Cavopulmonary Assist Device to Bridge Failing Fontan Circulations

摘要

A novel cavopulmonary assist strategy with a multi-lumen cannula powered by an external centrifugal pump is proposed for use in failing Fontan patients. Steady-state computational fluid dynamics simulations are used to characterize hemodynamic performance in an idealized and two patient-specific Fontan pathway models for a wide range of cardiac outputs and pump intake flows, while further transient simulations are conducted for one of the patient-specific models with a periodic cardiac output and coupled to a Windkessel model. Simulations show that the proposed cannula can provide sufficient pressure gain required for cavopulmonary assist. A rigid 3D printed cannula prototype is also tested inside a mock circulation loop. Improvements in mean Fontan pressures from a typical failing circulation occurred at certain flow cases with cannulated assist while venous return flows were altered significantly in the presence of the cannula.