Supporting information may be found in the online version of this article.
Treatment planning for a TCPC test case: A numerical investigation under rigid and moving wall assumptions†
Article first published online: 29 SEP 2012
Copyright © 2012 John Wiley & Sons, Ltd.
International Journal for Numerical Methods in Biomedical Engineering
Special Issue: Patient Specific Modelling
Volume 29, Issue 2, pages 197–216, February 2013
How to Cite
Mirabella, L., Haggerty, C. M., Passerini, T., Piccinelli, M., Powell, A. J., Del Nido, P. J., Veneziani, A. and Yoganathan, A. P. (2013), Treatment planning for a TCPC test case: A numerical investigation under rigid and moving wall assumptions. Int. J. Numer. Meth. Biomed. Engng., 29: 197–216. doi: 10.1002/cnm.2517
- Issue published online: 5 FEB 2013
- Article first published online: 29 SEP 2012
- Manuscript Revised: 17 AUG 2012
- Manuscript Received: 14 MAY 2012
- National Heart, Lung, and Blood Institute. Grant Number: R01HL098252
- total cavopulmonary connection TCPC;
- computational fluid dynamics CFD;
- moving wall;
- surgical planning;
- MRI-based displacement;
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.