Experimental investigation into the effect of compliance of a mock aorta on cardiac performance

PLoS One. 2020 Oct 12;15(10):e0239604. doi: 10.1371/journal.pone.0239604. eCollection 2020.

Abstract

Demand for heart transplants far exceeds supply of donated organs. This is attributed to the high percentage of donor hearts that are discarded and to the narrow six-hour time window currently available for transplantation. Ex-vivo heart perfusion (EVHP) provides the opportunity for resuscitation of damaged organs and extended transplantation time window by enabling functional assessment of the hearts in a near-physiologic state. Present work investigates the fluid mechanics of the ex-vivo flow loop and corresponding impact on cardiac performance. A mechanical flow loop is developed that is analogous to the region of the EVHP system that mimics in-vivo systemic circulation, including the body's largest and most compliant artery, the aorta. This investigation is focused on determining the effect of mock aortic tubing compliance on pump performance. A custom-made silicone mock aorta was developed to simulate a range of in-vivo conditions and a physiological flow was generated using a commercial ventricular assist device (VAD). Monitored parameters, including pressure, tube distension and downstream velocity, acquired using time-resolved particle imaging velocimetry (PIV), were applied to an unsteady Bernoulli analysis of the flow in a novel way to evaluate pump performance as a proxy for cardiac workload. When compared to the rigid case, the compliant mock aorta case demonstrated healthier physiologic pressure waveforms, steadier downstream flow and reduced energetic demands on the pump. These results provide experimental verification of Windkessel theory and support the need for a compliant mock aorta in the EVHP system.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aorta / physiology*
  • Compliance
  • Extracorporeal Circulation
  • Heart Transplantation / methods*
  • Heart-Assist Devices
  • Hemodynamics
  • Humans
  • In Vitro Techniques
  • Models, Cardiovascular*
  • Organ Preservation / instrumentation
  • Organ Preservation / methods
  • Perfusion / instrumentation
  • Perfusion / methods
  • Tissue Donors
  • Tissue and Organ Procurement

Grants and funding

Financial support for this project was provided by the Natural Sciences and Engineering Research Council (NSERC) of Canada (DSN), Canadian Foundation for Innovation (DSN), Canadian National Transplant Research Program (DHF), and University Hospital Foundation (DHF).