Simulation of Apical and Atrio-aortic VAD in Patients with Transposition or Congenitally Corrected Transposition of the Great Arteries

Abstract

Purpose

VADs could be used for transportation of the great arteries (TGA) and for congenitally corrected transposition (ccTGA) treatment. A cardiovascular numerical model (NM) may offer a useful clinical support in these complex physiopathologies. This work aims at developing and preliminarily verifying a NM of ccTGA and TGA interacting with VADs.

Methods

Hemodynamic data were collected at the baseline (BL) and three months (FUP) after apical (atrio-aortic) VAD implantation in a TGA (ccTGA) patient and used in a lumped parameter NM to simulate the patient's physiopathology. Measured (MS) and simulated (SIM) data were compared.

Results

MS and SIM data are in accordance at the BL and at FUP. Cardiac output (l/min): BL_m = 2.9 ± 0.4, BL_s = 3.0 ± 0.3; FUP_m = 4.2 ± 0.2, FUP_s = 4.1 ± 0.1. Right atrial pressure (mmHg): BL_m = 21.4 ± 4.1, BL_s = 18.5 ± 4.5; FUP_m = 13 ± 4, FUP_s = 14.8 ± 3.6. Pulmonary arterial pressure (mmHg): BL_m = 56 ± 6.3, BL_s = 57 ± 2, FUP_m = 37.5 ± 7.5, FUP_s = 35.5 ± 5.9. Systemic arterial pressure (mmHg): BL_m = 71 ± 2, BL_s = 74.6 ± 2.1; FUP_m = 84 ± 9, FUP_s = 81.9 ± 9.8.

Conclusions

NM can simulate the effect of a VAD in complex physiopathologies, with the inclusion of changes in circulatory parameters during the acute phase and at FUP. The simulation of differently assisted physiopathologies offers a useful support for clinicians.