Computational fluid dynamics in the evaluation of hemodynamic performance of cavopulmonary connections after the norwood procedure for hypoplastic left heart syndrome

Bove, Edward L.; Leval, Marc R. de; Migliavacca, Francesco; Guadagni, Gualtiero; Dubini, Gabriele

doi:10.1016/s0022-5223(03)00698-6

Cited by 154 publications

(80 citation statements)

References 22 publications

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“…This last conclusion was confirmed also in successive studies (Khunatorn et al 2002;Migliavacca et al 1999b;Ryu et al 2001;Bove et al 2003). Most research on the TCPC so far has been done under the hypothesis of steady inlet flows, which is reasonable as they come from systemic venous districts.…”

Section: Modeling Of Vascular Anastomoses In Surgical Procedures For supporting

confidence: 54%

“…Right atrial contraction is usually considered not essential after the TCPC operation, but a certain degree of flow pulsatility may appear as a consequence of: (1) tethering of the intra or extra cardiac conduit due to heart contraction and (2) respiratory effects. As far as we know only few CFD quantitative studies have appeared which include transient flows (Migliavacca et al 1999a;DeGroff and Shandas 2002;Migliavacca et al 2003;Bove et al 2003). The local effects of pulsatile forward flow from the native pulmonary artery on blood flow distribution between the lungs in the BCPA have also been investigated (Migliavacca et al , 1997.…”

Section: Modeling Of Vascular Anastomoses In Surgical Procedures For mentioning

confidence: 99%

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Computational modeling of vascular anastomoses

Migliavacca

Dubini

2005

Biomech Model Mechanobiol

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Recent development of computational technology allows a level of knowledge of biomechanical factors in the healthy or pathological cardiovascular system that was unthinkable a few years ago. In particular, computational fluid dynamics (CFD) and computational structural (CS) analyses have been used to evaluate specific quantities, such as fluid and wall stresses and strains, which are very difficult to measure in vivo. Indeed, CFD and CS offer much more variability and resolution than in vitro and in vivo methods, yet computations must be validated by careful comparison with experimental and clinical data. The enormous parallel development of clinical imaging such as magnetic resonance or computed tomography opens a new way toward a detailed patient-specific description of the actual hemodynamics and structural behavior of living tissues. Coupling of CFD/CS and clinical images is becoming a standard evaluation that is expected to become part of the clinical practice in the diagnosis and in the surgical planning in advanced medical centers. This review focuses on computational studies of fluid and structural dynamics of a number of vascular anastomoses: the coronary bypass graft anastomoses, the arterial peripheral anastomoses, the arterio-venous graft anastomoses and the vascular anastomoses performed in the correction of congenital heart diseases.

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Section: Modeling Of Vascular Anastomoses In Surgical Procedures For supporting

confidence: 54%

Section: Modeling Of Vascular Anastomoses In Surgical Procedures For mentioning

confidence: 99%

Computational modeling of vascular anastomoses

Migliavacca

Dubini

2005

Biomech Model Mechanobiol

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“…Numerical techniques allow us to examine the effects of the geometry of the Fontan connection that plays an important role in the overall success of the surgery, and assess blood flow characteristics and energy losses associated with a given surgical design. There are numerous articles on the total cavopulmonary connection simulation (see, e.g., [7,11,22,25,26]) that do a very careful CFD analysis on complex patient-specific configurations in an attempt to answer some of these questions. Some of the earlier work in computational fluid dynamics applied to congenital heart disease compared energy loss in the standard "t" junction Fontan with the proposed "offset" model, and led to the adoption of the offset model as the currently preferred method [9,10,28,29].…”

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confidence: 99%

Computational fluid–structure interaction: methods and application to a total cavopulmonary connection

et al. 2009

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The Fontan procedure is a surgery that is performed on single-ventricle heart patients, and, due to the wide range of anatomies and variations among patients, lends itself nicely to study by advanced numerical methods. We focus on a patient-specific Fontan configuration, and perform a fully coupled fluid-structure interaction (FSI) analysis of hemodynamics and vessel wall motion. To enable physiologically realistic simulations, a simple approach to constructing a variable-thickness blood vessel wall description is proposed. Rest and exercise conditions are simulated and rigid versus flexible vessel wall simulation results are compared. We conclude that flexible wall modeling plays an important role in predicting quantities of hemodynamic interest in the Fontan connection. To the best of our knowledge, this paper presents the first three-dimensional patientspecific fully coupled FSI analysis of a total cavopulmonary connection that also includes large portions of the pulmonary circulation.

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“…CFD has also been employed to compare hydraulic performance between the hemi-Fontan and bidirectional Glenn procedures, as well as the various types of completion Fontan operations. 29) Based on 3D anatomical mesh models derived from image data of various sources, it was shown that the hemi-Fontan and bidirectional Glenn procedures performed almost identically, in spite of the fact that important differences in energy losses and flow distribution were found after the completion of Fontan procedure. Moreover, the lateral tunnel FO showed superior hydraulic performance after the hemi-Fontan, possibly due to closer to optimal caval offset achieved in the surgical reconstruction.…”

Section: Computational Fluid Dynamics Studiesmentioning

confidence: 99%

Evolution in Experimental Fontan Circulation: A Review

Kanakis

Lioulias

Samanidis

et al. 2013

ATCS

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Experimental right heart bypass operations have influenced the evolution of current application of the Fontan procedure. In this review, we summarize the evolution and progress of the experimental Fontan operation (FO) and discuss the questions raised so far. The evolution and progress of the experimental FO is analyzed in this review by collecting data retrieved from English literature research. The establishment of Fontan circulation on an experimental animal model is extremely difficult and until today, a chronic experimental model has never been described. Computational fluid dynamics (CFD) has played a significant role in the investigation of the hemodynamic characteristics of the FO and has been applied to the design and integration of the procedure. CFD was also employed to evaluate the performance of assisted Fontan circulation. Accumulated experience from the experimental studies and clinical practice, in combination with the cooperation of different fields in medicine and positive sciences, are definitely expected to help the evolution furthermore.

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Computational fluid dynamics in the evaluation of hemodynamic performance of cavopulmonary connections after the norwood procedure for hypoplastic left heart syndrome

Cited by 154 publications

References 22 publications

Computational modeling of vascular anastomoses

Computational modeling of vascular anastomoses

Computational fluid–structure interaction: methods and application to a total cavopulmonary connection

Evolution in Experimental Fontan Circulation: A Review

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