Pump and Tissue Function in the Infarcted Heart Supported by a Regenerative Assist Device: A Computational Study.

Adverse ventricular remodelling following acute myocardial infarction (MI) may induce ventricular dilation, fibrosis and loss of global contractile function, possibly resulting in heart failure. Cardiac patches, composed of living cardiac tissue, may be able to restore cardiac function and reduce adverse ventricular remodelling post-MI. The design of these devices is complex and computational modelling may provide means to create an efficient design from a mechanical point of view. In this study, we used a finite element approach to analyze the effect of a cardiac patch, mounted over a chronic infarct region, on left ventricular pump function and myocardial tissue function. The infarct, 15% in size, was found to reduce stroke work by 30% compared to the healthy heart. This disproportional loss was attributed to unfavourable mechanical interactions in healthy tissue, adjacent to the infarction. The effect of the patch was investigated for a circumferential, an oblique, and a longitudinal orientation. In its most favourable oblique configuration, the cardiac patch was able to recover 6% of stroke work lost. This specific configuration was found to best restore the transmission of active force, that was lost due to the myocardial infarction.