A numerical fluid mechanical study of repaired congenital heart defects. Application to the total cavopulmonary connection

Boundary conditions of patient-specific fluid dynamics modelling of cavopulmonary connections: possible adaptation of pulmonary resistances results in a critical issue for a virtual surgical planning

“…Multi-scale modelling is thus necessary to account for the former, through the three-dimensional model, and the latter, through the LPM. The presence of an only small imbalance in the individual lung resistances in the investigated patient is consistent with several assumptions of equal lung resistances used in the literature [19,21,22]. However, it can be expected that such a hypothesis would not be realistic in a patient with asymmetrical lung development.…”

Noninvasive quantification of fluid mechanical energy losses in the total cavopulmonary connection with magnetic resonance phase velocity mapping

“…Conserving as much as possible the mechanical energy of blood that flows through the connection is of crucial importance, considering that the single ventriele is respon sible fo r both the systemic and the pulmonary circulation. As a result, the fluid mechanical optimization of the TCPC has becn invcstigated through several in vitro, numerical and in vivo studi es [5][6][7][8][9][10][11][12][13][14][15][16][17][18], leading to improvements in the connection between thc caval and pulmonary vessels .…”

Blood flow measurements with magnetic resonance phase velocity mapping

“…Optimization of the TCPC has been inves tigated through several in vitro, numerical, and in vivo studies, focusing on the reduction of the en ergy losses of blood flow through the connection and providing proper blood flow distribution to the lungs. The optimal design should prevent strong flow collisions, allowing at the same time adequate IVC flow to both the RPA and the LPA, as shown by in vitro and numerical studies [47][48][49]. One way to avoid a direct caval flow col lision (and conserve energy) is to introduce an off set between the points of SVC and IVC connection with the RPA, as shown in vitro and in vivo [50][51][52][53].…”

“…One way to avoid a direct caval flow col lision (and conserve energy) is to introduce an off set between the points of SVC and IVC connection with the RPA, as shown in vitro and in vivo [50][51][52][53]. Addition of flaring at the connection site fur ther improves the energetics of the system reducing the energy losses as much as 68% due to smoother transition of SVC and IVC flows to the pulmonary arteries [48,[51][52][53].…”