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Pascal R Verdonck

Publications and source records attributed to Pascal R Verdonck.

11 recordsLinked to original sources

Three-dimensional numerical modeling and computational fluid dynamics simulations to analyze and improve oxygen availability in the AMC bioartificial liver.

A numerical model to investigate fluid flow and oxygen (O(2)) transport and consumption in the AMC-Bioartificial Liver (AMC-BAL) was developed and applied to two representative micro models of the AMC-BAL with two different gas capillary patterns, each combined with two proposed hepatocyte distributions. Parameter studies were performed on each configuration to gain insight in fluid flow, shear stress distribution and oxygen availability in the AMC-BAL. We assessed the function of the internal oxygenator, the effect of changes in hepatocyte oxygen consumption parameters in time and the effect of the change from an experimental to a clinical setting. In addition, different methodologies were studied to improve cellular oxygen availability, i.e. external oxygenation of culture medium, culture medium flow rate, culture gas oxygen content (pO(2)) and the number of oxygenation capillaries. Standard operating conditions did not adequately provide all hepatocytes in the AMC-BAL with sufficient oxygen to maintain O(2) consumption at minimally 90% of maximal uptake rate. Cellular oxygen availability was optimized by increasing the number of gas capillaries and pO(2) of the oxygenation gas by a factor two. Pressure drop over the AMC-BAL and maximal shear stresses were low and not considered to be harmful. This information can be used to increase cellular efficiency and may ultimately lead to a more productive AMC-BAL.

Cell Culture Techniques↗

Operator dependence of 3-D ultrasound-based computational fluid dynamics for the carotid bifurcation.

The association between vascular wall shear stress (WSS) and the local development of atherosclerotic plaque makes estimation of in vivo WSS of considerable interest. Three-dimensional ultrasound (3DUS) combined with computational fluid dynamics (CFD) provides a potentially valuable tool for acquiring subject-specific WSS, but the interoperator and intraoperator variability associated with WSS calculations using this method is not known. Here, the accuracy, reproducibility and operator dependence of 3DUS-based computational fluid dynamics were examined through a phantom and in vivo studies. A carotid phantom was scanned and reconstructed by two operators. In the in vivo study, four operators scanned a healthy subject a total of 11 times, and their scan data were processed by three individuals. The study showed that with some basic training, operators could acquire accurate carotid geometry for flow reconstructions. The variability of measured cross-sectional area and predicted shear stress was 8.17% and 0.193 N/m2 respectively for the in vivo study. It was shown that the variability of the examined parameters was more dependent on the scan operators than the image processing operator. The range of variability of geometrical and flow parameters reported here can be used as a reference for future in vivo studies using the 3DUS-based CFD approach.

Adult↗

Predicting ATS Open Pivot heart valve performance with computational fluid dynamics.

BACKGROUND AND AIM OF THE STUDY: In-vitro studies on the ATS heart valve have indicated that valve opening is less in an expanding conduit than in a straight conduit. METHODS: Bileaflet valve behavior was studied using a new computational fluid-structure interaction model. A three-dimensional model of the ATS valve was studied in two geometries, simulating the valve in a geometry with sudden expansion downstream of the valve, and in a straight conduit. Mitral and aortic flow patterns were simulated. RESULTS: The ATS valve in the expanding geometry showed opening to a maximum angle of 77.5 degrees; this was confirmed in previous clinical and in-vitro studies. The mean and maximum transvalvular Doppler pressure gradients were 1.1 and 4.3 mmHg, respectively. The maximum shear stress calculated on the leaflet was 25 Pa. Maximum opening of the valve was achieved in the straight conduit; with mean and maximum pressure gradients of 2.1 and 4.6 mmHg, respectively. The maximum shear stress calculated on the leaflet was 35 Pa. CONCLUSION: The results of this numerical study confirmed that valve hemodynamics and leaflet motion were dependent on the geometrical conditions of the valve: the presence of a diverging flow influenced the maximum opening angle of the valve leaflets. This model could be used to predict pressure gradients, effective orifice area, performance index and shear stress loading of mechanical heart valves, and in future will serve as a major research tool to characterize the hemodynamics of existing and new mechanical heart valves.

Aortic Valve↗

Echocardiographic assessment of aortic elastic properties with automated border detection in an ICU: in vivo application of the arctangent Langewouters model.

We studied whether combined pressure and transesophageal ultrasound monitoring is feasible in the intensive care unit (ICU) setting for global cardiovascular hemodynamic monitoring [systemic vascular resistance (SVR) and total arterial compliance (C(PPM))] and direct estimation of local ascending and descending aortic mechanical properties, i.e., distensibility and compliance coefficients (DC and CC). Pressure-area data were fitted to the arctangent Langewouters model, with aortic cross-sectional area obtained via automated border detection. Data were measured in 19 subjects at baseline, during infusion of sodium nitroprusside (SNP), and after washout. SNP infusion lowered SVR from 1.15 +/- 0.40 to 0.80 +/- 0.32 mmHg.ml(-1).s (P < 0.05), whereas C(PPM) increased from 0.87 +/- 0.46 to 1.02 +/- 0.42 ml/mmHg (P < 0.05). DC and CC increased from 0.0018 +/- 0.0007 to 0.0025 +/- 0.0009 l/mmHg (P < 0.05) and from 0.0066 +/- 0.0028 to 0.0083 +/- 0.0026 cm2/mmHg (P < 0.05), respectively, at the descending, but not ascending, aorta. The Langewouters model fitted the descending aorta data reasonably well. Assessment of local mechanical properties of the human ascending aorta in a clinical setting by automated border detection remains technically challenging.

Aged↗

Influence of zero flow pressure on fractional flow reserve.

Fractional flow reserve (FFR) is a commonly used index to assess the functional severity of a coronary artery stenosis. It is conventionally calculated as the ratio of the pressure distal (Pd) and proximal (Pa) to the stenosis (FFR= Pd/Pa). We hypothesize that the presence of a zero flow pressure (Pzf), requires a modification of this equation. Using a dynamic hydraulic bench model of the coronary circulation, which allows one to incorporate an adjustable Pzf, we studied the relation between pressure-derived FFR = Pdo/Pa, flow-derived true FFRQ = Qs/QN (= ratio of flow through a stenosed vessel to flow through a normal vessel), and the corrected pressure-derived FFRc = (Pd-Pzf)/(Pa-Pzf) under physiological aortic pressures (70 mmHg, 90 mmHg, and 110 mmHg). Imposed Pzf values varied between 0 mmHg and 30 mmHg. FFRc was in good agreement with FFRQ, whereas FFR consistently overestimated FFRQ. This overestimation increased when Pzf increased, or when Pa decreased, and could be as high as 56% (Pzf=30 mmHg and Pa =70 mmHg). According to our experimental study, calculating the corrected FFRC instead of FFR, if Pzf is known, provides a physiologically more accurate evaluation of the functional severity of a coronary artery stenosis.

Blood Pressure↗

Computational fluid dynamics-analysis of the Niagara hemodialysis catheter in a right heart model.

Central venous catheters are widely used as a hemoaccess method for dialysis therapy. In this study, the performance parameters (velocities, pressure drop, shear rates, access recirculation) of the Niagara catheter are analyzed using computational fluid dynamics. Side holes are left open, closed, or reduced in size to assess the influence of this design feature. Initially the catheter is inserted in a tube which represents the vena cava. In the "arterial" luminal tip, wall shear rates over 20,000 s(-1) are common and peaks attain 55,000 s(-1) at a 300 mL/min blood flow rate. The presence of side holes appears to affect the location but not the level of these elevated shear rates. Halving their diameter causes elevated shear rates to appear in a more extended region with peaks up to 80,000 s(-1). Simulated recirculation percentage is nil in normal catheter use, but attains 30% with reversed catheter connections. The results of the tube model are compared to those of an anatomically realistic right atrium model, which was three-dimensionally reconstructed. It is concluded that most catheter's specific hemodynamic properties can be deduced from the tube model.

Atrial Function, Right↗

Design of a new pulsatile bioreactor for tissue engineered aortic heart valve formation.

Evidence has been gathered that biomechanical factors have a significant impact on cell differentiation and behavior in in vitro cell cultures. The aim of this bioreactor is to create a physiological environment in which tissue engineered (TE) aortic valves seeded with human cells can be cultivated during a period of several days. The bioreactor consists of 2 major parts: the left ventricle (LV) and the afterload consisting of a compliance, representing the elastic function of the large arteries, and in series a resistance, mimicking the arterioles and capillaries. The TE aortic valve is placed between the LV and the compliance. With controllable resistance, compliance, stroke volume and frequency, and hydrodynamic conditions can be changed over a wide physiological range. This study resulted in a prototype of a compact pulsatile flow system for the creation of TE aortic valves. In addition a biocompatibility study of the used materials is performed.

Aortic Valve↗

Mock loop testing of On-x prosthetic mitral valve with Doppler echocardiography.

Previous in vitro testing (mainly in aortic position) and clinical experience (often based on Doppler echocardiographic observations) demonstrated an excellent hemodynamic behavior of the On-X valve. However, integrative studies including simultaneous hemodynamic pressure and flow measurements and Doppler echocardiography are lacking. Using our computer-controlled mock loop system, two samples of the Mitral 27/29 and one sample of the Conform-X Mitral 25/33 are tested in mitral position. Data include transvalvular pressure gradient and flow as well as transthoracic Doppler echocardiography. The valves are tested under three pressure conditions (ventricular systolic pressure of 100, 130, and 160 mm Hg) at three different heart rates (60, 100, and 140 beats/min). In addition, ventricular pressure conditions simulating fibrillation are imposed. Both valve types show similar hydrodynamic characteristics and have an effective orifice area of 2.1 cm2 and a performance index of 0.56 for a cardiac output of 3.5 L/min. Regurgitant volumes remain below 6 ml.

Coronary Circulation↗

Effect of rotary blood pump failure on left ventricular energetics assessed by mathematical modeling.

In this study, we used a mathematical model to study the influence of backflow through a failing rotary blood pump. We performed simulations based on animal experiments that were published earlier by Nishida et al., who used the Medos Microdiagonal pump to assess the acute effect of sudden pump failure. The mathematical model consists of validated cardiac and arterial modules and a pump module. We could evaluate the influence of pump failure with mechanoenergetic parameters and wall stress obtained from model output. Simulations were performed at baseline and after 15 min of backflow in a control group and a heart failure group. Simulation results agreed well with the experiment. Stroke volume, aortic flow, and stress time integral increased significantly because of pump failure. However, total systemic flow and arterial pressure were not altered by backflow, and a life-threatening situation did not appear.

Animals↗

Hydrodynamics of color M-mode Doppler flow wave propagation velocity V(p): a computer study.

This study was designed to show the hydrodynamic mechanism of left ventricular (LV) flow wave propagation and to relate this propagated velocity to 2-dimensional (2D) color and color M-mode Doppler echocardiograms. A computer model is developed describing 3-dimensional axisymmetrical LV filling flow. The unsteady Navier-Stokes flow equations are solved in an LV truncated ellipsoid geometry with moving LV walls, including relaxation and compliance of the wall. The computed results confirm both intraventricular flow and pressure patterns during filling. Vortices are formed during the acceleration phases of the early and atrial filling waves. During the deceleration phases, the vortices are amplified and convected into the ventricle. The vortices are recognized on the derived 2D color echocardiograms as in vivo. The propagation of this vortex determines the propagation of the maximum velocity observed in the color M-mode Doppler echocardiogram. For pseudonormal filling of the left ventricle, the LV flow wave propagation velocity decreases.

Blood Flow Velocity↗

Hemodynamic modes of ventricular assist with a rotary blood pump: continuous, pulsatile, and failure.

Pulsatile operation of rotary blood pumps (RBPs) has received interest due to potential concern with nonphysiological hemodynamics. This study aimed to gain insight to the effects of various RBP modes on the heart-device interaction. A Deltastream diagonal pump (Medos Medizintechnik GmbH) was inserted in a cardiovascular simulator with apical-to-ascending aorta cannulation. The pump was run in continuous mode with incrementally increasing rotating speed (0-5000 rpm). This was repeated for three heart rates (50-100-150 bpm) and three levels of left ventricular (LV) contractility. Subsequently, the Deltastream was run in pulsatile mode to elucidate the effect of (de)synchronization between heart and pump. LV volume and pressure, arterial pressure, flows, and energetic parameters were used to evaluate the interaction. Pump failure (0 rpm) resulted in aortic pressure drops (17-46 mm Hg) from baseline. In continuous mode, pump flow compensated by diminished aortic flow, thus yielding constant total flow. High continuous rotating speed resulted in acute hypertension (mean aortic pressure up to 178 mm Hg). In pulsatile mode, unmatched heart and pulsatile pump rates yielded unphysiologic pressure and flow patterns and LV unloading was found to be highly dependent on synchronization phase. Optimal unloading was achieved when the minimum rotating speed occurred at end-systole. We conclude that, in continuous mode, a perfusion benefit can only be achieved if the continuous pump flow exceeds the preimplant (baseline) cardiac output. Pulsatile mode of support results in complex pressure and volume variations and requires accurate triggering to achieve optimal unloading.

Data Interpretation, Statistical↗