TY - JOUR
T1 - Computational Investigation of Anastomosis Options of a Right-Heart Pump to Patient Specific Pulmonary Arteries
AU - Tobin, Nicolas
AU - Good, Bryan C.
AU - Plasencia, Jonathan D.
AU - Fogel, Mark A.
AU - Weiss, William J.
AU - Manning, Keefe B.
N1 - Publisher Copyright:
© 2022, The Author(s) under exclusive licence to Biomedical Engineering Society.
PY - 2022/8
Y1 - 2022/8
N2 - Patients with Fontan circulation have increased risk of heart failure, but are not always candidates for heart transplant, leading to the development of the subpulmonic Penn State Fontan Circulation Assist Device. The aim of this study was to use patient-specific computational fluid dynamics simulations to evaluate anastomosis options for implanting this device. Simulations were performed of the pre-surgical anatomy as well as four surgical options: a T-junction and three Y-grafts. Cases were evaluated based on several fluid-dynamic quantities. The impact of imbalanced left-right pulmonary flow distribution was also investigated. Results showed that a 12-mm Y-graft was the most energy efficient. However, an 8-mm graft showed more favorable wall shear stress distribution, indicating lower risk of thrombosis and endothelial damage. The 8-mm Y-grafts also showed a more balanced pulmonary flow split, and lower residence time, also indicating lower thrombosis risk. The relative performance of the surgical options was largely unchanged whether or not the pulmonary vascular resistance remained imbalanced post-implantation.
AB - Patients with Fontan circulation have increased risk of heart failure, but are not always candidates for heart transplant, leading to the development of the subpulmonic Penn State Fontan Circulation Assist Device. The aim of this study was to use patient-specific computational fluid dynamics simulations to evaluate anastomosis options for implanting this device. Simulations were performed of the pre-surgical anatomy as well as four surgical options: a T-junction and three Y-grafts. Cases were evaluated based on several fluid-dynamic quantities. The impact of imbalanced left-right pulmonary flow distribution was also investigated. Results showed that a 12-mm Y-graft was the most energy efficient. However, an 8-mm graft showed more favorable wall shear stress distribution, indicating lower risk of thrombosis and endothelial damage. The 8-mm Y-grafts also showed a more balanced pulmonary flow split, and lower residence time, also indicating lower thrombosis risk. The relative performance of the surgical options was largely unchanged whether or not the pulmonary vascular resistance remained imbalanced post-implantation.
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U2 - 10.1007/s10439-022-02969-2
DO - 10.1007/s10439-022-02969-2
M3 - Article
C2 - 35451680
AN - SCOPUS:85128724250
SN - 0090-6964
VL - 50
SP - 929
EP - 940
JO - Annals of Biomedical Engineering
JF - Annals of Biomedical Engineering
IS - 8
ER -