between hydraulic performance and hemocompatibility of blood pumps (based on 125 working conditions): (a) Schematic diagram of the relationship between hydraulic performance and hemocompatibility of blood pumps; (b) Correlation analysis of shear stress and power loss of blood pumps; (c) Correlation analysis of shear stress and efficiency of blood pumps; (d) Correlation analysis of blood damage indicators and unit power loss of blood pumps; and (c) Correlation analysis of hemocompatibility and efficiency of blood pumps.

Figure 11. Comparison of original and optimized blood pump configurations and non-physiological environments: (a) Original blood pump configuration and shear stress distribution; (b) Optimized blood pump configuration and shear stress distribution; (c) Comparison the efficiency of original and optimized blood pumps; (d) Comparison the power loss of original and optimized pumps; (e) Comparison of the mean shear stress of original and optimized pumps; (f) Comparison of the threshold shear stresses of original and optimized blood pumps.

Figure 12. Comparison of original and optimized blood pumps for hemocompatibility: (a) Comparison of the risk of hemolysis in original and optimized blood pumps; (b) Comparison of the risk of thrombosis in original and optimized blood pumps; (c) Comparison of the risk of bleeding in original and optimized blood pumps; (d) Comparison of the risk of ischemic stroke in original and optimized blood pumps.

Paul, R., Apel, J., Klaus, S., Schügner, F., Schwindke, P., & Reul, H. (2003). Shear stress related blood damage in laminar couette flow. Artificial Organs, 27(6), 517–529. https://doi.org/10.1046/j.1525-1594.2003.07103.x

 PubMed Web of Science ®Google Scholar

Zhang, T., Taskin, M. E., Fang, H. B., Pampori, A., Jarvik, R., Griffith, B. P., & Wu, Z. J. (2011). Study of flow-induced hemolysis using novel couette-type blood-shearing devices. Artificial Organs, 35(12), 1180–1186. https://doi.org/10.1111/j.1525-1594.2011.01243.x

 PubMed Web of Science ®Google Scholar

Arwatz, G., & Smits, A. J. (2013). A viscoelastic model of shear-induced hemolysis in laminar flow. Biorheology, 50(1-2), 45–55. https://doi.org/10.3233/BIR-130626

 PubMed Web of Science ®Google Scholar

Boehning, F., Mejia, T., Schmitz-Rode, T., & Steinseifer, U. (2014). Hemolysis in a laminar flow-through couette shearing device: An experimental study. Artificial Organs, 38(9), 761–765.

 PubMed Web of Science ®Google Scholar

Ding, J., Niu, S., Chen, Z., Zhang, T., Griffith, B. P., & Wu, Z. J. (2015). Shear-Induced hemolysis: Species differences. Artificial Organs, 39(9), 795–802. https://doi.org/10.1111/aor.12459

 PubMed Web of Science ®Google Scholar

Chen, Z., Mondal, N. K., Ding, J., Koenig, S. C., Slaughter, M. S., & Wu, Z. J. (2016). Paradoxical effect of nonphysiological shear stress on platelets and von willebrand factor. Artificial Organs, 40(7), 659–668. https://doi.org/10.1111/aor.12606

 PubMed Web of Science ®Google Scholar

Lu, Q., Hofferbert, B. V., Koo, G., & Malinauskas, R. A. (2013). In vitro shear stress-induced platelet activation: Sensitivity of human and bovine blood. Artificial Organs, 37(10), 894–903. https://doi.org/10.1111/aor.12099

 PubMed Web of Science ®Google Scholar

Chan, C. H. H., Simmonds, M. J., Fraser, K. H., Igarashi, K., Ki, K. K., Murashige, T., Joseph, M. T., Fraser, J. F., Tansley, G. D., & Watanabe, N. (2022). Discrete responses of erythrocytes, platelets, and von willebrand factor to shear. Journal of Biomechanics, 130, 110898. https://doi.org/10.1016/j.jbiomech.2021.110898

 PubMed Web of Science ®Google Scholar

Colace, T. V., & Diamond, S. L. (2013). Direct observation of von willebrand factor elongation and fiber formation on collagen during acute whole blood exposure to pathological flow. Arteriosclerosis, Thrombosis, and Vascular Biology, 33(1), 105–113. https://doi.org/10.1161/ATVBAHA.112.300522

 PubMed Web of Science ®Google Scholar

Lippok, S., Radtke, M., Obser, T., Kleemeier, L., Schneppenheim, R., Budde, U., Netz, R. R., & Rädler, J. O. (2016). Shear-Induced unfolding and enzymatic cleavage of full-length VWF multimers. Biophysical Journal, 110(3), 545–554. https://doi.org/10.1016/j.bpj.2015.12.023

 PubMed Web of Science ®Google Scholar

Schneider, S. W., Nuschele, S., Wixforth, A., Gorzelanny, C., Alexander-Katz, A., Netz, R. R., & Schneider, M. F. (2007). Shear-induced unfolding triggers adhesion of von willebrand factor fibers. Proceedings of the National Academy of Sciences, 104(19), 7899–7903. https://doi.org/10.1073/pnas.0608422104

 PubMed Web of Science ®Google Scholar

Siedlecki, C. A., Lestini, B. J., Kottke-Marchant, K. K., Eppell, S. J., Wilson, D. L., & Marchant, R. E. (1996). Shear-dependent changes in the three-dimensional structure of human von willebrand factor. Blood, 88(8), 2939–2950. https://doi.org/10.1182/blood.V88.8.2939.bloodjournal8882939

 PubMed Web of Science ®Google Scholar