Hemodynamic Indicators of Cerebrovascular Accidents in Patients Implanted With a Left Ventricular Assist Device*

Left Ventricular Assist Device (LVAD) is a mechanical circulatory support pump used for advanced Heart Failure (HF) treatment which operates by directing blood flow from a dysfunctional left ventricle directly into the aorta. Despite the emergence of LVAD as a primary treatment modality for HF, it is associated with serious complications such as stroke and thromboembolic events (referred to here as cerebrovascular accidents or CVA) after deployment. Such post-implant complications can reduce treatment efficacy and lead to fatalities as well. These complications have been found to be intimately linked to LVAD induced altered state of hemodynamics, particularly in the aorta. In this study we quantify several aortic hemodynamic features – namely wall shear stress, local normalized helicity, Q-criterion, and energy dissipation through virtual surgical in-silico models of patients treated with LVAD. We will illustrate these hemodynamic descriptors through patient-specific CFD simulations in two cohorts of patients – one with post-implant CVA and one without. Quantitative descriptors will be compared and contrasted across the two cohorts to identify hemodynamic indicators for CVA in patients with an LVAD.