Towards Centrifugal Compressor Stages Virtual Testing

Flow features inside centrifugal compressor stages are very complicated to simulate with numerical tools due to the highly complex geometry and varying gas conditions all across the machine. For this reason, a big effort is currently being made to increase the fidelity of the numerical models during the design and validation phases. Computational Fluid Dynamics (CFD) plays an increasing role in the assessment of the performance prediction of centrifugal compressor stages. Historically, CFD was considered reliable for performance prediction on a qualitatively level, whereas tests were necessary to predict compressors performance on a quantitatively basis. In fact "standard" CFD with only the flow-path and blades included into the computational domain is known to be weak in capturing efficiency level and operating range accurately due to the under-estimation of losses and the lack of secondary flows modeling. This research project aims to fill the gap in accuracy between "standard" CFD and tests data by including a high fidelity reproduction of the gas domain and the use of advanced numerical models and tools introduced in the author's OEM in-house CFD code. In other words, this thesis describes a methodology by which virtual tests can be conducted on single stages and multistage centrifugal compressors in a similar fashion to a typical rig test that guarantee end users to operate machines with a confidence level not achievable before. Furthermore, the new "high fidelity" approach allowed understanding flow phenomena not fully captured before, increasing aerodynamicists capability and confidence in designing high efficiency and high reliable centrifugal compressor stages.

Balloon Aortic Valvuloplasty as Bridge-to-Decision in High Risk Patients with Severe Aortic Valve Stenosis

Background. A sizable group of patients with symptomatic aortic stenosis (AS) can undergo neither surgical aortic valve replacement (AVR) nor transcatheter aortic valve implantation (TAVI) because of clinical contraindications. The aim of this study was to assess the potential role of balloon aortic valvuloplasty (BAV) as a “bridge-to-decision” in selected patients with severe AS and potentially reversible contraindications to definitive treatment. Methods. We retrospectively enrolled 645 patients who underwent first BAV at our Institution between July 2007 and December 2012. Of these, the 202 patients (31.2%) who underwent BAV as bridge-to-decision (BTD) requiring clinical re-evaluation represented our study population. BTD patients were further subdivided in 5 groups: low left ventricular ejection fraction; mitral regurgitation grade ≥3; frailty; hemodynamic instability; comorbidity. The main objective of the study was to evaluate how BAV influenced the final treatment strategy in the whole BTD group and in its single specific subgroups. Results. Mean logistic EuroSCORE was 23.5±15.3%, mean age was 81±7 years. Mean transaortic gradient decreased from 47±17 mmHg to 33±14 mmHg. Of the 193 patients with BTD-BAV who received a second heart team evaluation, 72.5% were finally deemed eligible for definitive treatment (25.4%for AVR; 47.2% for TAVI): respectively, 96.7% of patients with left ventricular ejection fraction recovery; 70.5% of patients with mitral regurgitation reduction; 75.7% of patients who underwent BAV in clinical hemodynamic instability; 69.2% of frail patients and 68% of patients who presented relevant comorbidities. 27.5% of the study population was deemed ineligible for definitive treatment and treated with standard therapy/repeated BAV. In-hospital mortality was 4.5%, cerebrovascular accident occurred in 1% and overall vascular complications were 4% (0.5% major; 3.5% minor). Conclusions. Balloon aortic valvuloplasty should be considered as bridge-to-decision in high-risk patients with severe aortic stenosis who cannot be immediate candidates for definitive percutaneous or surgical treatment.