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Numerical investigation of Antegrade Flow effects on fl ow pulsations in Fontan operation

Ghoreyshi, M ; Sharif University of Technology | 2012

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  1. Type of Document: Article
  2. DOI: 10.1504/IJBET.2012.050291
  3. Publisher: 2012
  4. Abstract:
  5. This study considers blood fl ow in Total Cavopulmonary Connection (TCPC) morphology, created in Fontan surgical procedure in patients with single ventricle heart disease. Ordinary process of TCPC operation reduces pulmonary blood fl ow pulsatility; because of right ventricle being bypassed. This reduction may limit the long term outcome of Fontan circulation. There is an idea stating that keeping Main Pulmonary Artery (MPA) partially open, would increase pulmonary fl ow pulsations. MPA gets closed in ordinary TCPC operation. The purpose of current study is to verify effects of Antegrade Flow (AF) coming through stenosed MPA on pulmonary fl ow pulsations, by means of Computational Fluid Dynamics (CFD). The 3-D geometry is reconstructed from CT Angiography (CTA) scan of a patient who has undergone an ordinary TCPC procedure. The stenosed MPA or Pulmonary Stenosis (PS) is virtually added to the original geometry. Inlet velocity profi les are obtained from Echocardiography data of the same patient. AF profi le in a cardiac cycle is obtained from a general pressure cycle of left ventricle, assuming a linear relationship between pressure gradient and fl ow rate in PS. Flow fi eld is studied in six different models in which average AF increasingly changes from 0 to 14% of total cardiac fl ow, using FLUENT. The results show that adding AF increases Pulsatility Index (PI) in both left and right pulmonary artery (LPA and RPA respectively), with a maximum amount of 140% in LPA. Moreover, adding AF leads to an increase in energy loss of the TCPC region, with a maximum amount of 67%. The addition of AF also increases pulmonaryto- systemic fl ow ratio which leads to an increase in total cardiac fl ow rate and hence heart power
  6. Keywords:
  7. Computational fluid dynamics ; Flow pulsations; AF ; Total cavopulmonary connection; CFD ; Antegrade fl ow ; Flow pulsation ; Fontan operation ; TCPC ; Total cavopulmonary connection ; Blood ; Computerized tomography ; Echocardiography ; Energy dissipation ; Heart ; Computational fluid dynamics
  8. Source: International Journal of Biomedical Engineering and Technology ; Volume 10, Issue 3 , 2012 , Pages 221-238 ; 17526418 (ISSN)
  9. URL: http://www.inderscience.com/offer.php?id=50291