Massimo Capoccia
University of Strathclyde, UK
Title: Mechanical circulatory support for advanced heart failure: Current views and future developments in relation to patient-specific computational modelling
Biography
Biography: Massimo Capoccia
Abstract
The impact of Ventricular Assist Devices (VAD) for the treatment of advanced heart failure has played a significant role as a bridge for transplantation and more recently as a long-term solution for non eligible candidates. Continuous flow rotary blood pumps are currently the most popular devices because of their size and performance and the trend towards their use is increasing. Although, very successful and technologically advanced, but still thrombus formation remains a feared complication that can affect clinical outcome. VADs operate in a flow regime which is difficult to simulate as the transitional region is at the boundary of laminar and turbulent flow (low Reynolds number). Different methods have been used but the best approach remains debatable. Computational Fluid Dynamics (CFD) has been an attractive and invaluable tool for the study of the interactions between VADs and the cardiovascular system. The development of a pre-operative strategy aimed at the reduction of complications and patient-device suitability may be appropriate. Patient-specific modelling based on 3D reconstruction from CT-scan combined with computational fluid dynamic studies is an attractive solution in order to identify potential areas of stagnation or challenging anatomy that could be addressed to achieve the desired outcome. The HeartMate II (axial) and the HeartWare HVAD (centrifugal) rotary blood pumps have been now used worldwide with proven outcome. There are enough pumps on the market; it is now time to focus on the complications in order to achieve the full potential and selling-point of this type of technology for the treatment of the increasing heart failure patient population.