Sophisticated hydrodynamic simulation of pulmonary circulation for the preclinical examination of right heart circulatory assist device

Abstract

To evaluate systemic circulatory support devices such as left ventricular assist system, surgical heart valve prosthesis, and transcatheter aortic valve, various in vitro hydrodynamic tests have been performed. As these devices are being applied to the pulmonary circulatory support in recent years, novel evaluation platform for right heart support is increasingly demanded. This study aims to develop a pulmonary mechanical circulatory simulation system to assess the hydrodynamic performance of newly designed artificial cardiovascular devices. For the construction of the system, we developed the pneumatically-driven polymer right atrial and ventricular models with the pulmonary arterial valve chamber, silicone-made peripheral pulmonary artery model, and a venous reservoir. A woven polyester vascular graft and commercially available mechanical bileaflet valve were installed into the valve chamber. Then, the right ventricular pressure and pulmonary arterial pressure were regulated by the peripheral resistive unit. As a result, we successfully obtained the standard conditions of our mechanical circulatory system to be 28/3 (systolic/diastolic) mmHg of right ventricular pressure, 29/7, mmHg of pulmonary arterial pressure, 6, mmHg of mean right atrial pressure, and 3.0 L/min of pulmonary flow rate. To carry out the sophisticated assessment for the support of the pulmonary surgical and percutaneous treatments, we are preparing the next step with the reproduction of respiratory changes in pulmonary peripheral resistance, and the patient-specific shape vascular model including catheter access vessels. Under the highly simulated both pulmonary anatomical morphology and hemodynamic function conditions, effective preclinical examination of newly designed surgical or percutaneous pulmonary circulatory support devices can be performed.