Computational Study of Mechanical Support to the Failing Total Cavopulmonary Connection

Mauro Grigioni, Giuseppe D'Avenio, Salvatore Donatiello, Antonio Amodeo

Abstract

The performance of an axial flow blood pump in an idealized total cavopulmonary connection (TCPC) model was intravascularly evaluated. This blood pump was inserted within a modified Fontan surgery using a reinforced Gore-Tex conduit, to be connected to the caval veins with the pulmonary arteries. Two different computational models were examined (i) the new geometric model without a pump and (ii) with the pump. Computational fluid dynamics analyses of these models were performed to assess the hydraulic performance under varying pump’s operating conditions. Numerical simulations indicate that the pump generates a pressure distribution which could prove to be beneficial for the univentricular patient with failing Fontan circulation, allowing to provide a possible intervention, at least as bridge to heart transplantation or as end-stage pump implant.

References

  1. Amodeo A., Grigioni M., Oppido G., Daniele C., D'Avenio G., Pedrizzetti G., Giannico S., Filippelli S., Di Donato R. M., 2002. The beneficial vortex and best spatial arrangement in total extracardiac cavopulmonary connection. J Thorac Cardiovasc Surg; 124(3):471-8.
  2. Cheung Y. F., Penny D. J., Redington A. N., 2000. Serial assessment of left ventricular diastolic function after Fontan procedure. Heart;83:420-4.
  3. Cromme-Dijkhuis A. H., Hess J., Hahlen K., et al., 1993. Specific sequelae after Fontan operation at mid and long-term follow-up J Thorac Cardiovasc Surg. 106:1126-1132.
  4. Cutnell, John & Johnson, Kenneth, 1998. Physics, Fourth Edition. Wiley: 308.
  5. de Leval M. R., 1998. The Fontan circulation: what have we learned? What to expect? Pediatr Cardiol; 19:316 - 20.
  6. Feldt R. H., Driscoll D. J., Offord K. P. et al., 1996. Protein-losing enteropathy after the Fontan operation. J Thorac Cardiovasc Surg; 112:672- 80.
  7. Fogel, M. A., P. M. Weinberg, J. Rychik, A. Hubbard, M. Jacobs, T. L. Spray, and J. Haselgrove, 1999. Caval contribution to flow in the branch pulmonary arteries of Fontan patients with a novel application of magnetic resonance presaturation pulse. Circulation 99:1215-1221.
  8. Gersony, W. M., 2008, Fontan Operation After 3 Decades: What We Have Learned. Circulation.; 117:13-15.
  9. Gewillig, M., 2005. The Fontan circulation. Heart; 91:839-46.
  10. Giannico, S., Hammad F, Amodeo A, Michielon G, Drago F, Turchetta A, Di Donato R, Sanders SP, 2006. Clinical outcome of 193 extracardiac Fontan patients: the first 15 years. J Am Coll Cardiol. 47:2065-73.
  11. Gibber, M., Wu Z. J., Chang, W., Bianchi G., Hu, J., Garcia J., Jarvik R., Griffith, B. P., 2010. In Vivo Experience of the Child-Size Pediatric Jarvik 2000 Heart: Update. ASAIO Journal; 56(4):369-376.
  12. Grigioni, M.1., Daniele C., D'Avenio G., Barbaro V., 2001. The influence of the leaflets' curvature on the flow field in two bileaflet prosthetic heart valves. J Biomech. 34(5):613-21.
  13. Khairy, P., Fernandes S. M., Mayer J. E. Jr. et al., 2008. Long-term survival, modes of death, and predictors of mortality in patients with Fontan surgery. Circulation; 117:85-92.
  14. Lacour-Gayet F. G., Lanning C. J., Stoica S., Wang R., Rech B. A., Goldberg S. and Shandas R., 2009. An Artificial Right Ventricle for Failing Fontan: In Vitro and Computational Study. The Annals of Thoracic Surgery. 88:170-176.
  15. Riemer R. K., Amir G., Reichenbach S. H., Reinhartz O., 2005. Mechanical support of total cavopulmonary connection with an axial flow pump. J. Thorac Cardiovasc Surg 130:351-4.
  16. Samanek M., Voriskova M., 1999. Congenital heart disease among 815,569 children born between 1980 and 1990 and their 15-year survival: a prospective Bohemia survival study. Pediatr Cardiol 20:411-417.
  17. Santhanakrishnan A., Maher K. O., Tang E., Khiabani R. H., Johnson J., Yoganathan A. P., 2013. Hemodynamic effects of implanting a unidirectional valve in the inferior vena cava of the Fontan circulation pathway: an in vitro investigation. Am J Physiol Heart Circ Physiol. Nov 15;305(10):H1538- 47.
  18. Yakhot et al., 1992. Development of turbulence models for shear flows by a double expansion technique, Physics of Fluids A; 4(7):1510-1520.
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Paper Citation


in Harvard Style

Grigioni M., D'Avenio G., Donatiello S. and Amodeo A. (2015). Computational Study of Mechanical Support to the Failing Total Cavopulmonary Connection . In Proceedings of the 3rd International Congress on Cardiovascular Technologies - Volume 1: CARDIOTECHNIX, ISBN 978-989-758-160-1, pages 43-48. DOI: 10.5220/0005610900430048


in Bibtex Style

@conference{cardiotechnix15,
author={Mauro Grigioni and Giuseppe D'Avenio and Salvatore Donatiello and Antonio Amodeo},
title={Computational Study of Mechanical Support to the Failing Total Cavopulmonary Connection},
booktitle={Proceedings of the 3rd International Congress on Cardiovascular Technologies - Volume 1: CARDIOTECHNIX,},
year={2015},
pages={43-48},
publisher={SciTePress},
organization={INSTICC},
doi={10.5220/0005610900430048},
isbn={978-989-758-160-1},
}


in EndNote Style

TY - CONF
JO - Proceedings of the 3rd International Congress on Cardiovascular Technologies - Volume 1: CARDIOTECHNIX,
TI - Computational Study of Mechanical Support to the Failing Total Cavopulmonary Connection
SN - 978-989-758-160-1
AU - Grigioni M.
AU - D'Avenio G.
AU - Donatiello S.
AU - Amodeo A.
PY - 2015
SP - 43
EP - 48
DO - 10.5220/0005610900430048