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Multiscale modeling of a modified Blalock‐Taussig surgery in a patient‐specific tetralogy of Fallot
Author(s) -
Keramati Hamed,
Houts Lex,
Chen Ching Kit,
Vosse Frans,
Nakao Masakazu,
Kim Sangho,
Leo Hwa Liang
Publication year - 2021
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.3436
Subject(s) - tetralogy of fallot , shunt (medical) , pulmonary artery , cardiology , diastole , shear stress , mechanics , medicine , physics , blood pressure , heart disease
Tetralogy of Fallot (TOF) is a congenital heart anomaly that causes a drastic reduction in the oxygen level. In this study, we coupled a lumped‐parameter model with a patient‐specific three‐dimensional (3D) model which included a modified Blalock‐Taussig (MBT) shunt. By forming a closed loop, we investigated the effects of certain parameters on the flow rates and the pressures at different locations of the developed network. A local sensitivity analysis on an initial zero‐dimensional (0D) closed‐loop model was conducted. The 0D lumped parameter (LP) model was then refined based on the results of the multiscale 0D‐3D model and the local sensitivity analysis was repeated for the refined 0D model. It was shown that the maximum pressure of the pulmonary bed had the highest sensitivity of 94% to the diameter of MBT shunt. We observed that the existence of the flow in the shunt during the diastole caused an elevated wall shear stress (WSS) in the pulmonary artery. In this work, we calculated the flow velocity and pressure field in a 3D patient‐specific aorta with an MBT shunt, and then we used the results to increase the accuracy of our LP model to simulate numerous 0D simulations in a significantly shorter time, which is potentially applicable for medical decision‐making.