Washout of the carmat total artificial heart: a numerical investigation.

Total Artificial Heart (TAH) represents the only valid alternative to heart transplantation, which number is continuously increasing in recent years. The Carmat-TAH, example of a modern generation of TAH, is a biventricular pulsatile, electrically powered, hydraulically actuated flow pump with all components embodied in a single device. One of the major issues for TAHs is the washout capability of the device, strictly correlated to the presence of blood stagnation sites. The aim of this work is to develop a numerical methodology to study the washout coupled with the fluid dynamics evaluation of the Carmat-TAH during nominal working conditions. The first part of this study, focussed on the CT scan analysis of the hybrid membrane kinematics during TAH operation which was replicated with a fluid-structure interaction simulation in the second part. The difference in percentage between the in-vitro and in-silico flow rates and stroke volume is 9.7% and 6.3%, respectively. An injection of contrast blood was simulated, and its washout was observed and quantified with the volume fraction of the contrast blood still in the ventricle. The left chamber of the device showed a superior washout performance, with a contrast volume still inside the device after four washout cycles of 6.2%, respect to the right chamber with 15%.