Numerical simulation of cardiovascular dynamics with left heart failure and in-series pulsatile ventricular assist device

This article presents a numerical model for investigations of the human cardiovascular circulation system response, where the function of the impaired left ventricle is augmented by the pumping action of a pulsatile ventricular assist device (VAD) connected in series to the native heart. The numerical model includes a module for detailed heart valve dynamics, which helps to improve the accuracy of simulation in studying the pulsatile type VAD designs. Simulation results show that, for the case with left ventricular (LV) failure, the VAD support successfully compensates the impaired cardiovascular response, and greatly reduces the after-load of the diseased ventricle, thus assisting possible recovery of the ventricle from the diseased condition. The effects of these conditions on pulmonary circulation are also shown. To investigate the effect of different pumping-activation functions (VAD motion profiles) on the cardiovascular response, three different VAD motion profiles are investigated. The numerical results suggest that Hermitian type motion profiles (smooth curves skewed toward early systole) have the advantage of requiring minimum power to the VAD, and producing the minimum after-load to the left ventricle, minimum ventricular wall stress, and minimum ventricular work to the diseased ventricle; while sawtooth type motions need slightly more power input, and induce slightly increased aortic pressure in diastole, thus improving coronary perfusion.