Lvad

Considerations
Life span
• More mechanical parts means
more wear means less life

• Recovery from lvad surgery takes

nearly 1 year.

• Service life of the lvad is expected

to be at least 5-10 years which is
the average wait time for heart
transplant recipients
(Sorensen,2007).
Thrombosis
• Are blood clots caused by anything that prevents blood from
circulating
• The ability to control the clotting of blood is a feature of human
circulation. The endothelial cells of arteries and veins secrete a variety
of chemical substances that inhibit blood clotting on their walls.
• Employing a textured surface to promote the growth of a protein
layer on the blood contacting surfaces reduce the level of thrombosis
formation (Maher, Butler et al. 2001).
• Using blood thinner like heparin
Haemolysis
• Haemolysis results from the shearing and rupturing of red blood cells
and consequent release of haemoglobin into the bloodstream.
• The degree of damage is proportional to shear level
• Studies agreed that threshold exists sparking significant damage, as
opposed to cumulative damage.
• Allaire et al. (1999) indicate shear stress levels in all areas of the pump
should always be kept below 500 Pa.
• Many authors present results of increased haemolysis with decreasing
radial clearance below 0.5mm.
Heat generation
• Proteins are sensitive to their environmental conditions, and therefore
irreversible damage occurs if blood is exposed to heat levels higher
than 44 o C (Tortora 1987).

• It was found that heat generation is a primarily a result of electrical

inefficiencies in the pump motors, rather than mechanical friction
(Gardner et al, 2016)

• Tasai et al. (1994) conducted heat generation tests on housing

materials and found anodised aluminium which exhibits excellent heat
conductivity. At worst case, the heat flux from the device was
calculated at an acceptable level to surrounding tissue, i.e. less than
0.062 W/cm 2
Pump type
A) Axial pump
Advantages:
• Compact size which allows
implantation to be less intrusive

Disadvantages:
• Axial pump operates at very high speeds causing haemolysis
• The stationary diffuser guide vanes that are usually required for
controlling the axial position of the impeller create a vulnerable
region for thrombus formation
Pump type
B) Centrifugal pump

Advantages:
• Lower operating speeds which decrease the
Rate of haemolysis
• No obstacles in the flow way

Disadvantages:
• Larger size which makes the implantation harder and it is heavier.
Pump type
Pump type

Conclusion

• Centrifugal pump is the better choice due to better handling of

Haemolysis and Thrombosis
Mean arterial pressure (MAP) 
Mean arterial pressure (MAP) represents
the “average” pressure of blood in the
arteries, that is, the average force driving
blood into vessels that serve the tissues.
Mean is a statistical concept and is calculated
by taking the sum of the values divided by
the number of values. Although complicated
to measure directly and complicated to
calculate, MAP can be approximated by
adding the diastolic pressure to one-third of
the pulse pressure or systolic pressure minus
the diastolic pressure:

MAP = diastolic BP + ((systolic-
diastolic BP) / 3)
Specific speed

• Specific speed is an index to predict the general shape of a pump’s impeller.

• Values of specific speed in centrifugal pumps lvad are generally around 1000
Impeller design
Discharge angle
• The vane discharge angle is the most
important element in the centrifugal pump
design process, as all design constants depend
directly or indirectly on β2
• An increase in the blade discharge angle leads
to an increase in the head.
• Larger angles may be advantageous by
producing a flatter pump curve (Tansley,
Vidakovic et al. 2000).
• A decrease is observed in the general
efficiency as the blade discharge angle is
increased (Korkmaz et al 2015)
• The selection of β2 is made for optimum
efficiency. In this case, the average design
value is 22.5 °. (Stepanoff 1957)
• Discharge angles has negligible effect on
haemolysis
Number of vanes
• large number of blades generate more centrifugal force and thus, a higher
head pressure
• The number of vanes contained on an impeller affects the level of slip, or
blade recirculation.
• large blade number reduces slip as there is less space in the vane channel to
allow recirculation.
• At low velocities and small pumps viscous effects dominate the core flow
within impeller passages as velocities are generally not sufficient to produce
separation from the blades (Curtas, Wood et al. 2002).
• This suggests that a larger blade number might result in a drop in efficiency,
due to viscous drag on the larger surface area.
• For a low blade angle, 6 vanes is considered for specific speeds up to 5000
(Stepanoff 1957).
Shroud configuration
• Open impeller has a low performance as the
fluid can leak from both above and below the
impeller blades
• Closed impeller reduces leakage and
improves performance, but small clearances
above and below shroud can cause blood
recirculation leading to thrombosis and
haemolysis.
• The semi-open impeller only has a circular
plate attached to the bottom side of the
blade; thus, the leakage flow can occur only
above the impeller
• Semi-open impeller is the most suitable
design for VAD
Volute type
• The single volute is the most basic and
common design of a centrifugal pump for
its simplicity and good efficiency. However,
the disadvantage of this type of volute is
the considerable radial force when
operated at a flow rate lower or higher than
the best efficiency point (BEP) due to the
imbalance in the pressure distribution
around the impeller.
• The double volute design has a similar
structure compared to the single volute but
it has a dividing rib to split the flow before
exiting to the outlet diffuser. This volute
design provides a lower radial force on the
impeller
• Double volute is harder in fabrication
Design values