Computational fluid dynamics of the right atrium: Assessment of modelling criteria for the evaluation of dialysis catheters
Central venous catheters are widely used in haemodialysis therapy, having to respect design requirements for appropriate performance. These are placed within the right atrium (RA); however, there is no prior computational study assessing different catheter designs while mimicking their native enviro...
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Published in | PloS one Vol. 16; no. 2; p. e0247438 |
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Main Authors | , , , , , |
Format | Journal Article |
Language | English |
Published |
United States
Public Library of Science
25.02.2021
Public Library of Science (PLoS) |
Subjects | |
Online Access | Get full text |
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Summary: | Central venous catheters are widely used in haemodialysis therapy, having to respect design requirements for appropriate performance. These are placed within the right atrium (RA); however, there is no prior computational study assessing different catheter designs while mimicking their native environment. Here, a computational fluid dynamics model of the RA, based on realistic geometry and transient physiological boundary conditions, was developed and validated. Symmetric, split and step catheter designs were virtually placed in the RA and their performance was evaluated by: assessing their interaction with the RA haemodynamic environment through prediction of flow vorticity and wall shear stress (WSS) magnitudes (1); and quantifying recirculation and tip shear stress (2). Haemodynamic predictions from our RA model showed good agreement with the literature. Catheter placement in the RA increased average vorticity, which could indicate alterations of normal blood flow, and altered WSS magnitudes and distribution, which could indicate changes in tissue mechanical properties. All designs had recirculation and elevated shear stress values, which can induce platelet activation and subsequently thrombosis. The symmetric design, however, had the lowest associated values (best performance), while step design catheters working in reverse mode were associated with worsened performance. Different tip placements also impacted on catheter performance. Our findings suggest that using a realistically anatomical RA model to study catheter performance and interaction with the haemodynamic environment is crucial, and that care needs to be given to correct tip placement within the RA for improved recirculation percentages and diminished shear stress values. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Competing Interests: Funding was provided to D. G.O., S.Q. and D.C.O. from D.M.E. and N.C.G. (P. I’s) grant through KIMAL PLC and the EPSRC Impact Acceleration Account: IAA 2017 – Using Computational Fluid Dynamics to design novel tips for KIMAL PLC dialysis catheters (601018). Project number: 20520. KIMAL PLC manufacture/sell multiple type of dialysis catheters and were involved in the initial conception of the study but were not involved in the data collection or analysis nor drafting of the manuscript and decision to publish. This does not alter our adherence to PLOS ONE policies on sharing data and materials. These authors also contributed equally to this work. |
ISSN: | 1932-6203 1932-6203 |
DOI: | 10.1371/journal.pone.0247438 |