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  • Open Access


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

    Jinlong Liu1,2,#, Jing Shi3,#, Weiru Luo1, Zhirong Tong1,2, Lefei Yang3, Peixuan Sun3, Tianyi Li3, Jun Du3,*, Qian Wang3,*

    Congenital Heart Disease, Vol.18, No.1, pp. 41-55, 2023, DOI:10.32604/chd.2023.025005

    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… More > Graphic Abstract

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

  • Open Access


    Prediction of Pulmonary Arterial Pressure Level after Repair of Congenital Cardiac Communications and Discharge from the Hospital: Role of Down Syndrome and Early Postoperative Hemodynamics

    Eloisa Sassá Carvalho#, Maria Francilene S. Souza, Kelly Cristina O. Abud, Claudia R. P. Castro, Juliano G. Penha, Ana Maria Thomaz, Vanessa A. Guimarães, Antonio Augusto Lopes*

    Congenital Heart Disease, Vol.17, No.3, pp. 351-363, 2022, DOI:10.32604/chd.2022.019382

    Abstract Background: Postoperative pulmonary hypertension limits the success of surgical treatment in some patients with unrestrictive congenital cardiac communications. Identifying patients at risk of developing postoperative pulmonary hypertension is important to individualize follow-up strategies. Methods: We analyzed a prospective cohort of 52 pediatric patients (age 3 to 35 months) looking for perioperative predictors of mildly elevated pulmonary arterial pressure 6 months after surgery, defined as a systolic pressure greater than 30 mmHg by transthoracic echocardiography. This corresponds to a mean pulmonary arterial pressure of >20 mmHg. Clinical, echocardiographic and hemodynamic parameters were investigated. Perioperative hemodynamics was assessed by directly measuring pulmonary and systemic… More >

  • Open Access


    Study of Effect of Boundary Conditions on Patient-Specific Aortic Hemodynamics

    Qingzhuo Chi1, Huimin Chen1, Shiqi Yang1, Lizhong Mu1,*, Changjin Ji2, Ying He1, Yong Luan3

    CMES-Computer Modeling in Engineering & Sciences, Vol.131, No.1, pp. 31-47, 2022, DOI:10.32604/cmes.2022.018286

    Abstract Cardiovascular computational fluid dynamics (CFD) based on patient-specific modeling is increasingly used to predict changes in hemodynamic parameters before or after surgery/interventional treatment for aortic dissection (AD). This study investigated the effects of flow boundary conditions (BCs) on patient-specific aortic hemodynamics. We compared the changes in hemodynamic parameters in a type A dissection model and normal aortic model under different BCs: inflow from the auxiliary and truncated structures at aortic valve, pressure control and Windkessel model outflow conditions, and steady and unsteady inflow conditions. The auxiliary entrance remarkably enhanced the physiological authenticity of numerical simulations of flow in the ascending… More >

  • Open Access


    Fluid-Structure Interaction in Problems of Patient Specific Transcatheter Aortic Valve Implantation with and Without Paravalvular Leakage Complication

    Adi Azriff Basri1,6,*, Mohammad Zuber2, Ernnie Illyani Basri1, Muhammad Shukri Zakaria5, Ahmad Fazli Abd Aziz3, Masaaki Tamagawa4, Kamarul Arifin Ahmad1,6

    FDMP-Fluid Dynamics & Materials Processing, Vol.17, No.3, pp. 531-553, 2021, DOI:10.32604/fdmp.2021.010925

    Abstract Paravalvular Leakage (PVL) has been recognized as one of the most dangerous complications in relation to Transcathether Aortic Valve Implantation (TAVI) activities. However, data available in the literature about Fluid Structure Interaction (FSI) for this specific problem are relatively limited. In the present study, the fluid and structure responses of the hemodynamics along the patient aorta model and the aortic wall deformation are studied with the aid of numerical simulation taking into account PVL and 100% TAVI valve opening. In particular, the aorta without valve (AWoV) is assumed as the normal condition, whereas an aorta with TAVI 26 mm for… More >

  • Open Access


    Computational Fluid Dynamics Simulations at Micro-Scale Stenosis for Microfluidic Thrombosis Model Characterization

    Yunduo Charles Zhao1,2,#, Parham Vatankhah1,#, Tiffany Goh1,2,3, Jiaqiu Wang4, Xuanyi Valeria Chen1, Moein Navvab Kashani5,6, Keke Zheng7, Zhiyong Li4, Lining Arnold Ju1,2,3,*

    Molecular & Cellular Biomechanics, Vol.18, No.1, pp. 1-10, 2021, DOI:10.32604/mcb.2021.012598

    Abstract Platelet aggregation plays a central role in pathological thrombosis, preventing healthy physiological blood flow within the circulatory system. For decades, it was believed that platelet aggregation was primarily driven by soluble agonists such as thrombin, adenosine diphosphate and thromboxane A2. However, recent experimental findings have unveiled an intriguing but complementary biomechanical mechanism—the shear rate gradients generated from flow disturbance occurring at sites of blood vessel narrowing, otherwise known as stenosis, may rapidly trigger platelet recruitment and subsequent aggregation. In our Nature Materials 2019 paper [1], we employed microfluidic devices which incorporated micro-scale stenoses to elucidate the molecular insights underlying the… More >

  • Open Access


    Pulmonary Hemodynamics and Outcome in a Large Cohort of Patients with Sinus Venosus Septal Defect

    Liesbeth van Dessel1, Béatrice Santens2, Els Troost2, Pieter De Meester2,3, Leen Roggen2, Filip Rega3,4, Bart Meyns3,4, Bjorn Cools5, Marc Gewillig5, Philip Moons6,7,8, Lukas Meier9, Werner Budts2,3, Alexander Van De Bruaene2,3,*

    Congenital Heart Disease, Vol.15, No.2, pp. 69-78, 2020, DOI:10.32604/CHD.2020.011512

    Abstract Background: Left-to-right shunt in sinus venosus septal defect (SVSD) may affect resistive (pulmonary vascular resistance–PVR) and elastic (pulmonary artery compliance-PAC) pulmonary artery properties. This study aimed at evaluating (1) impact of age, (2) pulmonary hemodynamics, and (3) outcome in a large cohort of SVSD patients. Methods: This study included 136 patients with SVSD (median age at diagnosis 14 (IQR 5–48) years, 47% male) of which 87 underwent catheterization. Pressures were measured and cardiac output was evaluated using the Fick principle at diagnosis. PVR, PAC and their product (RC time) were calculated. Results: Surgical repair was performed in 128 (94%) at… More >

  • Open Access


    Evaluation of Fontan liver disease: Correlation of transjugular liver biopsy with magnetic resonance and hemodynamics

    Jose A. Silva‐Sepulveda1, Yudy Fonseca2, Irine Vodkin3, Gabrielle Vaughn1, Robert Newbury4, Vera Vavinskaya5, Jerry Dwek6, James C. Perry1, Preeti Reshamwala7, Cynthia Baehling8, James Lyon9, Christopher Davis1, Jesse W. Lee1, Hannah El‐Sabrout10, Doaa Shahbah11, Laith Alshawabkeh12, John W Moore1, Howaida El‐Said1

    Congenital Heart Disease, Vol.14, No.4, pp. 600-608, 2019, DOI:10.1111/chd.12770

    Abstract Introduction: Liver fibrosis and cirrhosis are late complications in Fontan palliation. Liver biopsy is the gold standard. The goal of this study is to correlate transjugular liver biopsy (TJLB) in the setting of Fontan palliation with noninvasive testing and hemodynamics.
    Methods: Between August 2014 and July 2017, 49 Fontan patients underwent TJLB. All the patients had hemodynamic evaluation, 28 patients had MRE (magnetic reso‐ nance elastography) and 40 patients had cardiopulmonary exercise test. Histologic liver fibrosis was quantitated using traditional histologic scoring systems and a modi‐ fied Ishak congestive hepatic fibrosis score.
    Results: Median age 17.8 years, median time since… More >

  • Open Access


    Inaccuracy of a continuous arterial pressure waveform monitor when used for congenital cardiac catheterization

    Michael D. Seckeler1, Katri Typpo2, Jendar Deschenes2, Ruth Higgins3, Ricardo Samson1, Peter Lichtenthal4

    Congenital Heart Disease, Vol.12, No.6, pp. 815-819, 2017, DOI:10.1111/chd.12517

    Abstract Objective: To determine the accuracy of a continuous cardiac output monitor (FloTrac sensor) for measuring cardiac index in children with congenital heart disease undergoing cardiac catheterization. Cardiac index is a critical hemodynamic parameter measured during catheterizations in children with congenital heart disease. This has been challenging to measure accurately and many clinicians rely on predictive equations for calculating cardiac index.
    Design: Prospective, nonrandomized trial.
    Setting: Tertiary care congenital heart center.
    Patients: Consecutive participants ≤18 years old undergoing clinically indicated cardiac catheterizations from September 2014 through August 2015.
    Interventions: Oxygen consumption was measured using the Vmax Encore 229 monitor attached to… More >

  • Open Access


    Hemodynamic effects of ketamine in children with congenital heart disease and/or pulmonary hypertension

    Rohit S. Loomba1, Seth B. Gray2, Saul Flores3

    Congenital Heart Disease, Vol.13, No.5, pp. 646-654, 2018, DOI:10.1111/chd.12662

    Abstract Introduction: Ketamine is a drug often used for procedural sedation or as adjunct agent for general sedation in children with congenital heart disease. In the clinical realm, there is often confusion regarding the effects of ketamine on hemodynamics, particularly pulmonary vascular resistance and systemic vascular resistance. We per‐ formed a meta‐analysis of studies investigating the effects of ketamine on hemodynamics.
    Methods: A systematic review was conducted to identify studies characterizing the hemodynamic effects of ketamine in children with congenital heart disease. Studies were assessed for quality and those of satisfactory quality with pre‐ and postketa‐ mine hemodynamics for each patient… More >

  • Open Access


    Pulmonary artery pulsatility index predicts prolonged inotrope/ pulmonary vasodilator use after implantation of continuous flow left ventricular assist device

    Varun Aggarwal1,2, Sebastian C. Tume3, Marco Rodriguez1, Iki Adachi4, Antonio G. Cabrera1, Hari Tunuguntla1, Athar M. Qureshi1

    Congenital Heart Disease, Vol.14, No.6, pp. 1130-1137, 2019, DOI:10.1111/chd.12860

    Abstract Objective: Predictors of right ventricle (RV) dysfunction after continuous‐flow left ventricular assist device (CF‐LVAD) implantation in children are not well described. We explored the association of preimplantation Pulmonary Artery Pulsatility index (PAPi) and other hemodynamic parameters as predictors of prolonged postoperative inotropes/pulmonary vasodilator use after CF‐LVAD implantation.
    Design: Retrospective chart review.
    Setting: Single tertiary care pediatric referral center.
    Patients: Patients who underwent CF‐LVAD implantation from January 2012 to October 2017.
    Interventions: Preimplantation invasive hemodynamic parameters were analyzed to evaluate the association with post‐CF‐LVAD need for prolonged (>72 hours) use of inotropes/pulmonary vasodilators.
    Measurements and main results: Preimplantation cardiac catheterization data… More >

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