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Applications of computational fluid dynamics to congenital heart diseases: a practical review for cardiovascular
Gianluca Rigatelli1, Claudio Chiastra2, Giancarlo Pennati3
1Cardiovascular Diagnosis and Endoluminal Interventions Unit, Rovigo General Hospital, Rovigo, Italy.
Insights
Computational fluid dynamics (CFD) helps understand abnormal blood flow in congenital heart disease (CHD). This technique aids in planning interventions and improving patient outcomes for complex cardiac conditions.
Area of Science:
- Cardiovascular Imaging and Hemodynamics
- Medical Simulation and Computational Modeling
Background:
- Increasing survival rates in congenital heart disease (CHD) necessitate lifelong patient monitoring and interventions.
- Abnormal blood flow patterns are common in CHD patients due to intrinsic defects and surgical repairs.
Purpose of the Study:
- To evaluate the role of computational fluid dynamics (CFD) in assessing blood flow in CHD.
- To explore CFD's utility in understanding CHD pathophysiology and predicting surgical outcomes.
Main Methods:
- Utilizing computational fluid dynamics (CFD) coupled with advanced imaging (CT, MRI, 3/4D ultrasound).
- Creating virtual reconstructions and simulations of patient-specific circulatory models for CHD.
- Applying physics-based principles to quantify and describe fluid flow characteristics.
Main Results:
- CFD enables detailed assessment of blood flow patterns in various CHD conditions.
- Simulations can anticipate the results of surgical or interventional procedures.
- Patient-specific data allows for accurate virtual circulation models.
Conclusions:
- CFD provides critical insights into the pathophysiology of complex CHDs like coronary artery anomalies, interatrial shunts, coarctation of the aorta, bicuspid aortic valve, Tetralogy of Fallot, and univentricular heart.
- CFD facilitates the simulation of different treatment strategies.
- This approach supports personalized treatment planning for CHD patients.
Introduction:
The increased survival rate of patients with congenital heart disease (CHD) has made it likely that 70%-95% of infants with CHDs surviving into adulthood often require careful follow-up and (repeat) interventions. Patients with CHDs often have abnormal blood flow patterns, due to both primary cardiac defect and the consequent surgical or endovascular repair.
Area Covered:
Computational fluid dynamics (CFD) alone or coupled with advanced imaging tools can assess blood flow patterns of CHDs to both understand their pathophysiology and anticipate the results of surgical or interventional repair.
Expert Opinion:
CFD is a mathematical technique that quantifies and describes the characteristics of fluid flow using the laws of physics. Through dedicated software based on virtual reconstruction and simulation and patients' real data coming from computed tomography, magnetic resonance imaging, and 3/4 D-ultrasound, reconstruction of models of circulation of most CHD can be accomplished. CFD can provide insights about the pathophysiology of coronary artery anomalies, interatrial shunts, coarctation of the aorta and aortic bicuspid valve, tetralogy of Fallot and univentricular heart, with the capability in some cases of simulating different types of surgical or interventional repair and tailoring the treatment on the basis of these findings.
