Characterization of Flow Dynamics in the Pulmonary Bifurcation of Patients With Repaired Tetralogy of Fallot: A Computational Approach

Frontiers in Cardiovascular Medicine

Maria Boumpouli¹  Asimina Kazakidi¹  Silvia Schievano²  Emilie L. Sauvage²  Claudio Capelli² 

[1] Department of Biomedical Engineering, University of Strathclyde, Glasgow, United Kingdom;Institute of Cardiovascular Science and Great Ormond Street Hospital for Children, NHS Foundation Trust, University College London, London, United Kingdom;

关键词: hemodynamics;    computational fluid dynamics;    congenital heart disease;    tetralogy of Fallot;    pulmonary bifurcation;   

DOI  :  10.3389/fcvm.2021.703717

来源: DOAJ

【 摘 要 】

The hemodynamic environment of the pulmonary bifurcation is of great importance for adult patients with repaired tetralogy of Fallot (rTOF) due to possible complications in the pulmonary valve and narrowing of the left pulmonary artery (LPA). The aim of this study was to computationally investigate the effect of geometrical variability and flow split on blood flow characteristics in the pulmonary trunk of patient-specific models. Data from a cohort of seven patients was used retrospectively and the pulmonary hemodynamics was investigated using averaged and MRI-derived patient-specific boundary conditions on the individualized models, as well as a statistical mean geometry. Geometrical analysis showed that curvature and tortuosity are higher in the LPA branch, compared to the right pulmonary artery (RPA), resulting in complex flow patterns in the LPA. The computational analysis also demonstrated high time-averaged wall shear stress (TAWSS) at the outer wall of the LPA and the wall of the RPA proximal to the junction. Similar TAWSS patterns were observed for averaged boundary conditions, except for a significantly modified flow split assigned at the outlets. Overall, this study enhances our understanding about the flow development in the pulmonary bifurcation of rTOF patients and associates some morphological characteristics with hemodynamic parameters, highlighting the importance of patient-specificity in the models. To confirm these findings, further studies are required with a bigger cohort of patients.

【 授权许可】

Unknown