Analysis of flow dynamics in right ventricular outflow tract

Area of Science:

• Cardiovascular Engineering
• Biomedical Fluid Dynamics
• Surgical Planning

Background:

• Early graft failure after right ventricular outflow tract (RVOT) reconstruction remains incompletely understood.
• Investigating hemodynamic conditions is crucial for understanding intimal hyperplasia and arteriosclerosis development.
• A three-dimensional computational fluid dynamics (CFD) model can simulate these conditions.

Purpose of the Study:

• To create a 3D CFD model of the RVOT.
• To investigate hemodynamic factors contributing to intimal hyperplasia and arteriosclerosis post-RVOT reconstruction.

Main Methods:

• Collected pressure, flow, and diameter data from 10 pigs (mean weight 24.8 kg) in the RVOT and pulmonary arteries (PAs).
• Utilized experimental data to simulate pressure, flow, and shear stress profiles using CFD from RVOT to left and right PAs.
• Developed CFD models for 2.0 and 2.5-L/min pulsatile inflow profiles.

Main Results:

• Low shear stress (0-6.0 Pa) and high pressure (14.0-20.0 mm Hg) regions were identified in the pulmonary trunk, bifurcation, and PA openings.
• Turbulent flow patterns were observed at the PA bifurcation and ostia.
• These hemodynamic conditions were consistent across both simulated inflow profiles.

Conclusions:

• Local low shear stress, high pressure, and turbulent flow patterns are identified as triggers for intimal hyperplasia and arteriosclerosis.
• The developed 3D CFD model offers a potential tool for planning, analyzing, and predicting outcomes of RVOT reconstruction.
• This approach may improve the long-term success of RVOT reconstruction procedures.