Abstract
Congenital heart disease, which affects more than one million newborns globally each year, contributes to an increased risk of cardiovascular disease and ultimately reduced life expectancy. Computational fluid dynamics (CFD) enables detailed, non-invasive characterization of complex physiological pressure and flow fields, thus improving our understanding of congenital heart disease hemodynamics. In recent years, this has driven clinical decision-making, surgical planning, and the evaluation of innovative surgical techniques. In this mini review, CFD methods applied to the study of congenital abnormalities, with a focus on the aorta and pulmonary bifurcation, are discussed. The clinical relevance and future directions of CFD modelling are also reviewed.
Highlights
An estimated 1.35 million newborns are diagnosed each year with congenital heart disease (CHD)[1], defined as structural abnormalities of the heart, and/or great vessels, which are present from birth
Complex models of arterial vessels have deepened our knowledge of the relationship between anatomical and hemodynamic factors related to the initiation and progression of cardiovascular diseases
In CHD patients with coarctation of the aorta, computational studies have revealed significantly altered flow dynamics, with a pressure-drop across the coarctation site, and a stenotic velocity jet resulting in elevated wall shear stress downstream[23,24]
Summary
An estimated 1.35 million newborns are diagnosed each year with congenital heart disease (CHD)[1], defined as structural abnormalities of the heart, and/or great vessels, which are present from birth. TOF patients are diagnosed with four cardiac defects: right ventricular hypertrophy, pulmonary stenosis, overriding aorta and ventricular septal defect, which require surgical intervention early in childhood These patients are still at risk of needing further surgical treatment, if pulmonary regurgitation and branch pulmonary obstruction are present[6]. Blood flow simulations, using patient-specific geometries and boundary conditions, can improve our understanding of the underlying hemodynamics, strengthen the diagnostic potential, and enhance the possibility for personalized patient-specific medicine. This non-invasive method enables detailed characterization of complex physiological pressure and flow fields, and the computation of variables not measurable in-vivo. The fluid solution can, be visualized through additional hemodynamic parameters, such as Wall Shear Stress (WSS), oscillatory shear index, relative residence time, etc., which are useful to identify areas where flow departs from a laminar, unidirectional pattern, and are commonly used in cardiovascular modelling
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