CARDIOSIM© : A Numerical Simulator and its Application to Study the Interactions between Mechanical Circulatory Assist Devices and the Native Cardiovascular System

In this chapter, we will present an "in silico" simulation study of the interactions between (mechanical) ventricular assist devices (VADs) and the native cardiovascular system. In this study, we aim at a quantitative description of these interactions which is based on a mathematical modeling concept and a numerical simulation approach of the underlying physiological and pathophysiological processes. Much progress has been achieved in the design of ventricular assist devices; VADs are now in position to provide patients suffering from a seriously impaired ventricular function with an excellent hemodynamic support. Although the implantation of VADs is already routinely done in clinical settings, the planning and carrying out of such interventions is nevertheless a challenging task. In the planning phase, cardiologists and heart surgeons must, among other things, consider the interactions of the ventricular assist device with the native cardiovascular system which are to be expected after the implantation of a VAD. Thus, the specific objective of our simulation efforts is to develop an "in silico" simulation system which will provide experienced cardiologists and especially novice cardiologists with a deeper understanding and a quantitative assessment of the hemodynamic changes after the implantation of a VAD. The simulation studies were carried out by using our in-house numerical simulation system CARDIOSIM©. In the following, we will present a detailed description of CARDIOSIM©, give an overview its performance capacities, and point out and analyze important simulation results.