Computational fluid dynamic study of flow optimization in realistic models of the total cavopulmonary connections

Hsia, Tain‐Yen; Migliavacca, Francesco; Pittaccio, Simone; Radaelli, Alessandro; Dubini, Gabriele; Pennati, Giancarlo; Leval, Marc de

doi:10.1016/j.jss.2003.08.004

Cited by 66 publications

(43 citation statements)

References 21 publications

(28 reference statements)

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“…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 .…”

Section: Introductionmentioning

confidence: 99%

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

Venkatachari

Halliburton

Setser

et al. 2007

Magnetic Resonance Imaging

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Section: Introductionmentioning

confidence: 99%

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

Venkatachari

Halliburton

Setser

et al. 2007

Magnetic Resonance Imaging

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“…However, the majority of existing studies focused on local hemodynamic phenomena, such as flow patterns, wall shear stress distribution in a cavopulmonary anastomosis, or associated energy loss (19,32,36,83,85,87). In studies where systemic hemodynamics was addressed, cardiovascular properties were usually fixed (55a), tuned to specific patients (40,54,63,64), or adjusted to represent certain physiological conditions (41,51).…”

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confidence: 99%

Hemodynamic performance of the Fontan circulation compared with a normal biventricular circulation: a computational model study

Liang

Senzaki

Kurishima

et al. 2014

American Journal of Physiology-Heart and Circulatory Physiology

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performance of the Fontan circulation compared with a normal biventricular circulation: a computational model study. Am J Physiol Heart Circ Physiol 307: H1056 -H1072, 2014. First published July 25, 2014 doi:10.1152/ajpheart.00245.2014The physiological limitations of the Fontan circulation have been extensively addressed in the literature. Many studies emphasized the importance of pulmonary vascular resistance in determining cardiac output (CO) but gave little attention to other cardiovascular properties that may play considerable roles as well. The present study was aimed to systemically investigate the effects of various cardiovascular properties on clinically relevant hemodynamic variables (e.g., CO and central venous pressure). To this aim, a computational modeling method was employed. The constructed models provided a useful tool for quantifying the hemodynamic effects of any cardiovascular property of interest by varying the corresponding model parameters in model-based simulations. Herein, the Fontan circulation was studied compared with a normal biventricular circulation so as to highlight the unique characteristics of the Fontan circulation. Based on a series of numerical experiments, it was found that 1) pulmonary vascular resistance, ventricular diastolic function, and systemic vascular compliance play a major role, while heart rate, ventricular contractility, and systemic vascular resistance play a secondary role in the regulation of CO in the Fontan circulation; 2) CO is nonlinearly related to any single cardiovascular property, with their relationship being simultaneously influenced by other cardiovascular properties; and 3) the stability of central venous pressure is significantly reduced in the Fontan circulation. The findings suggest that the hemodynamic performance of the Fontan circulation is codetermined by various cardiovascular properties and hence a full understanding of patientspecific cardiovascular conditions is necessary to optimize the treatment of Fontan patients.

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“…It is suggested that when performing a TCPC, an extracardiac lateral conduit diverts more flow to the left lung, and shows higher energy losses when compared with a connection with intra-atrial tunnel. The importance of local geometry of the surgically created pathway in the TCPC was also confirmed by a similar study of Hsia, et al 27) Other CFD studies have investigated the effects of the pulmonary afterload on the hemodynamics after the hemi-Fontan procedure (HFP). 28) A finite volume solver was linked to a mechanical model of the pulmonary circulation to reproduce the pulmonary afterload conditions.…”

Section: Computational Fluid Dynamics Studiesmentioning

confidence: 62%

Evolution in Experimental Fontan Circulation: A Review

Kanakis

Lioulias

Samanidis

et al. 2013

ATCS

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Experimental right heart bypass operations have influenced the evolution of current application of the Fontan procedure. In this review, we summarize the evolution and progress of the experimental Fontan operation (FO) and discuss the questions raised so far. The evolution and progress of the experimental FO is analyzed in this review by collecting data retrieved from English literature research. The establishment of Fontan circulation on an experimental animal model is extremely difficult and until today, a chronic experimental model has never been described. Computational fluid dynamics (CFD) has played a significant role in the investigation of the hemodynamic characteristics of the FO and has been applied to the design and integration of the procedure. CFD was also employed to evaluate the performance of assisted Fontan circulation. Accumulated experience from the experimental studies and clinical practice, in combination with the cooperation of different fields in medicine and positive sciences, are definitely expected to help the evolution furthermore.

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Computational fluid dynamic study of flow optimization in realistic models of the total cavopulmonary connections

Cited by 66 publications

References 21 publications

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

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

Hemodynamic performance of the Fontan circulation compared with a normal biventricular circulation: a computational model study

Evolution in Experimental Fontan Circulation: A Review

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