Numerical Simulation of the Influence of Geometric Configurations on Pressure Difference in the Intraventricular Tunnel

Yang, Yao; Wang, Junjie; Qiao, Aike; Fan, Xiaoxuan

doi:10.3389/fphys.2020.00133

Cited by 6 publications

(5 citation statements)

References 20 publications

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“…26 Both cMRI/CT are both excellent tools in this context, with CT providing the best spatial resolution for small vessels such as coronary arteries 26 and cMRI complementing the assessment for biventricular size/function, differential pulmonary blood flow and myocardial scarring. 27 Bioengineering research has also augmented flow visualization with computational fluid dynamic simulation, using cMRI/CT data to bridge our understanding between postoperative anatomy and physiology 28; for example, computational studies have investigated abnormal patchbaffle angle in subaortic stenosis, 29 abnormal bending and flow separation in post-Lecompte pulmonary arteries, 30 or abnormal vortex formation from pulmonary insufficiency. 31 These simulated flow features, with very high spatial and temporal resolution, can be quantified as parameters such as turbulent kinetic energy, 30,32 wall shear stress, 33 vorticity and energy loss, 34,35 which in turn could also be detected in vivo by 4D flow 10 (Figs.…”

Section: Double Outlet Right Ventricle (Dorv) Including Tof-type and ...mentioning

confidence: 99%

Congenital Heart Disease Illustrated

Loke

Gupta

Mandell

et al. 2023

Journal of Thoracic Imaging

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In the modern era of cardiac imaging, there is increasing use of cardiac computed tomography and cardiac magnetic resonance for visualization of congenital heart disease (CHD). Advanced visualization techniques such as virtual dissection, 3-dimensional modeling, and 4-dimensional flow are also commonly used in clinical practice. This review highlights such methods in five common forms of CHD, including double outlet right ventricle, common arterial trunk, sinus venosus defects, Tetralogy of Fallot variants, and heterotaxy, providing visualizations of pathology in both conventional and novel formats.

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Section: Double Outlet Right Ventricle (Dorv) Including Tof-type and ...mentioning

confidence: 99%

Congenital Heart Disease Illustrated

Loke

Gupta

Mandell

et al. 2023

Journal of Thoracic Imaging

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“…The turning radius of the intraventricular tunnel is the main factor, affecting the pressure difference. A small turning radius of the intraventricular tunnel will lead to a large pressure difference in the intraventricular tunnel [Yang 2020]. The surgical techniques used for SSS repair include the extended septoplasty and the fibromuscular resection.…”

Section: E111mentioning

confidence: 99%

Surgical Repair of Secondary Subaortic Stenosis in Congenital Heart Disease Without Initial Subaortic Obstruction

Cao

Fan

2022

HSF

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Background: Secondary subaortic stenosis (SSS) is a rare heart disease of the left ventricular outflow tract (LVOT). It usually occurs after cardiovascular correction with or without initial left ventricular outflow tract obstruction (LVOTO). Because most patients with SSS are asymptomatic, many do not realize the need for reoperation until the obstruction worsens. Few studies suggest the characteristics and reasons of SSS without initial SAS. We conducted a retrospective study to describe the characteristics and surgical outcomes of these patients. Methods: In this study, we examined a single-center retrospective cohort of SSS patients without initial SAS undergoing resection from 2010 to 2019. Patients are defined as secondary subaortic obstruction requiring surgery after cardiovascular correction. Demographics, perioperative findings, and clinical data were analyzed. Results: Twenty-three patients had undergone secondary cardiac surgery for SSS without initial SAS during 10 years in our center. The median age at operation was 7.3 (4.0-13.5) years. In this study, the most commonly associated cardiac lesions were ventricular septal defect (VSD), atrioventricular septal defect (AVSD), patent ductus arteriosus (PDA), and coarctation arch hypoplasia (COA). The surgical techniques included membranous resection of five patients, fibromuscular resection of 17 patients, and reconstruction of the intraventricular baffle of one patient. The results of surgery in these patients are satisfied. The average LVOT gradient at the last follow up was 14.9 (7.8-26.2) mmHg. There was no operative mortality. Two patients had postoperative complications. The median follow-up period was 2.9 (1.1-4.3) years with one late death. Two patients (8.7%) had recurrence of stenosis. Conclusions: Secondary subaortic stenosis is an uncommon heart disease. The reason is related to several causes, including missed diagnosis, unnoticed abnormalities of LVOT, and further changes of geometric morphology by intracardiac surgery. The results of surgery in these patients are satisfied. However, the recurrence of stenosis is still frequent.

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“…In this regard, the recent advances in high resolution cross-sectional imaging, along with threedimensional anatomical reconstruction and printing, have also generated a series of articles highlighting their usefulness in planning the surgical approach for the repair (40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50). Others have evaluated the numerical simulations obtained with various geometric configurations (51,52).…”

Section: Irrespective Of the Precise Definition An Extensive Numbermentioning

confidence: 99%

“…One of the criteria utilized in the past to define the suitability of a ventricular chamber to sustain either the systemic or pulmonary circulation was the size of its respective atrioventricular valve, which should be within 2 standard deviations of the normal values. Nowadays, segmentation of the ventricular cavities from electrocardiographicallygated cardiac computed tomographic scans, or magnetic resonance imaging data (42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52), allows for the calculation of the right and ventricular volumes indexed for the patient body surface area. Using three-dimensional anatomical reconstruction software, it is now possible to simulate the planned ventricular septation.…”

Section: Ventricular Sizementioning

confidence: 99%

Narrative review of assessing the surgical options for double outlet right ventricle

2021

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The individualized surgical approach in individuals with both arterial trunks arising from the morphologically right ventricle is dictated by the extreme morphological variability encountered in this setting, with each patient being unique. An individualized surgical approach has been designed to take account of the morphological variations, identifying the anatomy with the preoperative three-dimensional CT scan reconstruction. The key features have been considered the distance between tricuspid and pulmonary valves, the size and location of the interventricular communication, and the relationship between the outflow tracts. The surgical approach is tailored, whenever feasible, to create a connection between left ventricle and aorta, but primarily to achieve biventricular repair. Account has been taken of all available surgical options already reported in the literature, identifying the most suitable to provide the best outcomes for each unique morphology. To date, meaningful comparison between different reported surgical series has been difficult because of the marked variation of individual intracardiac morphology, and the lack of reports of specific surgical approaches for well-categorized groups of patients. Our approach, being tailored to the individual cardiac morphology, can be offered to any patient with this ventriculo-arterial connection.Given the difficulties of diagnosis, and the multiple therapeutic indications, very close collaboration between cardiologists and surgeons is indispensable for further progress in the understanding and management of this complex congenital cardiac lesion.

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Numerical Simulation of the Influence of Geometric Configurations on Pressure Difference in the Intraventricular Tunnel

Cited by 6 publications

References 20 publications

Congenital Heart Disease Illustrated

Congenital Heart Disease Illustrated

Surgical Repair of Secondary Subaortic Stenosis in Congenital Heart Disease Without Initial Subaortic Obstruction

Narrative review of assessing the surgical options for double outlet right ventricle

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