Evaluation of pulmonary artery stenosis in congenital heart disease patients using functional diagnostic parameters: An in vitro study

D’Souza, Gavin A.; Banerjee, Rupak K.; Taylor, Michael D.

doi:10.1016/j.jbiomech.2018.09.014

Cited by 9 publications

(6 citation statements)

References 49 publications

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“…Hence, numerical modeling can help the surgeon in the choosing optimal choice of shunt size based on the individual patient. D'Souza et al [8] showed that the RPA/LPA flow is not symmetric in all shunt configurations. In particular, the CS configuration causes nonsymmetric pulmonary artery flow in favor of LPA for all shunt sizes studied, which is consistent with our study.…”

Section: Discussionmentioning

confidence: 99%

“…where p, ρ, v, and Q indicate the static pressure, density of blood, mean velocity, and volumetric flow rate, respectively. An important purpose of SPS is to promote the symmetric development of the PA without causing congestive heart failure [8], which is evaluated by LPA/RPA flow split (Q LPA/RPA ).…”

Section: Hemodynamic Parametermentioning

confidence: 99%

“…Studies have shown that abnormal hemodynamic factors could lead a series of complications such as thrombosis [6]. At the same time, hemodynamics has strong geometric sensitivity [7,8]. Hemodynamics parameters such as LPR/RPA flow split, power loss, and so forth will be greatly affected by shunt diameters and pulmonary artery stenosis.…”

Section: Introductionmentioning

confidence: 99%

“…Piskin et al [10] studied the hemodynamics of different shunt configurations and diameters in patients with PA atresia. D'Souza et al [8] used in vitro methods to evaluate the pathophysiologic hemodynamics of a PA stenosis with varying degrees of severity. ese studies focused on the hemodynamics of PA atresia or an idealized geometric model but failed to describe local fluid dynamics and the influence of shunt diameter and different degrees of PA stenosis.…”

Section: Introductionmentioning

confidence: 99%

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3D Simulation Analysis of Central Shunt in Patient-Specific Hemodynamics: Effects of Varying Degree of Pulmonary Artery Stenosis and Shunt Diameters

Liu

Yuan

Zhang

et al. 2020

Computational and Mathematical Methods in Medicine

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The objective of this study was to compare the effects of different shunt diameters and pulmonary artery (PA) stenosis grades on the hemodynamics of central shunts to determine an optimal surgical plan and improve the long-term outcomes of the operation. A 3D anatomical model was reconstructed based on the patient’s clinical CT data. 3D computational fluid dynamics models were built with varying degrees of stenosis (the stenosis ratio α was represented by the ratio of blood flow through the main pulmonary artery to cardiac output, ranging from 0 to 30%; the smaller the value of α, the more severe the pulmonary artery stenosis) and varying shunt diameters (3, 3.5, 4, 4.5, and 5 mm). Our results show that the asymmetry of pulmonary artery flow increased with increasing shunt diameter and α, which will be more conducive to the development of the left pulmonary artery. Additionally, the pulmonary-to-systemic flow ratio (QP/QS) increases with the shunt diameter and α, and all the values exceed 1. When the shunt diameter is 3 mm and α = 0%, QP/QS reaches the minimum value of 1.01, and the oxygen delivery reaches the maximum value of 205.19 ml/min. However, increasing shunt diameter and α is beneficial to reduced power loss and smoother PA flow. In short, for patients with severe PA stenosis (α is small), a larger-diameter shunt may be preferred. Conversely, when the degree of PA stenosis is moderate, a smaller shunt diameter can be considered.

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Section: Discussionmentioning

confidence: 99%

Section: Hemodynamic Parametermentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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3D Simulation Analysis of Central Shunt in Patient-Specific Hemodynamics: Effects of Varying Degree of Pulmonary Artery Stenosis and Shunt Diameters

Liu

Yuan

Zhang

et al. 2020

Computational and Mathematical Methods in Medicine

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“…Early studies on hemodynamics in PH focused mainly on the metric of WSS, its action on vascular morphology/function, and disease progression. However, several other hemodynamics studies have shown that EL is a key factor in evaluation of hemodynamic disorders (23)(24)(25).…”

Section: Discussionmentioning

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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Simulating Radial Pressure Waveforms with a Mock Circulatory Flow Loop to Characterize Hemodynamic Monitoring Systems

Packy

D’Souza

Farahmand

et al. 2021

Cardiovasc Eng Tech

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Evaluation of pulmonary artery stenosis in congenital heart disease patients using functional diagnostic parameters: An in vitro study

Cited by 9 publications

References 49 publications

3D Simulation Analysis of Central Shunt in Patient-Specific Hemodynamics: Effects of Varying Degree of Pulmonary Artery Stenosis and Shunt Diameters

3D Simulation Analysis of Central Shunt in Patient-Specific Hemodynamics: Effects of Varying Degree of Pulmonary Artery Stenosis and Shunt Diameters

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

Simulating Radial Pressure Waveforms with a Mock Circulatory Flow Loop to Characterize Hemodynamic Monitoring Systems

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