Cardiac Support for the Right Ventricle: Effects of Timing on Hemodynamics-Biomechanics Tradeoff

A well-established treatment option for advanced heart failure is the implantation of a ventricular assist device (VAD) in the left heart. In over one quarter of patients, however, failure of the right ventricle (RV) occurs shortly after implantation, with a paucity of options for RV failure management in this clinical context. A possible treatment for RV failure is the application of regional mechanical support to the free surface of the RV. Here, we investigate the effect of this treatment using a multiscale finite element model. We discuss a trade-off between hemodynamic benefits and biomechanical effects of simulated interventions with respect to the complex dynamics of RV contraction. Specifically, we report on timing of support with respect to the cardiac cycle, duration of applied force, and force profile distribution. Insights from these preliminary studies can be informative in the rational design of RV-specific mechanical support solutions.