It is well known that the zero-crossings of the longitudinal velocity fluctuations can be used to estimate the Taylor length scale of turbulence via the Rice theorem. Furthermore, it has recently ...been shown that they can also be used to compute the turbulence integral length scale. We show how these two findings can be combined to study single-point statistics in turbulent flows. As these parameters are shaped by particular averaged properties of the turbulence cascade, they can be used to deduce some aspects of it. This approach is advantageous, as it makes possible the characterisation of turbulent flows in extremely challenging situations, i.e., statistically unsteady flows or conditions when adequate instrument calibration cannot be maintained. Using experimental data for a wide range of Taylor-scale-based Reynolds numbers from different flows (passive- and active-grid-generated turbulence and planar turbulent wakes), we show how, by solely using the zero-crossings of the longitudinal velocity fluctuations, some aspects of the energy cascade can be studied. Furthermore, using Voronoï tessellations, we study zero-crossing clustering properties. In particular, we discuss how its clusters and voids are related to the separation of scales in turbulent flows.
As heart failure prevalence continues to increase in the setting of a static donor supply, left ventricular assist device (LVAD) therapy for end-stage heart failure continues to grow. Anecdotal ...evidence suggests that malalignment of the LVAD inflow cannula may increase thrombosis risk, but this effect has not been explored mechanistically or quantified statistically. Our objective is to elucidate the impact of surgical angulation of the inflow cannula on thrombogenicity.
Unsteady computational fluid dynamics is used in conjunction with computational modeling and virtual surgery to model flow through the left ventricle for 5 different inflow cannula angulations. We use a holistic approach to evaluate thrombogenicity: platelet-based (Lagrangian) metrics to evaluate the platelet mechanical environment, combined with flow-based (Eulerian) metrics to investigate intraventricular hemodynamics. The thrombogenic potential of each LVAD inflow cannula angulation is quantitatively evaluated based on platelet shear stress history and residence time. Intraventricular hemodynamics are strongly influenced by LVAD inflow cannula angulation. Platelet behavior indicates elevated thrombogenic potential for certain inflow cannula angles, potentially leading to platelet activation. Our analysis demonstrates that the optimal range of inflow angulation is within 0±7° of the left ventricular apical axis.
Angulation of the inflow cannula >7° from the apical axis (axis connecting mitral valve and ventricular apex) leads to markedly unfavorable hemodynamics as determined by computational fluid dynamics. Computational hemodynamic simulations incorporating Lagrangian and Eulerian metrics are a powerful tool for studying optimization of LVAD implantation strategies, with the long-term potential of improving outcomes.
Stroke has become the main cause of mortality and morbidity in patients treated with Left Ventricular Assist Devices (LVADs). The hemodynamics of the left ventricle are altered by the implantation of ...an LVAD, with the increase of thrombogenic flow patterns, such as stagnation regions. Time-resolved stereo particle image velocimetry (Stereo-PIV) measurements of the flow inside a patient-specific model of the left ventricle (LV) implanted with an LVAD were performed. The effects of LVAD speed, peripheral resistance and afterload were investigated. The impact of activating the LVAD pulsatility mode (periodic speed modulation) was also evaluated. Analysis of the velocity measurements in two orthogonal planes revealed stagnation zones which may be favorable to thrombus formation. Increasing LVAD speed, despite increasing the flow rate through the inflow cannula, does not automatically result in smaller stagnation regions. These results demonstrated the strong interdependence of peripheral resistance, afterload and flow through the LVAD. As a consequence, the pulsatility mode showed very limited effect on overall flow rate. However, it did reduce the size of high stagnation areas. This study showed how LVAD speed, peripheral resistance and afterload impact the complex intraventricular flow patterns in a ventricle implanted with an LVAD and quantify their thrombogenic risk.
Flow in sidewall cerebral aneurysms can be ideally modelled as the combination of flow over a spherical cavity and flow in a curved circular pipe, two canonical flows. Flow in a curved pipe is known ...to depend on the Dean number $De$, combining the effects of Reynolds number $\textit {Re}$ and of the curvature along the pipe centreline, $\kappa$. Pulsatility in the flow introduces a dependence on the Womersley number $Wo$. Using stereo particle image velocimetry measurements, this study investigated the effect of these three key non-dimensional parameters, by modifying pipe curvature ($De$), flow rate ($Re$) and pulsatility frequency ($Wo$), on the flow patterns in a spherical cavity. A single counter-rotating vortex was observed in the cavity for all values of pipe curvature $\kappa$ and Reynolds number $\textit {Re}$, for both steady and pulsatile inflow conditions. Increasing the pipe curvature impacted the flow patterns in both the pipe and the cavity, by shifting the velocity profile towards the cavity opening and increasing the flow rate in to the cavity. The circulation in the cavity was found to collapse well with only the Dean number, for both steady and pulsatile inflows. For pulsatile inflow, the counter-rotating vortex was unstable and the location of its centre over time was impacted by the curvature of the pipe, as well as $\textit {Re}$ and $Wo$ in the free stream. The circulation in the cavity was higher for steady inflow than for the equivalent average Reynolds number and Dean number pulsatile inflow, with very limited impact of the Womersley number in the range studied. A second part of this study, that focuses on the changes in fluid dynamics when the intracranial aneurysm is treated with a flow-diverting stent, can be found in this issue (Barbour et al., J. Fluid Mech., vol. 915, 2021, A124).
Purpose
In this study,
in vitro
experiments and computational fluid dynamic (CFD) simulations are used to expand the understand of the physics of saline flushing of a blocked artery to enable optical ...imaging. This process involves saline injection, mixing with blood, and advection of the mixture away from the region of interest to provide a clear optical path for imaging.
Methods
CFD simulations are used as a rapid turn-around tool for the evolutionary design process of an endovascular catheter that combines imaging forward-viewing element with saline flushing lumens.
Results
A novel design and control technique is developed that provides the method to regulate the pressure in a blocked artery during saline flushing, so only small deviations from physiological pressure values are exerted on the damaged artery wall at any time, minimizing risk of rupture.
In vitro
experiments demonstrate the optical clearing process in phantoms simulating chronic total occlusions (CTOs) in coronary arteries with an opaque blood surrogate being removed by saline flushing. With the CFD compared by the experiments, parametric analyses of artery diameter and curvature, and flushing lumen diameter size were conducted to understand their impact on flushing times and pressures. Different plaque morphologies were studied to explore the feasibility of saline flushing in different CTO conditions.
Conclusions
A new catheter design is demonstrated to safely and effectively produce saline flushing, leading to a clear optical imaging field, and an improved technique is outlined that overcomes some practical challenges and limitations commonly encountered in angioscopy.
Introduction:
Despite significant technical advancements in the design and manufacture of Left Ventricular Assist Devices, post-implant thrombotic and thromboembolic complications continue to affect ...long-term outcomes. Previous efforts, aimed at optimizing pump design as a means of reducing supraphysiologic shear stresses generated within the pump and associated prothrombotic shear-mediated platelet injury, have only partially altered the device hemocompatibility.
Methods:
We examined hemodynamic mechanisms that synergize with hypershear within the pump to contribute to the thrombogenic potential of the overall Left Ventricular Assist Device system.
Results:
Numerical simulations of blood flow in differing regions of the Left Ventricular Assist Device system, that is the diseased native left ventricle, the pump inflow cannula, the impeller, the outflow graft and the anastomosed downstream aorta, reveal that prothrombotic hemodynamic conditions might occur at these specific sites. Furthermore, we show that beyond hypershear, additional hemodynamic abnormalities exist within the pump, which may elicit platelet activation, such as recirculation zones and stagnant platelet trajectories. We also provide evidences that particular Left Ventricular Assist Device implantation configurations and specific post-implant patient management strategies, such as those allowing aortic valve opening, are more hemodynamically favorable and reduce the thrombotic risk.
Conclusion:
We extend the perspective of pump thrombosis secondary to the supraphysiologic shear stress environment of the pump to one of Left Ventricular Assist Device system thrombosis, raising the importance of comprehensive characterization of the different prothrombotic risk factors of the total system as the target to achieve enhanced hemocompatibility and improved clinical outcomes.
Purpose
Computational fluid dynamics (CFD) has been used to evaluate the efficiency of endovascular treatment in coiled cerebral aneurysms. The explicit geometry of the coil mass cannot typically be ...incorporated into CFD simulations since the coil mass cannot be reconstructed from clinical images due to its small size and beam hardening artifacts. The existing methods use imprecise porous medium representations. We propose a new porous model taking into account the porosity heterogeneity of the coils deployed in the aneurysm.
Methods
The porosity heterogeneity of the coil mass deployed inside two patients’ cerebral aneurysm phantoms is first quantified based on 3D X-ray synchrotron images. These images are also used to compute the permeability and the inertial factor arising in porous models. A new homogeneous porous model (porous crowns model), considering the coil’s heterogeneity, is proposed to recreate the flow within the coiled aneurysm. Finally, the validity of the model is assessed through comparisons with coil-resolved simulations.
Results
The strong porosity gradient of the coil measured close to the aneurysmal wall is well captured by the porous crowns model. The permeability and the inertial factor values involved in this model are closed to the ideal homogeneous porous model leading to a mean velocity in the aneurysmal sac similar as in the coil-resolved model.
Conclusion
The porous crowns model allows for an accurate description of the mean flow within the coiled cerebral aneurysm.
This study quantifies thrombogenic potential (TP) of a wide range of left ventricular assist device (LVAD) outflow graft anastomosis angles through state-of-the-art techniques: 3D imaged-based ...patient-specific models created via virtual surgery and unsteady computational fluid dynamics with Lagrangian particle tracking. This study aims at clarifying the influence of a single parameter (outflow graft angle) on the thrombogenesis associated with flow patterns in the aortic root after LVAD implantation. This is an important and poorly-understood aspect of LVAD therapy, because several studies have shown strong inter and intrapatient thrombogenic variability and current LVAD implantation strategies do not incorporate outflow graft angle optimization. Accurate platelet-level investigation, enabled by statistical treatment of outliers in Lagrangian particle tracking, demonstrates a strong influence of outflow graft anastomoses angle on thrombogenicity (platelet residence times and activation state characterized by shear stress accumulation) with significantly reduced TP for acutely-angled anastomosed outflow grafts. The methodology presented in this study provides a device-neutral platform for conducting comprehensive thrombogenicity evaluation of LVAD surgical configurations, empowering optimal patient-focused surgical strategies for long-term treatment and care for advanced heart failure patients.
The prevalence of ventricular assist device (VAD) therapy has continued to increase due to a stagnant donor supply and growing advanced heart failure (HF) population. We hypothesize that left ...ventricular (LV) size strongly influences biocompatibility and risk of thrombosis. Unsteady computational fluid dynamics (CFD) was used in conjunction with patient-derived computational modeling and virtual surgery with a standard, apically implanted inflow cannula. A dual-focus approach of evaluating thrombogenicity was employed: platelet-based metrics to characterize the platelet environment and flow-based metrics to investigate hemodynamics. Left ventricular end-diastolic dimensions (LVEDds) ranging from 4.5 to 6.5 cm were studied and ranked according to relative thrombogenic potential. Over 150,000 platelets were individually tracked in each LV model over 15 cardiac cycles. As LV size decreased, platelets experienced markedly increased shear stress histories (SHs), whereas platelet residence time (RT) in the LV increased with size. The complex interplay between increased SH and longer RT has profound implications on thrombogenicity, with a significantly higher proportion of platelets in small LVs having long RT times and being subjected to high SH, contributing to thrombus formation. Our data suggest that small LV size, rather than decreased VAD speed, is the primary pathologic mechanism responsible for the increased incidence of thrombosis observed in VAD patients with small LVs.
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