Framework for Patient-Specific Hemodynamic Modeling of Left Ventricle Assist Device (LVAD) Patients

Framework for Patient-Specific Hemodynamic Modeling of Left Ventricle Assist Device (LVAD) Patients | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Framework for Patient-Specific Hemodynamic Modeling of Left Ventricle Assist Device (LVAD) Patients Mia Bonini, Marc Hirschvogel, Michael Ferguson, Francis Pagani, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7715752/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 11 You are reading this latest preprint version Abstract We present a high-fidelity, patient-specific computational framework for simulating cardiovascular hemodynamics in left ventricular assist device (LVAD) patients, with the ability to evaluate the impact of mitral and aortic valve repair. The method couples three-dimensional computational fluid dynamics (CFD) with a zero-dimensional lumped-parameter network representing the full cardiovascular system. Valve dynamics are governed by pressure–flow physics with patient-specific regurgitant areas, enabling the investigation of valve insufficiency and surgical repair. The model incorporates dynamic contrast-enhanced CT imaging, echocardiography, and catheter-based measurements. We demonstrate the utility of this framework using a clinical case involving a patient on long-term LVAD support with mitral regurgitation and aortic insufficiency. The coupled model resolves detailed pressure and velocity fields in the left heart, LVAD cannulae, and aortic root, while maintaining system-wide physiological consistency. Importantly, the framework also quantifies right ventricular loading and function, allowing assessment of how left-sided valve interventions propagate through the cardiopulmonary circulation. Using this pipeline, we simulate mitral and aortic valve repair by modulating valve closure mechanics and regurgitant area, revealing changes in both local and global hemodynamics. This modeling platform provides a powerful means to study the interplay between mechanical circulatory support, native valve physiology, and right heart function. It enables rigorous, patient-specific evaluation of surgical interventions in LVAD patients and delivers quantitative insight into clinically important metrics—such as aortic pulsatility, RV afterload, and chamber-level flow patterns—that are challenging to capture with current imaging modalities. Patient-specific Modeling Left Ventricle Assist Device Hemodynamic Modeling Computational Fluid Dynamics Lumped Parameter Modeling Full Text Additional Declarations Competing interest reported. FP is a non-compensated ad-hoc scientific advisor for Abbott, BrioHealth Solutions, and FineHeart. RP is a on-compensated medical monitor for Abiomed and receives grant funding from the National Heart, Lung, and Blood Institute and the Agency for Healthcare Research and Quality. FP receives partial salary support from Blue Cross / Blue Shield of Michigan as Associate Director of the Michigan Society of Thoracic and Cardiovascular Surgeons Quality Collaborative. The other authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. The need for consent was waived by the approving ethics committee, IRB HUM00196629. Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 27 Nov, 2025 Reviews received at journal 26 Nov, 2025 Reviews received at journal 24 Nov, 2025 Reviews received at journal 06 Nov, 2025 Reviewers agreed at journal 09 Oct, 2025 Reviewers agreed at journal 09 Oct, 2025 Reviewers agreed at journal 09 Oct, 2025 Reviewers invited by journal 06 Oct, 2025 Editor assigned by journal 05 Oct, 2025 Submission checks completed at journal 03 Oct, 2025 First submitted to journal 25 Sep, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7715752","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":527084555,"identity":"df6a0c85-dda0-4a44-867a-f835b565c0a9","order_by":0,"name":"Mia Bonini","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAqklEQVRIiWNgGAWjYDACCSBOYJCQY2BgbGBmAJHEajEmUQsQJIJUEqdFd3bzsQcPd1ikb7h2uPFzAYON7IYDBLSY3TmWbpB4RiJ3w+3EZukZDGnGhLXcyDGTSGwDa2lj5mE4nEi0lnQDiJb/xGtJgGo5QISWO8fSQFoMZ4L8wmOQbDyToJbbzcckf7bVyfPdTn/4mafCTraPkBY0YECa8lEwCkbBKBgFOAAAqAdDmfd3DbEAAAAASUVORK5CYII=","orcid":"","institution":"University of Michigan–Ann Arbor","correspondingAuthor":true,"prefix":"","firstName":"Mia","middleName":"","lastName":"Bonini","suffix":""},{"id":527084556,"identity":"f8620905-cecd-4618-9e9c-48ce4fd1205d","order_by":1,"name":"Marc Hirschvogel","email":"","orcid":"","institution":"Bundesanstalt für Materialforschung und -prüfung (BAM)","correspondingAuthor":false,"prefix":"","firstName":"Marc","middleName":"","lastName":"Hirschvogel","suffix":""},{"id":527084557,"identity":"1a0632f0-81f5-4bab-9691-3110340bebe1","order_by":2,"name":"Michael Ferguson","email":"","orcid":"","institution":"University of Michigan–Ann Arbor","correspondingAuthor":false,"prefix":"","firstName":"Michael","middleName":"","lastName":"Ferguson","suffix":""},{"id":527084558,"identity":"f13cb070-6a02-4f9f-a9e2-21eaf7cbac3e","order_by":3,"name":"Francis Pagani","email":"","orcid":"","institution":"Michigan Medicine","correspondingAuthor":false,"prefix":"","firstName":"Francis","middleName":"","lastName":"Pagani","suffix":""},{"id":527084559,"identity":"e88d23f6-2d31-440f-9e2c-24ecf392cbcc","order_by":4,"name":"Paul Tang","email":"","orcid":"","institution":"Mayo Clinic","correspondingAuthor":false,"prefix":"","firstName":"Paul","middleName":"","lastName":"Tang","suffix":""},{"id":527084560,"identity":"d8e8be62-8fca-48c0-9ca5-c99848ac104d","order_by":5,"name":"David Nordsletten","email":"","orcid":"","institution":"University of Michigan–Ann Arbor","correspondingAuthor":false,"prefix":"","firstName":"David","middleName":"","lastName":"Nordsletten","suffix":""}],"badges":[],"createdAt":"2025-09-25 19:23:15","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7715752/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7715752/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":93741258,"identity":"4f5ddb4b-b898-41bc-9d8f-0cf51f8f1ca4","added_by":"auto","created_at":"2025-10-17 05:14:11","extension":"json","order_by":0,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":8734,"visible":true,"origin":"","legend":"","description":"","filename":"0836728023db4099887115cc2f3c7fd7.json","url":"https://assets-eu.researchsquare.com/files/rs-7715752/v1/d719114e774dd808a83e3950.json"},{"id":93741498,"identity":"a0394a6d-2f1f-40ff-9683-550ce5a0931b","added_by":"auto","created_at":"2025-10-17 05:22:25","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":7617358,"visible":true,"origin":"","legend":"","description":"","filename":"LVADMethodsPaper.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7715752/v1_covered_6095c320-dc66-44ef-b1cc-57dde84ddb83.pdf"}],"financialInterests":"\u003cp\u003eCompeting interest reported. 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