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Multiblock High Order Large Eddy Simulation of Powered Fontan Hemodynamics: Towards Computational Surgery.

Yann T Delorme1, Mark D Rodefeld2, Steven H Frankel1

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|June 27, 2017
PubMed
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Children with single ventricle defects need Fontan circulation, which is inefficient. This study uses CFD to test a novel pump implant designed to improve blood flow and restore normal circulation, offering hope for better long-term outcomes.

Keywords:
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Area of Science:

  • Biomedical Engineering
  • Cardiovascular Physiology
  • Computational Fluid Dynamics

Background:

  • Single ventricle congenital heart defects necessitate Fontan circulation, a palliative procedure with inherent circulatory inefficiencies and long-term risks.
  • Current management focuses on optimizing the Total Cavopulmonary Connection (TCPC) or employing mechanical support.
  • A novel implantable pump is proposed to augment pressure within the TCPC, aiming to restore a two-ventricle-like circulation.

Purpose of the Study:

  • To evaluate the hemodynamic performance of a proposed vaned impeller pump for Fontan circulation.
  • To investigate the flow dynamics within a patient-specific Total Cavopulmonary Connection (TCPC) with and without the novel mechanical support.
  • To assess the feasibility of using Computational Fluid Dynamics (CFD) for simulating blood flow in complex, patient-specific cardiovascular geometries.

Main Methods:

  • Development of an in-house high-order Large Eddy Simulation (LES) solver coupled with an Immersed Boundary Method (IBM) for complex geometries.
  • Implementation of multiblock capabilities for efficient simulation of patient-specific TCPC models.
  • Performing CFD simulations of blood flow in a patient-specific TCPC, including scenarios with virtual implantation of temporary and chronic pump designs.

Main Results:

  • Detailed analysis of instantaneous flow structures and hepatic flow distribution under different simulated conditions.
  • Quantitative assessment of hemodynamic parameters with and without the proposed mechanical circulatory support.
  • Validation of CFD as a powerful tool for evaluating novel cardiovascular device designs and patient-specific hemodynamics.

Conclusions:

  • The developed CFD framework, incorporating LES and IBM, is capable of simulating complex, unsteady blood flow in patient-specific TCPC geometries.
  • The proposed vaned impeller pump shows potential for augmenting pressure and improving hemodynamic efficiency in Fontan circulation.
  • CFD simulations provide crucial insights for the design and optimization of mechanical circulatory support devices for single ventricle physiology.