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At least 163 records · Page 9Linked to original sources
PubMed2000

Pulsatile flow in patients with a novel nonpulsatile implantable ventricular assist device.

BACKGROUND: Ventricular assist devices (VADs) are an accepted therapy for patients with end-stage heart failure. The implantable devices that are available produce a pulsatile flow and are very large. In 6 patients, beginning in November 1998, we started to use the continuous-flow implantable DeBakey VAD device, which weighs 93 g. To detect the flow in peripheral vessels, we measured transcranial Doppler signals in patients after implantation. METHODS AND RESULTS: Transcranial Doppler studies were performed with the MULTI-DOP X4 device with two 2-MHz probes (for the middle cranial arteries) in 4 patients for up to 12 weeks twice weekly after implantation. The blood velocity was measured, and the pulsation index (PI) calculated. The measured pump flow and rotations per minute were registered. The preoperative echocardiographic assessment values were compared with those acquired 6 weeks after implantation. The PI increased continually in all patients after VAD implantation, left ventricular (LV) ejection fraction did not improve, but right ventricular (RV) ejection fraction after implantation improved compared with preoperative values. The LV end-diastolic diameter after implantation decreased between 11% and 46% intraindividually. There was no correlation between PI and blood pressure or, except in 1 patient, between PI and blood flow through the VAD. CONCLUSIONS: The DeBakey VAD unloads the LV, which leads to a decrease in LV end-diastolic LV diameter and to the restoration of RV function. The unloaded LV and partially recovered RV provide a nearly physiological pulsatile flow despite the continuous flow of the VAD. Pulsatility is independent of peripheral vascular resistance. The first clinical experience with the DeBakey VAD was positive and has resulted in its continued use.

Adult↗
PubMed1987

The frequency response of electrochemical wall shear probes in pulsatile flow.

The frequency response of surface-mounted electrochemical mass transfer probes used to deduce wall shear rates has been investigated experimentally for the case of fully developed laminar pulsatile flow in a straight tube. Generally good agreement is found with the asymptotic results obtained by Lighthill's methods. The significance of the results with regard to the investigation of models of pulsatile flows of physiological interest is discussed. It is concluded that the frequency-dependent phase and amplitude corrections required to obtain accurate wall shear measurements are of such magnitudes as to render impractical the use of electrochemical probes to determine wall shear rates in these flows.

Biomechanical Phenomena↗
PubMed1998

Analysis of the Proximal Orifice Flowfield Under Pulsatile Flow Conditions and Confining Wall Geometry: Implications in Valvular Regurgitation.

Hemodynamic studies of regurgitant lesions in the heart focus on identifying a reliable noninvasive method of volumetric flow calculation. In these studies the influence of blood viscosity to the flowfield under pulsatile flow conditions and constraining wall geometry has not been examined in detail. Pulsatile flow studies in straight tubes have shown that viscous effects significantly influence the periodic flowfield, especially near the wall. The purpose of this study is to investigate the significance of transient effects in the flowfield proximal to a lesion under constraining wall geometry. The proximal flowfield was analyzed with computational fluid dynamics (CFD) computer simulations and color flow Doppler mapping (CFM). Three different stroke volumes and regurgitant waveforms were investigated for upstream wall orientations that varied from -64 degrees to +64 degrees (measured from the orifice plane). Results showed that for each upstream wall orientation, a single instantaneously normalized centerline velocity distribution characterized the flowfield throughout the cycle. The centerline distributions were in phase with the pressure gradient and almost identical to the corresponding steady-state distributions. Minor deviations were observed near the wall, where viscous effects were predominant. Transient flow effects such as blunt profiles and pressure velocity phase shifts, which were observed in straight circular tubes, were not observed in regurgitant orifice flowfields. This is true even under severe confinement conditions.

Journal Article↗
PubMed1986

Microprocessor-controlled pulsatile flow loop for hemodynamic studies.

Validation of spectral analytic techniques in the clinical assessment and quantitation of vascular stenoses has been aided by use of in vitro flow loops. We have used a recently developed microprocessor-controlled pulsatile flow model to examine the influence of varying stenoses on Doppler-shifted peak systolic frequencies. A nonaxisymmetric, vertically oriented stenosis was produced by extrinsic compression of latex rubber tubing 12 mm in diameter, reducing the cross-sectional area (CSA) by 25, 40, 50, 60, 70, 85, and 97%. A rolling diaphragm pump, driven through a slider-crank mechanism by a microprocessor-controlled stepper motor, generated characteristic arterial pulse waves at a rate of 75 cycles per minute. Using an 8 MHz, continuous-wave, directional Doppler velocimeter, the Doppler-shifted frequencies were recorded at the stenosis. Four sets of observations were made at each of the stenoses, and the peak systolic frequency (PSF) was determined using a spectrum analyzer. The PSF in the absence of an obstructing stenosis was 2.56 +/- 0.03 (KHz +/- SEM). This increased significantly (P less than 0.05) to 4.80 +/- 0.09 when the CSA was reduced by 50%, to 5.90 +/- 0.37 when the CSA was reduced by 60% (P less than 0.05), to 8.40 +/- 0.10 when the CSA was reduced by 70% (P less than 0.05), and to 17.84 +/- 0.89 when the CSA was reduced by 85% (P less than 0.05). These data establish the utility of this pulsatile flow model, confirming the direct relationship between the Doppler-shifted PSF and the percentage reduction in CSA.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Flow Velocity↗
PubMedDate not supplied

Experimental studies of pulsatile flow and endothelial cell adaptation in ventricle shaped cell culture chambers.

The authors' long-term research goal is to minimize the risk of thromboembolic complications in cardiac prostheses by lining blood contacting surfaces with a functional monolayer of autologous endothelial cells. These cells recognize changes in hemodynamics and can adapt effectively to experimentally manipulated flow conditions. By implication, the morphology of endothelial cells, in conjunction with their function, might serve as an indicator of the flow patterns in a particular location. It was hypothesized that, by understanding flow patterns at a given site, the local morphology and function of the endothelial cells in such a region could be predicted. To test this hypothesis, a series of ventricle shaped flow chambers were designed and perfused with pulsatile flow. The flow field in the chambers was studied by computer aided dye visualization and nuclear scintigraphy. The results showed that the large scale motion of the fluid in the cavity was highly coherent and consisted of distinct flow patterns. The temporal and spatial characteristics of the flow patterns, and their implications with respect to endothelial cell endurance in this in vitro environment, were examined in detail.

Adaptation, Physiological↗
PubMed2001

Three-dimensional pulsatile flow simulation before and after endovascular coil embolization of a terminal cerebral aneurysm.

The effect of different percentages of coil mesh in a cerebral aneurysm on the pulsatile flow and pressure in the parent vessel and aneurysm lumen was evaluated. Geometric data on a basilar tip aneurysm and vertebrobasilar arteries after subarachnoid hemorrhage was obtained by computer tomographic angiography. Intraarterial pressure was measured at four vertebrobasilar points before and after treatment with detachable coils. Pulsatile flow was documented by transcranial ultrasonography. A three-dimensional computer simulation was created using a commercial fluid dynamics solver for four aneurysm conditions: (1) before intervention; (2) with a 20% filling showing a complete cessation of the inflow through the aneurysm neck; (3) with a 12% filling showing an incomplete deceleration of inflow through the aneurysm neck, with a remaining flow around the embedded platinum coils; and (4) with a 12% filling and simulation of clotted aneurysm dome, which did not inhibit persisting flow phenomena. The relative pressure amplitudes neither increased nor decreased under the different simulated aneurysm filling conditions. Inserted platinum coils can immediately and decisively relieve the influx of pulsating blood and allow for initial clotting. To reach this effect, a volume density of 20% platinum coil mesh in the aneurysm neck is needed.

Blood Pressure↗
PubMed1987

[Observation of CSF pulsatile flow in MRI--the signal void phenomenon].

In a comparative study of MR images of 289 neurosurgical patients, loss of the signal intensity (signal void phenomenon) of CSF in the aqueduct was observed in 77 patients. This signal void phenomenon was seen most frequently in infants with chronic subdural hematoma (12 of 18) and patients of all age groups suffering from communicating hydrocephalus (10 of 14). It is known that CSF in the cranial cavity flows toward the spinal CSF space in to and fro manner responding to brain parenchyma pulsations. The velocity of this flow is to be faster in the narrower parts through the ventricular systems such as the aqueduct, Monro's foramen and the 4th ventricles. We think that in T2 weighted images signal void phenomenon reflects "high velocity signal loss" due to CSF flow. When the subarachnoid adhesions secondary to subarachnoid hemorrhage stagnate CSF flow in the subarachnoid space, the intraventricular CSF flow forms the main buffer for changes of the brain volume. This causes an increase in the amplitude of the pulsatile flow in the ventricular systems. Therefore the signal void phenomenon in the aqueductal CSF becomes more pronounced. It may be possible to differentiate normal circulation of CSF from abnormal with the bigger amplitude of CSF pulsatile flow, to understand the mechanisms of the normal pressure hydrocephalus or to diagnose a shunt malfunction. Therefore more insight in the CSF flow as imaged by MRI is needed, quantification of CSF flow will be the subjects of our further research.

Aged↗
PubMed1992

Finite element simulation of pulsatile flow through arterial stenosis.

The problem of blood flow through a stenosis is solved using the incompressible Navier-Stokes equations in a rigid circular tube presenting a partial occlusion. Calculations are based on a Galerkin finite element method. The time marching scheme employs a predictor-corrector technique using a variable time step. Results are obtained for steady and physiological pulsatile flows. Computational experiments analyse the effect of varying the degree of stenosis, the stricture length, the Reynolds number and Womersley number. The method gives results which agree well with previous computations for steady flows and experimental findings for steady and pulsatile flows.

Arterial Occlusive Diseases↗
PubMed2002

Laminar-to-turbulent transition in pulsatile flow through a stenosis.

Laminar-to-turbulent transition in pulsatile flow through a stenosis is studied by means of three-dimensional numerical simulations. The flow transition is associated with the occurrence of a flow instability initiating in the stenosis region. The instability is manifested by a three-dimensional symmetry-breaking and leads to asymmetric separation and intense swirling motion downstream of the stenosis. The above have profound effects on the wall shear stress (WSS). The simulations reveal that the asymmetric separation is extended several radii downstream of the stenosis with substantial WSS fluctuations, in both space and time, occurring in the poststenotic region.

Arteriosclerosis↗
PubMed1999

Experimental and numerical study of pulsatile flows through stenosis: wall shear stress analysis.

Different shapes of pulsatile flows through a model of stenosis are experimentally and numerically modeled to validate both methods and to determine the wall shear stress temporal evolution downstream from the stenosis. Two-dimensional velocity measurements are performed in a 75% severity stenosis using a pulsed Doppler ultrasonic velocimeter. Finite element package is employed for the transient numerical simulations. Polynomial method, based on the experimental velocity values, is proposed to determine the wall shear stress temporal evolution. There is a good agreement between the numerical and experimental results. The wall shear stress temporal analysis shows oscillating wall shear stress values during the cycle with high wall shear stress values at the throat of about 120 dyn/cm2, and low values downstream from the stenosis of about - 2.5 dyn/cm2. The key result of the study is that the presence of the stenosis leads the artery to work in a direction which is opposite to the direction of a healthy artery.

Animals↗
PubMedDate not supplied

Pulsatile flow during routine cardiopulmonary bypass.

The effect of pulsatile flow during cardiopulmonary bypass (CPB) was studied on two groups of 11 patients each (aged between 18 and 48 years) undergoing open valvular and congenital heart surgery. In the nonpulsatile group, mean blood pressure (BP) and systemic vascular resistance index (SVRI) increased steadily during CPB; while in the pulsatile group, both BP and SVRI remained stationary. The difference of SVRI between the two groups was not significant within 30 minutes after initiation of CPB (3136 +/- 882 to 2536 +/- 530 dynes X sec X cm-5 X m2). Contrarily, it was significantly higher in the nonpulsatile group after 40 minutes of CPB (3748 +/- 562 to 2612 +/- 609 dynes X sec X cm-5 X m2, p less than 0.02) and thereafter. Oxygen consumption index (59.6 +/- 12.9 to 77.8 +/- 32.6 ml X min-1 X m-2) and carbon dioxide production index (41.1 +/- 16.0 to 59.3 +/- 28.1 ml X min-1 X m-2) measured 20 minutes after institution of CPB seemed lower in the nonpulsatile group than in the pulsatile group, but the differences were not statistically significant. Increased urine flow during CPB (1.8 +/- 1.1 to 6.3 +/- 3.8 ml X min-1 X m-2, p less than 0.001) with less variability indicated better reserve of renal function in the pulsatile group; and less percent change of postoperative sGOT from preoperative level (529.8 +/- 129.8 to 310.0 +/- 175.2%, p less than 0.005) also showed better hepatic function in the pulsatile group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

Development of a parallel plate flow chamber for studying cell behavior under pulsatile flow.

The design of a new parallel plate perfusion chamber for cell behavior studies involving pulsatile flowrates is presented. It was based on fluid mechanical considerations to ensure a region of regular and uniform shear stress at the wall. A numeric solution of the flow was performed to study the effect of pulsating flow on the entrance length. Dye injection investigations in the chamber showed laminar and uniform flow in the culture region under steady state conditions.

Cell Adhesion↗
PubMed1992

Nuclear magnetic resonance velocity spectra of pulsatile flow in a rigid tube.

Velocity spectra can be derived from velocity-encoded nuclear magnetic resonance (NMR) images. Velocity spectra are histograms showing the amounts of fluid flowing at different velocities in the sensitive volume of the measurement. Velocity spectra may prove to be useful in characterizing the flow of blood in small vessels, for example, in detecting the presence of stenoses and in evaluating their severity. NMR velocity spectra acquired in vivo are sufficiently complicated that a model system was designed and tested to investigate the velocity spectra of pulsatile flow. This study measured the NMR velocity spectra of pulsatile flow in a rigid tube and compared them to velocity spectra derived from Doppler ultrasound measurements and to velocity spectra inferred from a theoretical model driven by the measured pressure difference function. The experimental results from each technique agree.

Blood Flow Velocity↗
PubMed2002

Pulsatile flow inside moderately elastic arteries, its modelling and effects of elasticity.

Pulsatile flow inside a moderately elastic circular conduit with a smooth expansion is studied as a model to understand the influence of wall elasticity in artery flow. The solution of the simultaneous fluid-wall evolution is evaluated by a perturbative method, where the zeroth order solution is represented by the flow in a rigid vessel; the first order correction gives the wall motion and induced flow modification without the need to solve the difficult coupled problem. Such an approach essentially assumes a locally infinite celerity, therefore it represent a good approximation for the fluid-wall interaction in sites of limited extent (branches, stenosis, aneurism, etc.), which include typical situations associated with vascular diseases. The problem is solved numerically in the axisymmetric approximation; the influence of wall elasticity on the flow and on the unsteady wall shear stress is studied in correspondence of parameters taken from realistic artery flow. Attention is posed to the role of phase difference between the incoming pressure and flow pulses.

Arteries↗
PubMed1994

Transition to turbulence in pulsatile flow through heart valves--a modified stability approach.

The presence of turbulence in the cardiovascular system is generally an indication of some type of abnormality. Most cardiologists agree that turbulence near a valve indicates either valvular stenosis or regurgitation, depending on the phase of its occurrence during the cardiac cycle. As no satisfying analytical solutions of the stability of turbulent pulsatile flow exist, accurate, unbiased flow stability criteria are needed for the identification of turbulence initiation. The traditional approach uses a stability diagram based upon the stability of a plane Stokes layer where alpha (the Womersley parameter) is defined by the fundamental heart rate. We suggest a modified approach that involves the decomposition of alpha into its frequency components, where alpha is derived from the preferred modes induced on the flow by interaction between flow pulsation and the valve. Transition to turbulence in pulsatile flow through heart values was investigated in a pulse duplicator system using three polymer aortic valve models representing a normal aortic valve, a 65 percent stenosed valve and a 90 percent severely stenosed valve, and two mitral valve models representing a normal mitral valve and a 65 percent stenosed valve. Valve characteristics were closely simulated as to mimic the conditions that alter flow stability and initiate turbulent flow conditions. Valvular velocity waveforms were measured by laser Doppler anemometry (LDA). Spectral analysis was performed on velocity signals at selected spatial and temporal points to produce the power density spectra, in which the preferred frequency modes were identified. The spectra obtained during the rapid closure stage of the valves were found to be governed by the stenosis geometry. A shift toward higher dominant frequencies was correlated with the severity of the stenosis. According to the modified approach, stability of the flow is represented by a cluster of points, each corresponding to a specific dominant mode apparent in the flow. In order to compare our results with those obtained by the traditional approach, the cluster of points was averaged to collapse into a single point that represents the flow stability. The comparison demonstrates the bias of the traditional stability diagram that leads to unreliable stability criteria. Our approach derives the stability information from measured flow phenomena known to initiate flow instabilities. It differentiates between stabilizing and destabilizing modes and depicts an unbiased and explicit stability diagram of the flow, thus offering a more reliable stability criteria.

Aortic Valve↗
PubMedDate not supplied

The effect of blood viscoelasticity on pulsatile flow in stationary and axially moving tubes.

An analytical solution for pulsatile flow of a generalized Maxwell fluid in straight rigid tubes, with and without axial vessel motion, has been used to calculate the effect of blood viscoelasticity on velocity profiles and shear stress in flows representative of those in the large arteries. Measured bulk flow rate Q waveforms were used as starting points in the calculations for the aorta and femoral arteries, from which axial pressure gradient delta P waves were derived that would reproduce the starting Q waves for viscoelastic flow. The delta P waves were then used to calculate velocity profiles for both viscoelastic and purely viscous flow. For the coronary artery, published delta P and axial vessel acceleration waveforms were used in a similar procedure to determine the separate and combined influences of viscoelasticity and vessel motion. Differences in local velocities, comparing viscous flow to viscoelastic flow, were in all cases less than about 2% of the peak local velocity. Differences in peak wall shear stress were less than about 3%. In the coronary artery, wall shear stress differences between viscous and viscoelastic flow were small, regardless of whether axial vessel motion was included. The shape of the wall shear stress waveform and its difference, however, changed dramatically between the stationary and moving vessel cases. The peaks in wall shear stress difference corresponded with large temporal gradients in the combined driving force for the flow.

Aorta↗
PubMed1980

Does pulsatile flow improve perfusion during hypothermic cardiopulmonary bypass?

Each of 10 patients undergoing hypothermic cardiopulmonary bypass was perfused in turn with (1) the standard flow delivered by a roller pump and (2) pulsatile flow induced by a "pulsatile assist device" (Datascope Corp., Paramus, N. J), presented in random order at the same mean flow. Whole-body oxygen consumption, blood lactate concentration, systemic vascular resistance, urinary flow, and thermal gradients were measured during each type of flow and after rewarming. No significant difference in any of these variables was seen between the two types of flow. After conventional rewarming the temperature gradient between core tissues and muscle was not influenced by the type of flow used during rewarming.

Aged↗
PubMed2000

Four dimensional bolus tagging imaging of pulsatile flow.

Inversion bolus tagging MR methods were used to provide a graphic depiction of the axial velocity in three spatial dimensions for pulsatile flow through complex geometries. Visualization of the flow field was readily apparent, and a train of tagged boli were depicted providing an immediate overview of the displacement of flowing fluid over the entire pulsatile cycle. Tagging efficiency obtained using adiabatic inversion pulses was improved compared to that with a windowed sinc pulse. Results from phantom experiments on steady flow were correlated with computational fluid dynamic (CFD) simulations. The use of 3D methods reduced spatial partial volume effects, and the displacement of boli in a steady flow experiment correlated well with CFD simulations. The use of adiabatic inversion pulses resulted in sharp edged inversion regions with good retention of longitudinal magnetization. However in order to keep the pulse duration short, of the order of 2-5 ms, a rather large RF amplitude had to be used. The inversion bolus tagging method is useful in visualizing the flow field in multiple levels for pulsatile fluid flowing through complex geometries, and may be useful in fluid dynamic applications.

Blood Flow Velocity↗