Open Access

ARTICLE

Preliminary Evaluation of Hemodynamic Effects of Fontan Palliation on Renal Artery Using Computational Fluid Dynamics

Jinlong Liu^1,2,#, Jing Shi^3,#, Weiru Luo¹, Zhirong Tong^1,2, Lefei Yang³, Peixuan Sun³, Tianyi Li³, Jun Du^3,*, Qian Wang^3,*

1 Institute of Pediatric Translational Medicine, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
2 Shanghai Engineering Research Center of Virtual Reality of Structural Heart Disease, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
3 Department of Imaging Diagnosis Center, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

* Corresponding Authors: Jun Du. Email: ; Qian Wang. Email:

Congenital Heart Disease 2023, 18(1), 41-55. https://doi.org/10.32604/chd.2023.025005

Received 17 June 2022; Accepted 05 September 2022; Issue published 09 January 2023

Abstract

Background: The assessment of renal function is important to the prognosis of patients needing Fontan palliation due to the reconstructed compromised circulation. To know the relationship between the kidney perfusion and hemodynamic characteristics during surgical design could reduce the risk of acute kidney injury (AKI) and the postoperative complications. However, the issue is still unsolved because the current clinical evaluation methods are unable to predict the hemodynamic changes in renal artery (RA). Methods: We reconstructed a three-dimensional (3D) vascular model of a patient requiring Fontan palliation. The technique of computational fluid dynamics (CFD) was utilized to explore the changes of RA hemodynamics under different possible blood flow rates. The relationship between the kidney perfusion and hemodynamic characteristics was investigated. Results: The calculated results indicated the declined tendency of the pressure and pressure drop as the flow rate decreased. When the flow rate decreased to two-thirds of its baseline, both the pressure of left renal artery (LRA) and the pressure of right renal artery (RRA) dipped below 50%, and the pressure of RRA fell more quickly than that of LRA. Uneven distribution of WSS was observed on the trunk of RA, and the lowest WSS was found at the distal of RA. The average WSS in RA dropped to around 50% as the flow rate reached one-third of its baseline. Conclusions: As a promising approach, CFD can be utilized to quantitatively evaluate the hemodynamic characteristics of RA and contribute to offsetting the drawbacks of clinical assessments of renal function, to help realize better prognosis for the patients with Fontan palliation.

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Graphical Abstract

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