Research progress on hemolysis of rotary blood pump_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

 JING Teng , CHENG Jianan , SUN Haoran , PAN Aidi

National Research Center of Pumps, Jiangsu University, Zhenjiang, 212013, Jiangsu, P. R. China;

Corresponding?author：

JING Teng, Email: jt-1981@163.com

Keywords：

Rotary blood pump; hemolysis; shear stress; structural optimization; review

DOI：

10.7507/1007-4848.202303052

Video：

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Hemolysis is one of the main complications associated with the use of ventricular assist devices. The primary factors influencing hemolysis include the shear stress and exposure time experienced by red blood cells. In addition, factors such as local negative pressure and temperature may also impact hemolysis. The different combinations of hemolysis prediction models and their empirical constants lead to significant variations in prediction results; compared to the power-law model, the OPO model better accounts for the complexity of turbulence. In terms of improving hemolytic performance, research has primarily focused on optimizing blood pump structures, such as adjustments to pump gaps, impellers, and guide vanes. A small number of scholars have studied hemolytic performance through control modes of blood pump speed and the selection of blood-compatible materials. This paper reviews the main factors influencing hemolysis, prediction methods, and improvement strategies for rotary blood pumps, which are currently the most widely used. It also discusses the limitations in current hemolysis research and provides an outlook on future research directions.

Citation： JING Teng, CHENG Jianan, SUN Haoran, PAN Aidi. Research progress on hemolysis of rotary blood pump. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2025, 32(4): 560-566. doi: 10.7507/1007-4848.202303052 Copy

1.	中國心血管健康與疾病報告編寫組. 中國心血管健康與疾病報告2021概要. 中國循環雜志, 2022, 37(6): 553-578.The Writing Committee of the Report on Cardiovascular Health and Diseases in China. Report on cardiovascular health and diseases in China 2021: An updated summary. Chin Circ J, 2022, 37(6): 553-578.
2.
3.
4.	Chen Z, Jena SK, Giridharan GA, et al. Flow features and device-induced blood trauma in CF-VADs under a pulsatile blood flow condition: A CFD comparative study. Int J Numer Method Biomed Eng, 2018, 34(2): e2924.
5.	Giersiepen M, Wurzinger LJ, Opitz R, et al. Estimation of shear stress-related blood damage in heart valve prostheses—In vitro comparison of 25 aortic valves. Intern J Artif Organs, 1990, 13(5): 300-306.
6.	Yen JH, Chen SF, Chern MK, et al. The effect of turbulent viscous shear stress on red blood cell hemolysis. J Artif Organs, 2014, 17(2): 178-185.
7.	Jhun CS, Stauffer MA, Reibson JD, et al. Determination of reynolds shear stress level for hemolysis. ASAIO J, 2018, 64(1): 63-69.
8.	Jing T, Cheng Y, Wang F, et al. Numerical investigation of centrifugal blood pump cavitation characteristics with variable speed. Processes, 2020, 8(3): 293.
9.	Ganushchak YM, K?rver EP, Maessen JG. Is there a "safe" suction pressure in the venous line of extracorporeal circulation system? Perfusion, 2020, 35(6): 521-528.
10.
11.
12.
13.	Zhang T, Taskin ME, Fang HB, et al. Study of flow-induced hemolysis using novel Couette-type blood-shearing devices. Artif Organs, 2011, 35(12): 1180-1186.
14.	Yu H, Engel S, Janiga G, et al. A review of hemolysis prediction models for computational fluid dynamics. Artif Organs, 2017, 41(7): 603-621.
15.
16.	Ozturk M, Papavassiliou DV, O'Rear EA. An approach for assessing turbulent flow damage to blood in medical devices. J Biomech Eng, 2017, 139(1): 011008.
17.	Avci M, Heck M, O'Rear EA, et al. Hemolysis estimation in turbulent flow for the FDA critical path initiative centrifugal blood pump. Biomech Model Mechanobiol, 2021, 20(5): 1709-1722.
18.
19.	Selmi M, Chiu WC, Chivukula VK, et al. Blood damage in left ventricular assist devices: Pump thrombosis or system thrombosis? Int J Artif Organs, 2019, 42(3): 113-124.
20.	Onder A, Incebay O, Sen MA, et al. Heuristic optimization of impeller sidewall gaps-based on the bees algorithm for a centrifugal blood pump by CFD. Int J Artif Organs, 2021, 44(10): 765-772.
21.
22.	Liu GM, Jin DH, Zhou JY, et al. Numerical investigation of the influence of blade radial gap flow on axial blood pump performance. ASAIO J, 2019, 65(1): 59-69.
23.	Rezaienia MA, Paul G, Avital E, et al. Computational parametric study of the axial and radial clearances in a centrifugal rotary blood pump. ASAIO J, 2018, 64(5): 643-650.
24.
25.	Park J, Oki K, Hesselmann F, et al. Biologically inspired, open, helicoid impeller design for mechanical circulatory assist. ASAIO J, 2020, 66(8): 899-908.
26.
27.	荊騰, 潘愛娣, 顧發東, 等. 主動脈穿刺型軸流血泵折邊結構葉輪的數值模擬及溶血分析. 排灌機械工程學報, 2024, 42(2): 109-117.Jing T, Pan AD, Gu FD, et al. Numerical simulation and hemolysis analysis of aortic perforating type axial bleeding pump with folded-edge structure impeller.J DrainIrrig Mach Eng, 2024, 42(2): 109-117.
28.	Ghadimi B, Nejat A, Nourbakhsh SA, et al. Multi-objective genetic algorithm assisted by an artificial neural network metamodel for shape optimization of a centrifugal blood pump. Artif Organs, 2019, 43(5): E76-E93.
29.
30.	Huang B, Guo M, Lu B, et al. Geometric optimization of an extracorporeal centrifugal blood pump with an unshrouded impeller concerning both hydraulic performance and shear stress. Processes, 2021, 9(7): 1211.
31.
32.	Yu Z, Tan J, Wang S, et al. Multiple parameters and target optimization of splitter blades for axial spiral blade blood pump using computational fluid mechanics, neural networks, and particle image velocimetry experiment. Sci Prog, 2021, 104(3): 368504211039363.
33.	Li Y, Yu J, Wang H, et al. Investigation of the influence of blade configuration on the hemodynamic performance and blood damage of the centrifugal blood pump. Artif Organs, 2022, 46(9): 1817-1832.
34.	李馳培, 楊秀萍, 陳俊, 等. 中間導葉對軸流血泵流動特性的影響分析. 第十二屆全國生物力學學術會議暨第十四屆全國生物流變學學術會議, 西安, 2018.Li CP, Yang XP, Chen J, et al. Analysis of the influence of intermediate guide vanes on the flow characteristics of axial blood pump. Proceedings of 12th National Conference on Biomechanics and 14th National Conference on Biorheology, Xi'an, 2018.
35.
36.
37.	Zhao ZX, Chen T, Liu XD, et al. Numerical investigation of an idealized total cavopulmonary connection physiology assisted by the axial blood pump with and without diffuser. CMES, 2020, 125(3): 1173-1184.
38.
39.	Wang Y, Shen P, Zheng M, et al. Influence of impeller speed patterns on hemodynamic characteristics and hemolysis of the blood pump. Appl Sci (Basel), 2019, 9(21): 4689.
40.	Yamane T, Adachi K, Kosaka R, et al. Suitable hemolysis index for low-flow rotary blood pumps. J Artif Organs, 2021, 24(2): 120-125.
41.	Wang S, Tan J, Yu Z. Shear stress and hemolysis analysis of blood pump under constant and pulsation speed based on a multiscale coupling model. Math Probl Eng, 2020, 2020(1922): 1-14.
42.
43.	Takashi yamane. Mechanism of artificial heart. Springer, Tokyo, 2016.
44.	Zhang M, Tansley GD, Dargusch MS, et al. Surface coatings for rotary ventricular assist devices: A systematic review. ASAIO J, 2022, 68(5): 623-632.
45.	Maruyama O, Nishida M, Yamane T, et al. Hemolysis resulting from surface roughness under shear flow conditions using a rotational shear stressor. Artif Organs, 2006, 30(5): 365-370.
46.

1. 中國心血管健康與疾病報告編寫組. 中國心血管健康與疾病報告2021概要. 中國循環雜志, 2022, 37(6): 553-578.The Writing Committee of the Report on Cardiovascular Health and Diseases in China. Report on cardiovascular health and diseases in China 2021: An updated summary. Chin Circ J, 2022, 37(6): 553-578.
2.
3.
4. Chen Z, Jena SK, Giridharan GA, et al. Flow features and device-induced blood trauma in CF-VADs under a pulsatile blood flow condition: A CFD comparative study. Int J Numer Method Biomed Eng, 2018, 34(2): e2924.
5. Giersiepen M, Wurzinger LJ, Opitz R, et al. Estimation of shear stress-related blood damage in heart valve prostheses—In vitro comparison of 25 aortic valves. Intern J Artif Organs, 1990, 13(5): 300-306.
6. Yen JH, Chen SF, Chern MK, et al. The effect of turbulent viscous shear stress on red blood cell hemolysis. J Artif Organs, 2014, 17(2): 178-185.
7. Jhun CS, Stauffer MA, Reibson JD, et al. Determination of reynolds shear stress level for hemolysis. ASAIO J, 2018, 64(1): 63-69.
8. Jing T, Cheng Y, Wang F, et al. Numerical investigation of centrifugal blood pump cavitation characteristics with variable speed. Processes, 2020, 8(3): 293.
9. Ganushchak YM, K?rver EP, Maessen JG. Is there a "safe" suction pressure in the venous line of extracorporeal circulation system? Perfusion, 2020, 35(6): 521-528.
10.
11.
12.
13. Zhang T, Taskin ME, Fang HB, et al. Study of flow-induced hemolysis using novel Couette-type blood-shearing devices. Artif Organs, 2011, 35(12): 1180-1186.
14. Yu H, Engel S, Janiga G, et al. A review of hemolysis prediction models for computational fluid dynamics. Artif Organs, 2017, 41(7): 603-621.
15.
16. Ozturk M, Papavassiliou DV, O'Rear EA. An approach for assessing turbulent flow damage to blood in medical devices. J Biomech Eng, 2017, 139(1): 011008.
17. Avci M, Heck M, O'Rear EA, et al. Hemolysis estimation in turbulent flow for the FDA critical path initiative centrifugal blood pump. Biomech Model Mechanobiol, 2021, 20(5): 1709-1722.
18.
19. Selmi M, Chiu WC, Chivukula VK, et al. Blood damage in left ventricular assist devices: Pump thrombosis or system thrombosis? Int J Artif Organs, 2019, 42(3): 113-124.
20. Onder A, Incebay O, Sen MA, et al. Heuristic optimization of impeller sidewall gaps-based on the bees algorithm for a centrifugal blood pump by CFD. Int J Artif Organs, 2021, 44(10): 765-772.
21.
22. Liu GM, Jin DH, Zhou JY, et al. Numerical investigation of the influence of blade radial gap flow on axial blood pump performance. ASAIO J, 2019, 65(1): 59-69.
23. Rezaienia MA, Paul G, Avital E, et al. Computational parametric study of the axial and radial clearances in a centrifugal rotary blood pump. ASAIO J, 2018, 64(5): 643-650.
24.
25. Park J, Oki K, Hesselmann F, et al. Biologically inspired, open, helicoid impeller design for mechanical circulatory assist. ASAIO J, 2020, 66(8): 899-908.
26.
27. 荊騰, 潘愛娣, 顧發東, 等. 主動脈穿刺型軸流血泵折邊結構葉輪的數值模擬及溶血分析. 排灌機械工程學報, 2024, 42(2): 109-117.Jing T, Pan AD, Gu FD, et al. Numerical simulation and hemolysis analysis of aortic perforating type axial bleeding pump with folded-edge structure impeller.J DrainIrrig Mach Eng, 2024, 42(2): 109-117.
28. Ghadimi B, Nejat A, Nourbakhsh SA, et al. Multi-objective genetic algorithm assisted by an artificial neural network metamodel for shape optimization of a centrifugal blood pump. Artif Organs, 2019, 43(5): E76-E93.
29.
30. Huang B, Guo M, Lu B, et al. Geometric optimization of an extracorporeal centrifugal blood pump with an unshrouded impeller concerning both hydraulic performance and shear stress. Processes, 2021, 9(7): 1211.
31.
32. Yu Z, Tan J, Wang S, et al. Multiple parameters and target optimization of splitter blades for axial spiral blade blood pump using computational fluid mechanics, neural networks, and particle image velocimetry experiment. Sci Prog, 2021, 104(3): 368504211039363.
33. Li Y, Yu J, Wang H, et al. Investigation of the influence of blade configuration on the hemodynamic performance and blood damage of the centrifugal blood pump. Artif Organs, 2022, 46(9): 1817-1832.
34. 李馳培, 楊秀萍, 陳俊, 等. 中間導葉對軸流血泵流動特性的影響分析. 第十二屆全國生物力學學術會議暨第十四屆全國生物流變學學術會議, 西安, 2018.Li CP, Yang XP, Chen J, et al. Analysis of the influence of intermediate guide vanes on the flow characteristics of axial blood pump. Proceedings of 12th National Conference on Biomechanics and 14th National Conference on Biorheology, Xi'an, 2018.
35.
36.
37. Zhao ZX, Chen T, Liu XD, et al. Numerical investigation of an idealized total cavopulmonary connection physiology assisted by the axial blood pump with and without diffuser. CMES, 2020, 125(3): 1173-1184.
38.
39. Wang Y, Shen P, Zheng M, et al. Influence of impeller speed patterns on hemodynamic characteristics and hemolysis of the blood pump. Appl Sci (Basel), 2019, 9(21): 4689.
40. Yamane T, Adachi K, Kosaka R, et al. Suitable hemolysis index for low-flow rotary blood pumps. J Artif Organs, 2021, 24(2): 120-125.
41. Wang S, Tan J, Yu Z. Shear stress and hemolysis analysis of blood pump under constant and pulsation speed based on a multiscale coupling model. Math Probl Eng, 2020, 2020(1922): 1-14.
42.
43. Takashi yamane. Mechanism of artificial heart. Springer, Tokyo, 2016.
44. Zhang M, Tansley GD, Dargusch MS, et al. Surface coatings for rotary ventricular assist devices: A systematic review. ASAIO J, 2022, 68(5): 623-632.
45. Maruyama O, Nishida M, Yamane T, et al. Hemolysis resulting from surface roughness under shear flow conditions using a rotational shear stressor. Artif Organs, 2006, 30(5): 365-370.
46.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Research progress on hemolysis of rotary blood pump

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