Premium
Treatment planning for a TCPC test case: A numerical investigation under rigid and moving wall assumptions
Author(s) -
Mirabella Lucia,
Haggerty Christopher M.,
Passerini Tiziano,
Piccinelli Marina,
Powell Andrew J.,
Del Nido Pedro J.,
Veneziani Alessandro,
Yoganathan Ajit P.
Publication year - 2013
Publication title -
international journal for numerical methods in biomedical engineering
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.741
H-Index - 63
eISSN - 2040-7947
pISSN - 2040-7939
DOI - 10.1002/cnm.2517
Subject(s) - test (biology) , structural engineering , mechanics , computer science , engineering , geology , physics , paleontology
SUMMARY The hemodynamics in patients with total cavopulmonary connections (TCPC) is generally very complex and characterized by patient‐to‐patient variability. To better understand its effect on patients’ outcome, CFD models are widely used, also to test and optimize surgical options before their implementation. These models often assume rigid geometries, despite the motion experienced by thoracic vessels that could influence the hemodynamics predictions. By improving their accuracy and expanding the range of simulated interventions, the benefit of treatment planning for patients is expected to increase. We simulate three types of intervention on a patient‐specific 3D model, and compare their predicted outcome with baseline condition: a decrease in pulmonary vascular resistance obtainable with medications; a surgical revision of the connection design; the introduction of a fenestration in the TCPC wall. The simulations are performed both with rigid wall assumption and including patient‐specific TCPC wall motion, reconstructed from a 4DMRI dataset. The results show the effect of each option on clinically important metrics and highlight the impact of patient‐specific wall motion. The largest differences between rigid and moving wall models are observed in measures of energetic efficiency of TCPC as well as in hepatic flow distribution and transit time of seeded particles through the connection.Copyright © 2012 John Wiley & Sons, Ltd.