Treatment planning for a TCPC test case: A numerical investigation under rigid and moving wall assumptions

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 im...

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Published inInternational journal for numerical methods in biomedical engineering Vol. 29; no. 2; pp. 197 - 216
Main Authors Mirabella, Lucia, Haggerty, Christopher M., Passerini, Tiziano, Piccinelli, Marina, Powell, Andrew J., Del Nido, Pedro J., Veneziani, Alessandro, Yoganathan, Ajit P.
Format Journal Article
LanguageEnglish
Published Chichester, UK John Wiley & Sons, Ltd 01.02.2013
Wiley Subscription Services, Inc
Subjects
Algorithms
Blood Flow Velocity
Child
computational fluid dynamics CFD
Computer Simulation
fenestration
Fontan Procedure
Heart Defects, Congenital - diagnostic imaging
Heart Defects, Congenital - surgery
Heart Defects, Congenital - therapy
Hemodynamics
Humans
Magnetic Resonance Imaging
Models, Cardiovascular
moving wall
MRI-based displacement
Pulmonary Artery - diagnostic imaging
Pulmonary Artery - surgery
Radiography
surgical planning
total cavopulmonary connection TCPC
Online AccessGet full text
ISSN2040-7939
2040-7947
2040-7947
DOI10.1002/cnm.2517

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Abstract 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. In this work, we simulate three types of intervention on a Fontan patient case study, and compare their predicted outcome with baseline conditions: decrease in pulmonary vascular resistance; surgical revision of the connection design; and introduction of a fenestration in the vessel wall. The simulations are performed both with rigid wall assumption and including patient‐specific wall motion, reconstructed from a 4DMRI data set. The results show the effect of each option on clinically important metrics and highlight the impact of patient‐specific wall motion.
AbstractList 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.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.
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.
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.
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. In this work, we simulate three types of intervention on a Fontan patient case study, and compare their predicted outcome with baseline conditions: decrease in pulmonary vascular resistance; surgical revision of the connection design; and introduction of a fenestration in the vessel wall. The simulations are performed both with rigid wall assumption and including patient‐specific wall motion, reconstructed from a 4DMRI data set. The results show the effect of each option on clinically important metrics and highlight the impact of patient‐specific wall motion.
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.
Author Haggerty, Christopher M.
Piccinelli, Marina
Powell, Andrew J.
Veneziani, Alessandro
Mirabella, Lucia
Yoganathan, Ajit P.
Passerini, Tiziano
Del Nido, Pedro J.
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  fullname: Yoganathan, Ajit P.
  email: Correspondence to: Ajit P. Yoganathan, Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology & Emory University, 313 Ferst Drive, Atlanta, GA 30332, U.S.A., ajit.yoganathan@bme.gatech.edu
  organization: Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology & Emory University, GA, Atlanta, U.S.A
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Whitehead KK, Pekkan K, Kitajima HD, Paridon SM, Yoganathan AP, Fogel MA. Nonlinear power loss during exercise in single-ventricle patients after the Fontan: insights from computational fluid dynamics. Circulation 2007; 116(11):I165-I171.
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Haggerty CM, de Zélicourt DA, Sundareswaran KS, Pekkan K, Whited B, Rossignac JR, Fogel MA, Yoganathan AP. Hemodynamic assessment of virtual surgery options for a failing Fontan using lumped parameter simulation. Computers in Cardiology 2009; 2009:389-392.
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Snippet SUMMARY The hemodynamics in patients with total cavopulmonary connections (TCPC) is generally very complex and characterized by patient‐to‐patient variability....
The hemodynamics in patients with total cavopulmonary connections (TCPC) is generally very complex and characterized by patient‐to‐patient variability. To...
The hemodynamics in patients with total cavopulmonary connections (TCPC) is generally very complex and characterized by patient-to-patient variability. To...
SUMMARY The hemodynamics in patients with total cavopulmonary connections (TCPC) is generally very complex and characterized by patient-to-patient variability....
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SubjectTerms Algorithms
Blood Flow Velocity
Child
computational fluid dynamics CFD
Computer Simulation
fenestration
Fontan Procedure
Heart Defects, Congenital - diagnostic imaging
Heart Defects, Congenital - surgery
Heart Defects, Congenital - therapy
Hemodynamics
Humans
Magnetic Resonance Imaging
Models, Cardiovascular
moving wall
MRI-based displacement
Pulmonary Artery - diagnostic imaging
Pulmonary Artery - surgery
Radiography
surgical planning
total cavopulmonary connection TCPC
Title Treatment planning for a TCPC test case: A numerical investigation under rigid and moving wall assumptions
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https://www.ncbi.nlm.nih.gov/pubmed/23345252
https://www.proquest.com/docview/1710187666
https://www.proquest.com/docview/1285079542
Volume 29
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