Boston - American Association for Thoracic Surgery

89 TH ANNUAL MEETING MAY 9–MAY 13, 2009BOSTON, MASSACHUSETTST4. Cavopulmonary Assist Using a Percutaneous, Bi-Conical, SingleImpeller Pump: A New Spin for Fontan Circulatory SupportMark D. Rodefeld, 1* Brandon Coats, 2 Travis Fisher, 2 John Brown, 1* Steve Frankel 21. Department of Surgery, Indiana University School of Medicine, Indianapolis,IN, USA; 2. Purdue University Department of Mechanical Engineering, WestLafayette, IN, USAInvited Discussant: Glen S. Van ArsdellOBJECTIVE: In a univentricular Fontan circulation, a delicate balance exists betweenthe systemic venous and pulmonary arterial circulations. Modest augmentation(2–5 mmHg) of existing cavopulmonary flow would reduce systemic venous pressure,improve ventricular filling, and substantially improve hemodynamic status. Areasonable means of providing high-volume, low-pressure flow in this unique situationdoes not exist. We hypothesized that an expandable single impeller pump,based on the von Karman viscous pump principle, is ideal for this function.METHODS: A 3-dimensional computational fluid dynamics (CFD) model of thetotal cavopulmonary connection (TCPC) was created. The impeller was representedby an actuator disk (a 2-sided conical disk) positioned in the center of the TCPCintersection with rotation in the vena caval axis. Flow was modeled under 3 conditions:1) passive flow with no disc present; 2) passive flow with a non-rotating disk,and 3) flow with a rotating disc (1K, 5K, and 10K rpm). Flow patterns, pressuregradient, and flow rate were estimated for each case. In vitro performance of a flexible2-sided conical disk impeller and protective cage was assessed by measuringpressure rise and induced flow rate at 5K, 10K, and 15K rpm.Cavopulmonary assist* AATS Member202