Background: The hybrid comprehensive stage 2 (HCS2) procedure is a novel palliative operation applicable to a select subset of single ventricle patients with adequate native antegrade aortic flow to the upper body. Flow to the descending aorta, through the pulmonary outlet and ductal arch, is influenced by a stented intrapulmonary baffle connecting the branch pulmonary arteries. We used computational fluid dynamics (CFD) to elucidate the hemodynamic characteristics of this reconstruction.Methods: We used multiscale CFD analysis of a synthetic, patient-derived HCS2 anatomic configuration with unsteady laminar flow conditions and a non-Newtonian blood model to quantify the resultant hemodynamics. The 3-dimensional CFD model was coupled to a 0-dimensional lumped parameter model of the peripheral circulation to determine the required boundary conditions.Results: For the specific anatomy studied, the intrapulmonary baffle did not obstruct flow from the pulmonary trunk to ductal arch as long as the distance between the anterior pulmonary artery wall and baffle wall exceeded $7 mm. Vortex shedding off of the baffle wall did not develop, because of the short distance to the ductal arch. The stented baffle experienced significantly uneven "inward" loading from the systemic side. Pulmonary outlet flow separation distal to the baffle produced a low-speed recirculation region.Conclusions: Hemodynamic patterns in this complex anatomy are generally favorable. Low flow recirculation could be mitigated by preoperative shape optimization. Calculated inward stresses on the pulmonary baffle can be used in the future to study baffle stent deformation, which is expected to be small. (JTCVS Open 2021;7:308-23) Hybrid comprehensive stage II synthetic model of the fluid domain.
This paper discusses the development of two different bi-phase flows. Fourth-grade fluid exhibiting the non-Newtonian fluid nature is taken as the base liquid. Two-phase suspension is obtained by using the spherically homogeneous metallic particle. Owing to the intense application of mechanical and chemical multiphase flows through curved and bent configurations effectively transforms the flow dynamics of the fluid. Differential equations for electro-osmotically driven fluid are modeled and solved with the help of the regular perturbation method. The obtained theoretical solution is further compared with the ones obtained by using two different numerical techniques and found to be in full agreement.
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