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Author Notes:

Ajit P. Yoganathan, Associate Chair, Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, 313 Ferst Drive, BME Building, Room 2119, Atlanta, GA 30332-0535, Phone: 404-894-2849, Fax: 404-894-4243, ajit.yoganathan@bme.gatech.edu.

There is no conflict of interest.

Subjects:

Research Funding:

This study was supported by the National Heart, Lung, and Blood Institute Grants HL67622 and R01HL098252.

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Technology
  • Biophysics
  • Engineering, Biomedical
  • Engineering
  • Fontan procedure
  • Total cavopulmonary connection
  • Computational fluid dynamics
  • Pulsatile modeling
  • FONTAN PROCEDURE
  • RECONSTRUCTION
  • SIMULATIONS
  • INTERPOLATION
  • ANATOMIES
  • EXERCISE

Effect of Flow Pulsatility on Modeling the Hemodynamics in the Total Cavopulmonary Connection

Tools:

Journal Title:

Journal of Biomechanical Engineering

Volume:

Volume 45, Number 14

Publisher:

, Pages 2376-2381

Type of Work:

Article | Post-print: After Peer Review

Abstract:

Total cavopulmonary connection is the result of a series of palliative surgical repairs performed on patients with single ventricle heart defects. The resulting anatomy has complex and unsteady hemodynamics characterized by flow mixing and flow separation. Although varying degrees of flow pulsatility have been observed in vivo, non-pulsatile (time-averaged) boundary conditions have traditionally been assumed in hemodynamic modeling, and only recently have pulsatile conditions been incorporated without completely characterizing their effect or importance. In this study, 3D numerical simulations with both pulsatile and non-pulsatile boundary conditions were performed for 24 patients with different anatomies and flow boundary conditions from Georgia Tech database. Flow structures, energy dissipation rates and pressure drops were compared under rest and simulated exercise conditions. It was found that flow pulsatility is the primary factor in determining the appropriate choice of boundary conditions, whereas the anatomic configuration and cardiac output had secondary effects. Results show that the hemodynamics can be strongly influenced by the presence of pulsatile flow. However, there was a minimum pulsatility threshold, identified by defining a weighted pulsatility index (wPI), above which the influence was significant. It was shown that when wPI < 30%, the relative error in hemodynamic predictions using time-averaged boundary conditions was less than 10% compared to pulsatile simulations. In addition, when wPI < 50, the relative error was less than 20%. A correlation was introduced to relate wPI to the relative error in predicting the flow metrics with non-pulsatile flow conditions.

Copyright information:

© 2012 Elsevier Ltd.

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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