Computational haemodynamic analysis of left pulmonary artery angulation effects on pulmonary blood flow

Zhang, Weimin; Liu, Jinlong; Yan, Qin; Hong, Haifa; Mao, Le

doi:10.1093/icvts/ivw179

Cited by 29 publications

(37 citation statements)

References 20 publications

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“…Area obstructions (stenosis) of the proximal PAs, steeper branching angles and curvatures as well as other anatomic alterations can lead to a completely different flow morphology, as shown for instance in the case of TGA patients after the arterial switch operation [6,7]. Zhang et al computationally analyzed the effect of the LPA branching angle (i.e., the angle formed between the MPA and LPA centerlines) and found a dramatic decrease of the energy efficiency with decreasing angles (i.e., sharper bends) [21]. Progresses in SSM methods, such as the one used in this work, are allowing a more quantitative analysis of the correlation between certain shape features and functional indices.…”

Section: Global Flow Featuresmentioning

confidence: 99%

“…Of note, Geiger et al found again right-handed helical flow in the RPA of 8 (out of 12) controls [17]. Other investigations focused on TOF and adverse haemodynamic consequences of post-operative morphology [20][21][22]. Recently, Boumpouli et al analyzed computationally the effect of the branching angle on flow separation in the pulmonary bifurcation, in the context of TOF [23].…”

Section: Introductionmentioning

confidence: 99%

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Blood Flow Dynamics at the Pulmonary Artery Bifurcation

Capuano

Loke

Balaras

2019

Fluids

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Knowledge of physiologic hemodynamics is a fundamental requirement to establish pathological findings. However, little is known about the normal flow fields in the pulmonary arteries, especially for children. The purpose of this study is to characterize flow patterns in the pulmonary artery bifurcation of healthy pediatric subjects using direct numerical simulations. A realistic geometry is obtained via statistical shape modeling, by averaging five subject-specific digital models extracted from cardiovascular magnetic resonance datasets of healthy volunteers. Boundary conditions are assigned to mimic physiological conditions at rest, corresponding to a peak Reynolds number equal to 3400 and a Womersley number equal to 15. Results show that the normal bifurcation is highly hemodynamically efficient, as measured by an energy dissipation index. The curvature of the pulmonary arteries is sufficiently small to prevent flow separation along the inner walls, and no signs of a turbulent-like state are found. In line with previous imaging studies, a helical structure protruding into the right pulmonary artery is detected, and its formation mechanism is elucidated in the paper. These findings might help to identify abnormal flow features in patients with altered anatomic and physiologic states, particularly those with repaired congenital heart disease.

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Section: Global Flow Featuresmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Blood Flow Dynamics at the Pulmonary Artery Bifurcation

Capuano

Loke

Balaras

2019

Fluids

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“…By matching closely computational predictions with experimental results, we can develop more complex models of the pulmonary arterial network with the objective of addressing, on a patient-specific basis, the potential role of computational hemodynamics as an aid to right heart catheterization in the diagnosis or follow-up of PH patients. A recent study by Zhang et al 51 reports on the three-dimensional reconstruction of the MPA from patient-specific images and the use of CFD for such reconstructed models. They analyzed the effect of different LPA angulations on the MPA hemodynamics and found that acute angulation of the LPA is associated with adverse hemodynamic performance.…”

Section: Discussionmentioning

confidence: 99%

Computational Fluid Dynamics Modeling of the Human Pulmonary Arteries with Experimental Validation

et al. 2018

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Pulmonary hypertension (PH) is a chronic progressive disease characterized by elevated pulmonary arterial pressure, caused by an increase in pulmonary arterial impedance. Computational fluid dynamics (CFD) can be used to identify metrics representative of the stage of PH disease. However, experimental validation of CFD models is often not pursued due to the geometric complexity of the model or uncertainties in the reproduction of the required flow conditions. The goal of this work is to validate experimentally a CFD model of a pulmonary artery phantom using a particle image velocimetry (PIV) technique. Rapid prototyping was used for the construction of the patient-specific pulmonary geometry, derived from chest computed tomography angiography images. CFD simulations were performed with the pulmonary model with a Reynolds number matching those of the experiments. Flow rates, the velocity field, and shear stress distributions obtained with the CFD simulations were compared to their counterparts from the PIV flow visualization experiments. Computationally predicted flow rates were within 1% of the experimental measurements for three of the four branches of the CFD model. The mean velocities in four transversal planes of study were within 5.9 to 13.1% of the experimental mean velocities. Shear stresses were qualitatively similar between the two methods with some discrepancies in the regions of high velocity gradients. The fluid flow differences between the CFD model and the PIV phantom are attributed to experimental inaccuracies and the relative compliance of the phantom. This comparative analysis yielded valuable information on the accuracy of CFD predicted hemodynamics in pulmonary circulation models.

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“…Many of those studies have concentrated mainly on assessment of shear stress (9, 10). Nevertheless, it has been shown that increased energy loss (EL) is closely related to the long-term outcome of patients (11)(12)(13).…”

Section: Introductionmentioning

confidence: 99%

Medical Image-Based Hemodynamic Analyses in a Study of the Pulmonary Artery in Children With Pulmonary Hypertension Related to Congenital Heart Disease

Wang

Liu

et al. 2020

Front. Pediatr.

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Objective: Pulmonary hypertension related to congenital heart disease (PH-CHD) is a devastating disease caused by hemodynamic disorders. Previous hemodynamic research in PH-CHD mainly focused on wall shear stress (WSS). However, energy loss (EL) is a vital parameter in evaluation of hemodynamic status. We investigated if EL of the pulmonary artery (PA) is a potential biomechanical marker for comprehensive assessment of PH-CHD.Materials and Methods: Ten PH-CHD patients and 10 age-matched controls were enrolled. Subject-specific 3-D PA models were reconstructed based on computed tomography. Transient flow, WSS, and EL in the PA were calculated using non-invasive computational fluid dynamics. The relationship between body surface area (BSA)-normalized EL (E.) and PA morphology and PA flow were analyzed.Results: Morphologic analysis indicated that the BSA-normalized main PA (MPA) diameter (DMPAnorm), MPA/aorta diameter ratio (DMPA/DAO), and MPA/(left PA + right PA) [DMPA/D(LPA+RPA)] diameter ratio were significantly larger in PH-CHD patients. Hemodynamic results showed that the velocity of the PA branches was higher in PH-CHD patients, in whom PA flow rate usually increased. WSS in the MPA was lower and E. was higher in PH-CHD patients. E. was positively correlated with DMPAnorm, DMPA/DAO, and DMPA/D(LPA+RPA) ratios and the flow rate in the PA. E. was a sensitive index for the diagnosis of PH-CHD.Conclusion:E. is a potential biomechanical marker for PH-CHD assessment. This hemodynamic parameter may lead to new directions for revealing the potential pathophysiologic mechanism of PH-CHD.

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Computational haemodynamic analysis of left pulmonary artery angulation effects on pulmonary blood flow

Abstract: Acute LPA angulation is associated with adverse haemodynamic performance. This should be particularly addressed during the reconstruction of pulmonary artery in the repair of tetralogy of Fallot.

Cited by 29 publications

References 20 publications

Blood Flow Dynamics at the Pulmonary Artery Bifurcation

Blood Flow Dynamics at the Pulmonary Artery Bifurcation

Computational Fluid Dynamics Modeling of the Human Pulmonary Arteries with Experimental Validation

Medical Image-Based Hemodynamic Analyses in a Study of the Pulmonary Artery in Children With Pulmonary Hypertension Related to Congenital Heart Disease

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