Computational fluid dynamics models and congenital heart diseases

Pennati, Giancarlo

doi:10.3389/fped.2013.00004

Cited by 41 publications

(26 citation statements)

References 56 publications

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“…While most steps of the patient-specific analysis methodology including the MRI scanning, segmentation, volume generation, mesh discretization and visualization has matured,42 as our study indicates, the predictive capability of realistic boundary conditions representing the peripheral circulation needs further emphasis. Particularly the inclusion of major cerebral vessels undertaken in the present work is a step towards this objective.…”

Section: Discussionmentioning

confidence: 92%

“…Patient-specific computational fluid dynamics evolved to be a standard tool for simulating the hemodynamic performance of pediatric cardiovascular shunts, reducing the need for in vitro tests as well as complex animal experiments 42. While most steps of the patient-specific analysis methodology including the MRI scanning, segmentation, volume generation, mesh discretization and visualization has matured,42 as our study indicates, the predictive capability of realistic boundary conditions representing the peripheral circulation needs further emphasis.…”

Section: Discussionmentioning

confidence: 93%

“…As our results demonstrate, the hemodynamic shunt analysis cannot be localized to the shunt region alone. The entire cardiovascular circulation system, including the natural shunt of DA, if it exists, must be considered for precise surgical decision-making 42. Finally, the addition of 3D cerebral arteries to the CFD domain will not eliminate the utility of lumped parameter model boundary conditions as they will still be needed for the rest of the vasculature.…”

Section: Discussionmentioning

confidence: 99%

“…Still, the comparative values of present results should be valid to a certain degree. The physiologically realistic geometry and boundary conditions are critical for replicating the physiological results, even if it is challenging to obtain accurate measurements and data needed for modeling purposes in infants and small babies 22,42,43. Likewise, the effects of disease-specific shunt configurations and anastomosis location on cerebral and coronary flow are all important considerations for the surgical decision-making process.…”

Section: Limitationsmentioning

confidence: 99%

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Tetralogy of Fallot Surgical Repair: Shunt Configurations, Ductus Arteriosus and the Circle of Willis

Pişkin

Ünal

Arnaz

et al. 2017

Cardiovasc Eng Tech

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In this study, hemodynamic performance of three novel shunt configurations that are considered for the surgical repair of tetralogy of Fallot (TOF) disease are investigated in detail. Clinical experience suggests that the shunt location, connecting angle, and its diameter can influence the post-operative physiology and the neurodevelopment of the neonatal patient. An experimentally validated second order computational fluid dynamics (CFD) solver and a parametric neonatal diseased great artery model that incorporates the ductus arteriosus (DA) and the full patient-specific circle of Willis (CoW) are employed. Standard truncated resistance CFD boundary conditions are compared with the full cerebral arterial system, which resulted 21, −13, and 37% difference in flow rate at the brachiocephalic, left carotid, and subclavian arteries, respectively. Flow splits at the aortic arch and cerebral arteries are calculated and found to change with shunt configuration significantly for TOF disease. The central direct shunt (direct shunt) has pulmonary flow 5% higher than central oblique shunt (oblique shunt) and 23% higher than modified Blalock Taussig shunt (RPA shunt) while the DA is closed. Maximum wall shear stress (WSS) in the direct shunt configuration is 9 and 60% higher than that of the oblique and RPA shunts, respectively. Patent DA, significantly eliminated the pulmonary flow control function of the shunt repair. These results suggests that, due to the higher flow rates at the pulmonary arteries, the direct shunt, rather than the central oblique, or right pulmonary artery shunts could be preferred by the surgeon. This extended model introduced new hemodynamic performance indices for the cerebral circulation that can correlate with the post-operative neurodevelopment quality of the patient.Electronic supplementary materialThe online version of this article (doi:10.1007/s13239-017-0302-5) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Limitationsmentioning

confidence: 99%

See 2 more Smart Citations

Tetralogy of Fallot Surgical Repair: Shunt Configurations, Ductus Arteriosus and the Circle of Willis

Pişkin

Ünal

Arnaz

et al. 2017

Cardiovasc Eng Tech

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“…Clinical‐data‐based model calibration has been widely addressed . However, relatively less effort has been attempted to calibrate a global cardiovascular model that incorporates both cardiac function and systemic vascular properties.…”

Section: Discussionmentioning

confidence: 99%

Patient‐specific assessment of cardiovascular function by combination of clinical data and computational model with applications to patients undergoing Fontan operation

Liang

Sughimoto

Matsuo

et al. 2014

Numer Methods Biomed Eng

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The assessment of cardiovascular function is becoming increasingly important for the care of patients with single-ventricle defects. However, most measurement methods available in the clinical setting cannot provide a separate measure of cardiac function and loading conditions. In the present study, a numerical method has been proposed to compensate for the limitations of clinical measurements. The main idea was to estimate the parameters of a cardiovascular model by fitting model simulations to patient-specific clinical data via parameter optimization. Several strategies have been taken to establish a well-posed parameter optimization problem, including clinical data-matched model development, parameter selection based on an extensive sensitivity analysis, and proper choice of parameter optimization algorithm. The numerical experiments confirmed the ability of the proposed parameter optimization method to uniquely determine the model parameters given an arbitrary set of clinical data. The method was further tested in four patients undergoing the Fontan operation. Obtained results revealed a prevalence of ventricular abnormalities in the patient cohort and at the same time demonstrated the presence of marked inter-patient differences and preoperative to postoperative changes in cardiovascular function. Because the method allows a quick assessment and makes use of clinical data available in clinical practice, its clinical application is promising.

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Physics‐Based Modeling for the Physiome

Pruett

Hester

2016

The Digital Patient

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Computational fluid dynamics models and congenital heart diseases

Cited by 41 publications

References 56 publications

Tetralogy of Fallot Surgical Repair: Shunt Configurations, Ductus Arteriosus and the Circle of Willis

Tetralogy of Fallot Surgical Repair: Shunt Configurations, Ductus Arteriosus and the Circle of Willis

Patient‐specific assessment of cardiovascular function by combination of clinical data and computational model with applications to patients undergoing Fontan operation

Physics‐Based Modeling for the Physiome

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