In Vitro Flow Analysis of a Patient-Specific Intraatrial Total Cavopulmonary Connection

2005 ◽  
Vol 79 (6) ◽  
pp. 2094-2102 ◽  
Author(s):  
Diane A. de Zélicourt ◽  
Kerem Pekkan ◽  
Lisa Wills ◽  
Kirk Kanter ◽  
Joseph Forbess ◽  
...  
Keyword(s):  
Flow Analysis ◽  
Patient Specific ◽  
Total Cavopulmonary Connection ◽  
Cavopulmonary Connection

In Vitro Investigation of the Effect of Flow Pulsatility on Power Loss in the Total Cavopulmonary Connection

2011 ◽  
Author(s):  
Elaine Tang ◽  
Reza H. Khiabani ◽  
Christopher M. Haggerty ◽  
Ajit P. Yoganathan
Keyword(s):  
Heart Defects ◽  
Pulmonary Arteries ◽  
Patient Specific ◽  
Total Cavopulmonary Connection ◽  
Unique Challenge ◽  
Venae Cavae ◽  
In Vitro Investigation ◽  
The Right ◽  
Cavopulmonary Connection

Total Cavopulmonary Connection (TCPC) is the most common surgical palliation for single ventricle heart defects. In such connections, venae cavae are connected to the pulmonary arteries, bypassing the right ventricle. The patient-specific anatomical complexity makes characterization and optimization of the fluid mechanics a unique challenge.

Effect of Vessel Size on the Flow Efficiency of the Total Cavopulmonary Connection: In Vitro Studies

2002 ◽  
Vol 23 (2) ◽  
pp. 171-177 ◽  
Author(s):  
C.G. DeGroff ◽  
J.D. Carlton ◽  
C.E. Weinberg ◽  
M.C. Ellison ◽  
R. Shandas ◽  
...  
Keyword(s):  
In Vitro Studies ◽  
Total Cavopulmonary Connection ◽  
Vessel Size ◽  
Cavopulmonary Connection

scholarly journals Toward designing the optimal total cavopulmonary connection: an in vitro study

1999 ◽  
Vol 68 (4) ◽  
pp. 1384-1390 ◽  
Author(s):  
Ann E Ensley ◽  
Patricia Lynch ◽  
George P Chatzimavroudis ◽  
Carol Lucas ◽  
Shiva Sharma ◽  
...  
Keyword(s):  
In Vitro Study ◽  
Vitro Study ◽  
Total Cavopulmonary Connection ◽  
Cavopulmonary Connection

Pulsatile Hemodynamics of the Fontan Connection: A Tri-Modal Investigation

2011 ◽  
Author(s):  
Christopher M. Haggerty ◽  
Diane A. de Zélicourt ◽  
Jessica R. Kanter ◽  
Kartik S. Sundareswaran ◽  
Mark A. Fogel ◽  
...  
Keyword(s):  
Pulsatile Flow ◽  
Imaging Techniques ◽  
Patient Specific ◽  
Qualitative Behavior ◽  
Total Cavopulmonary Connection ◽  
Computational Accuracy ◽  
Flow Through ◽  
Cavopulmonary Connection

To evaluate the qualitative impact and computational accuracy of pulsatile flow through the total cavopulmonary connection (TCPC), multiple patient-specific models were studied using computational, experimental, and imaging techniques and the multi-modality results compared. Agreement with regard to both qualitative behavior and quantitative velocity measures was very convincing, which robustly demonstrates the precision of our various investigational methods.

Haemodynamic impact of stent implantation for lateral tunnel Fontan stenosis: a patient-specific computational assessment

2015 ◽  
Vol 26 (1) ◽  
pp. 116-126 ◽  
Author(s):  
Elaine Tang ◽  
Doff B. McElhinney ◽  
Maria Restrepo ◽  
Anne M. Valente ◽  
Ajit P. Yoganathan
Keyword(s):  
Stent Implantation ◽  
Patient Specific ◽  
Total Cavopulmonary Connection ◽  
Computational Framework ◽  
Specific Flow ◽  
Minimum Diameter ◽  
Physiological Importance ◽  
Lateral Tunnel ◽  
The Impact ◽  
Cavopulmonary Connection

AbstractBackgroundThe physiological importance of the lateral tunnel stenosis in the Fontan pathway for children with single ventricle physiology can be difficult to determine. The impact of the stenosis and stent implantation on total cavopulmonary connection resistance has not been characteriszed, and there are no clear guidelines for intervention.Methods and resultsA computational framework for haemodynamic assessment of stent implantation in patients with lateral tunnel stenosis was developed. Cardiac magnetic resonances images were reconstructed to obtain total cavopulmonary connection anatomies before stent implantation. Stents with 2-mm diameter increments were virtually implanted in each patient to understand the impact of stent diameter. Numerical simulations were performed in all geometries with patient-specific flow rates. Exercise conditions were simulated by doubling and tripling the lateral tunnel flow rate. The resulting total cavopulmonary connection vascular resistances were computed. A total of six patients (age: 14.4±3.1 years) with lateral tunnel stenosis were included for preliminary analysis. The mean baseline resistance was 1.54±1.08 WU·m2 and dependent on the stenosis diameter. It was further exacerbated during exercise. It was observed that utilising a stent with a larger diameter lowered the resistance, but the resistance reduction diminished at larger diameters.ConclusionsUsing a computational framework to assess the severity of lateral tunnel stenosis and the haemodynamic impact of stent implantation, it was observed that stenosis in the lateral tunnel pathway was associated with higher total cavopulmonary connection resistance than unobstructed pathways, which was exacerbated during exercise. Stent implantation could reduce the resistance, but the improvement was specific to the minimum diameter.

Hemostatic Changes following the Modified Fontan Operation (Total Cavopulmonary Connection)

2000 ◽  
Vol 83 (05) ◽  
pp. 678-682 ◽  
Author(s):  
Martin Ries ◽  
Michael Hofbeck ◽  
Gernot Buheitel ◽  
Helmut Singer ◽  
Jens Klinge ◽  
...  
Keyword(s):  
Fontan Operation ◽  
Protein S ◽  
Coagulation System ◽  
Clot Lysis ◽  
Total Cavopulmonary Connection ◽  
Thrombotic Risk ◽  
Normal Ranges ◽  
Thrombin Activation ◽  
Cavopulmonary Connection

SummaryThromboembolism is a serious complication after Fontan operation, which may be caused by alterations of the coagulation system. We therefore investigated pro- and anticoagulant factors in 20 patients aged 4 to 21 years, 4 to 63 months following total cavopulmonary connection. Furthermore we compared markers of thrombin activation and fibrinolysis and in vitro clotting and clot-lysis to age-matched healthy subjects.Compared to results of age-matched controls, the Fontan operated individuals had significant decreases in levels of protein C (0.88 U/ml in controls, 0.67 U/ml in patients; p <0.001) and protein S (1.05 in controls, 0.93 U/ml in patients; p <0.05). Moreover, half of the patients had high values of FVIII (>1.5 IU/ml), which are associated with an increased thrombotic risk. These changes may result in enhanced generation of thrombin and plasmin, indicated by our finding of increased thrombin-antithrombin III (TAT) and plasmin-antiplasmin (PAP) levels and a similar trend in prothrombin fragments F1+2. Clot lysis tests, global coagulation tests, red blood cell count, liver enzymes AST, ALT, but not GGT, were generally within the normal ranges.

The Effects of Different Mesh Generation Methods on Computational Fluid Dynamic Analysis and Power Loss Assessment in Total Cavopulmonary Connection

2004 ◽  
Vol 126 (5) ◽  
pp. 594-603 ◽  
Author(s):  
Yutong Liu ◽  
Kerem Pekkan ◽  
S. Casey Jones ◽  
Ajit P. Yoganathan
Keyword(s):  
Energy Loss ◽  
Mesh Generation ◽  
Flow Fields ◽  
Energetic Efficiency ◽  
Energy Losses ◽  
Total Cavopulmonary Connection ◽  
Structured Model ◽  
Unstructured Model ◽  
Cavopulmonary Connection

The flow field and energetic efficiency of total cavopulmonary connection (TCPC) models have been studied by both in vitro experiment and computational fluid dynamics (CFD). All the previous CFD studies have employed the structured mesh generation method to create the TCPC simulation model. In this study, a realistic TCPC model with complete anatomical features was numerically simulated using both structured and unstructured mesh generation methods. The flow fields and energy losses were compared in these two meshes. Two different energy loss calculation methods, the control volume and viscous dissipation methods, were investigated. The energy losses were also compared to the in vitro experimental results. The results demonstrated that: (1) the flow fields in the structured model were qualitatively similar to the unstructured model; (2) more vortices were present in the structured model than in the unstructured model; (3) both models had the least energy loss when flow was equally distributed to the left and right pulmonary arteries, while high losses occurred for extreme pulmonary arterial flow splits; (4) the energy loss results calculated using the same method were significantly different for different meshes; and (5) the energy loss results calculated using different methods were significantly different for the same mesh.

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