{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T20:37:41Z","timestamp":1771101461689,"version":"3.50.1"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T00:00:00Z","timestamp":1766016000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Physiol."],"abstract":"\n Introduction<\/jats:title>\n Traditional percutaneous ventricular assist devices (PVADs) face limitations due to their small implantation size, requiring higher rotational speeds to meet left ventricular support demands. However, the elevated shear stress induced by high-speed operation leads to excessive hemolysis, necessitating design improvements for better clinical applicability.<\/jats:p>\n <\/jats:sec>\n \n Method<\/jats:title>\n This study presents a foldable implantable blood pump featuring a collapsible flexible impeller and pump casing, which reduces its profile during implantation and expands to operational size at the target position, thereby allowing lower rotational speeds and improved hemolytic performance. Through numerical simulations combined with response surface methodology (RSM), we systematically analyzed the influence of various structural parameters on pump head and hemolysis index (HI), aiming at parametric optimization of the initial model for enhanced hydraulic efficiency and reduced blood trauma risk.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Simulation analysis of seven parameter configurations identified five key structural parameters with dominant effects on head and HI: impeller inlet angle, impeller outlet angle, diffuser inlet angle, diffuser wrap angle, and impeller-diffuser gap. Using Box-Behnken Design (BBD), we established dual-response prediction models for both head and HI, analyzed significant interaction terms, and derived an optimized configuration achieving a 6.9% increase in head pressure and 17.9% reduction in HI compared to the initial design. Additional analysis revealed that increasing tip clearance reduces hemolysis at the cost of moderate head decrease.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n We designed and optimized a foldable axial-flow blood pump for transaortic implantation. The optimized configuration demonstrates a 6.9% head improvement to 2.346 m and 17.9% HI reduction to\n \n \n \n 1.081<\/mml:mn>\n \u00d7<\/mml:mo>\n 1<\/mml:mn>\n \n \n 0<\/mml:mn>\n <\/mml:mrow>\n \n \u2212<\/mml:mo>\n 2<\/mml:mn>\n <\/mml:mrow>\n <\/mml:msup>\n %<\/mml:mi>\n <\/mml:mrow>\n <\/mml:math>\n <\/jats:inline-formula>\n . Furthermore, increasing tip clearance from 0.2\u2009 mm to 0.4 mm provides additional hemolysis reduction without excessively compromising the pressure head.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fphys.2025.1632333","type":"journal-article","created":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T05:16:17Z","timestamp":1766034977000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Mechanically-foldable axial flow blood pump: response-surface-based structural optimization and hemolytic performance evaluation"],"prefix":"10.3389","volume":"16","author":[{"given":"Tairan","family":"Ji","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teng","family":"Jing","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jianan","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,12,18]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"856870","DOI":"10.3389\/fcvm.2022.856870","article-title":"Ventricular unloading using the impellatm device in cardiogenic shock","volume":"9","author":"Attinger-Toller","year":"2022","journal-title":"Front. Cardiovasc. Med."},{"key":"B2","volume-title":"Fluid-structure analysis of a collapsible axial impeller pump cage design for the fontan circulation","author":"Bisirri","year":"2018"},{"key":"B3","doi-asserted-by":"publisher","first-page":"590","DOI":"10.1111\/j.1525-1594.1995.tb02386.x","article-title":"Three-dimensional numerical prediction of stress loading of blood particles in a centrifugal pump","volume":"19","author":"Bludszuweit","year":"1995","journal-title":"Artif. Organs"},{"key":"B4","doi-asserted-by":"publisher","first-page":"03913988251346712","DOI":"10.1177\/03913988251346712","article-title":"Optimization of hemocompatibility metrics in ventricular assist device design using machine learning and cfd-based response surface analysis","author":"Bounouib","year":"2025","journal-title":"Int. J. Artif. Organs"},{"key":"B5","doi-asserted-by":"publisher","first-page":"107919","DOI":"10.1016\/j.cmpb.2023.107919","article-title":"An in silico analysis of unsteady flow structures in a microaxial blood pump under a pulsating rotation speed","volume":"243","author":"Chen","year":"2024","journal-title":"Comput. Methods Programs Biomed."},{"key":"B6","doi-asserted-by":"publisher","first-page":"962839","DOI":"10.3389\/fcvm.2022.962839","article-title":"Device-based therapy for decompensated heart failure: an updated review of devices in development based on the dri2p2s classification","volume":"9","author":"de Oliveira Cardoso","year":"2022","journal-title":"Front. Cardiovasc. Med."},{"key":"B7","doi-asserted-by":"publisher","first-page":"124504","DOI":"10.1115\/1.4034786","article-title":"Extending the power-law hemolysis model to complex flows","volume":"138","author":"Faghih","year":"2016","journal-title":"J. Biomechanical Eng."},{"key":"B8","doi-asserted-by":"publisher","first-page":"845","DOI":"10.1007\/s10237-019-01137-1","article-title":"Modeling and prediction of flow-induced hemolysis: a review","volume":"18","author":"Faghih","year":"2019","journal-title":"Biomechanics Model. Mechanobiol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1177\/039139889001300507","article-title":"Estimation of shear stress-related blood damage in heart valve prostheses-in vitro comparison of 25 aortic valves","volume":"13","author":"Giersiepen","year":"1990","journal-title":"Int. J. Artif. Organs"},{"key":"B10","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1007\/s10237-005-0005-y","article-title":"A novel formulation for blood trauma prediction by a modified power-law mathematical model","volume":"4","author":"Grigioni","year":"2005","journal-title":"Biomechanics Model. Mechanobiol."},{"key":"B11","doi-asserted-by":"publisher","first-page":"100153","DOI":"10.1016\/j.medntd.2022.100153","article-title":"Computational fluid dynamics analysis and experimental hemolytic performance of three clinical centrifugal blood pumps: revolution, rotaflow and centrimag","volume":"15","author":"Han","year":"2022","journal-title":"Med. Nov. Technol. Devices"},{"key":"B12","doi-asserted-by":"publisher","first-page":"130","DOI":"10.1111\/aor.14665","article-title":"Computational fluid dynamics-based design and in vitro characterization of a novel pediatric pump-lung","volume":"48","author":"Han","year":"2024","journal-title":"Artif. Organs"},{"key":"B13","doi-asserted-by":"publisher","first-page":"829","DOI":"10.1177\/03913988211041635","article-title":"Flow characteristics and hemolytic performance of the new breethe centrifugal blood pump in comparison with the centrimag and rotaflow pumps","volume":"44","author":"He","year":"2021","journal-title":"Int. J. Artif. Organs"},{"key":"B14","doi-asserted-by":"publisher","first-page":"E337","DOI":"10.1111\/aor.13685","article-title":"Fluid-structure interaction analysis of a collapsible axial flow blood pump impeller and protective cage for fontan patients","volume":"44","author":"Hirschhorn","year":"2020","journal-title":"Artif. Organs"},{"key":"B15","doi-asserted-by":"publisher","first-page":"298","DOI":"10.1111\/aor.12145","article-title":"Design method of a foldable ventricular assist device for minimally invasive implantation","volume":"38","author":"Hsu","year":"2014","journal-title":"Artif. Organs"},{"key":"B16","doi-asserted-by":"publisher","first-page":"406","DOI":"10.3390\/mi14020406","article-title":"Optimization of a screw centrifugal blood pump based on random forest and multi-objective gray wolf optimization algorithm","volume":"14","author":"Jing","year":"2023","journal-title":"Micromachines"},{"key":"B17","doi-asserted-by":"publisher","first-page":"365","DOI":"10.1016\/j.probengmech.2010.04.002","article-title":"An efficient response surface method using moving least squares approximation for structural reliability analysis","volume":"25","author":"Kang","year":"2010","journal-title":"Probabilistic Eng. Mech."},{"key":"B18","doi-asserted-by":"publisher","first-page":"474","DOI":"10.1177\/0267659120931307","article-title":"Haemolysis induced by mechanical circulatory support devices: unsolved problems","volume":"35","author":"K\u00f6hne","year":"2020","journal-title":"Perfusion"},{"key":"B19","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1002\/ejhf.2333","article-title":"2021 esc guidelines for the diagnosis and treatment of acute and chronic heart failure: developed by the task force for the diagnosis and treatment of acute and chronic heart failure of the european society of cardiology (esc). with the special contribution of the heart failure association (hfa) of the esc","volume":"24","author":"McDonagh","year":"2022","journal-title":"Eur. J. Heart Fail."},{"key":"B20","doi-asserted-by":"publisher","first-page":"1618","DOI":"10.1056\/NEJMoa1900486","article-title":"A fully magnetically levitated left ventricular assist device - final report","volume":"380","author":"Mehra","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"B21","doi-asserted-by":"publisher","first-page":"2343","DOI":"10.1016\/j.jacc.2023.11.003","article-title":"A heart-healthy and stroke-free world: using data to inform global action","volume":"82","author":"Mensah","year":"2023","journal-title":"J. Am. Coll. Cardiol."},{"key":"B22","doi-asserted-by":"publisher","first-page":"650","DOI":"10.1001\/jamacardio.2018.0522","article-title":"Evolution of left ventricular assist device therapy for advanced heart failure: a review","volume":"3","author":"Miller","year":"2018","journal-title":"JAMA Cardiol."},{"key":"B23","doi-asserted-by":"publisher","first-page":"169","DOI":"10.3233\/BME-201088","article-title":"Shear stress evaluation on blood cells using computational fluid dynamics","volume":"31","author":"Mitoh","year":"2020","journal-title":"Bio-Medical Mater. Eng."},{"key":"B24","doi-asserted-by":"publisher","first-page":"823","DOI":"10.1007\/s12206-010-0117-x","article-title":"Multi-objective optimization of the tooth surface in helical gears using design of experiment and the response surface method","volume":"24","author":"Park","year":"2010","journal-title":"J. Mech. Sci. Technol."},{"key":"B25","doi-asserted-by":"publisher","first-page":"710","DOI":"10.1177\/0391398820909843","article-title":"Hemolysis associated with impella heart pump positioning: in vitro hemolysis testing and computational fluid dynamics modeling","volume":"43","author":"Roberts","year":"2020","journal-title":"Int. J. Artif. Organs"},{"key":"B26","doi-asserted-by":"publisher","first-page":"734","DOI":"10.1097\/MAT.0b013e318159d14b","article-title":"Mechanical cavopulmonary assist for the univentricular fontan circulation using a novel folding propeller blood pump","volume":"53","author":"Throckmorton","year":"2007","journal-title":"Asaio J."},{"key":"B27","doi-asserted-by":"publisher","first-page":"1949","DOI":"10.1016\/j.jacc.2022.02.052","article-title":"Anticoagulation for percutaneous ventricular assist device-supported cardiogenic shock: jacc review topic of the week","volume":"79","author":"Vandenbriele","year":"2022","journal-title":"J. Am. Coll. Cardiol."},{"key":"B28","doi-asserted-by":"publisher","first-page":"1","DOI":"10.26599\/1671-5411.2025.01.008","article-title":"Chinese guidelines for the prevention and treatment of hypertension (2024 revision)","volume":"22","author":"Wang","year":"2025","journal-title":"J. Geriatric Cardiol."},{"key":"B29","doi-asserted-by":"publisher","first-page":"325","DOI":"10.5301\/ijao.5000419","article-title":"Multi-objective optimization of pulsatile ventricular assist device hemocompatibility based on neural networks and a genetic algorithm","volume":"38","author":"Xu","year":"2015","journal-title":"Int. J. Artif. Organs"},{"key":"B30","doi-asserted-by":"publisher","first-page":"504","DOI":"10.1111\/aor.14701","article-title":"Numerical methods for hemolysis and thrombus evaluation in the percutaneous ventricular assist device","volume":"48","author":"Xu","year":"2024","journal-title":"Artif. Organs"},{"key":"B31","doi-asserted-by":"publisher","first-page":"178","DOI":"10.1007\/s10047-014-0755-3","article-title":"The effect of turbulent viscous shear stress on red blood cell hemolysis","volume":"17","author":"Yen","year":"2014","journal-title":"J. Artif. Organs"},{"key":"B32","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1016\/s1001-0742(10)60369-5","article-title":"Optimization of phenol degradation by candida tropicalis z-04 using plackett-burman design and response surface methodology","volume":"23","author":"Zhou","year":"2011","journal-title":"J. Environ. Sci."}],"container-title":["Frontiers in Physiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphys.2025.1632333\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T05:16:18Z","timestamp":1766034978000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphys.2025.1632333\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,18]]},"references-count":32,"alternative-id":["10.3389\/fphys.2025.1632333"],"URL":"https:\/\/doi.org\/10.3389\/fphys.2025.1632333","relation":{},"ISSN":["1664-042X"],"issn-type":[{"value":"1664-042X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,18]]},"article-number":"1632333"}}