Flow Patterns in Aortic Circulation Associated to the Mustard Procedure
Abstract
The transposition of the great arteries (aorta and main pulmonary artery) is a pathological condition which is faced with negative outcome in the very first years of life, if left untreated. A surgical procedure for restoring a more physiological situation is the Mustard procedure, which allows total correction of transposition of the great vessels, by means of surgical redirection of caval blood to appropriate atria. In the Mustard procedure, pulmonary and systemic circulation are driven by the left and right ventricle, respectively. With respect to the physiological case, after the Mustard operation the ascending part of the aorta, immediately downstream of the ventricle, has a lower curvature. The present study is meant to characterize, by means of patient-specific modelling and computational simulation, the aortic hemodynamics in patients operated on with a Mustard procedure, in order to highlight whether the native connection of the aorta to the right ventricle can cause particular concerns, with respect to the physiological case.
Keywords
Cardiovascular surgery Aortic circulation Fluid dynamicsReferences
- 1.Carroll GT, McGloughlin TM, Burke PE, Egan M, Wallis F, Walsh MT (2011) Wall shear stresses remain elevated in mature arteriovenous fistulas: a case study. J Biomech Eng 133(2):021003CrossRefGoogle Scholar
- 2.Hope MD, Hope TA, Meadows AK, Ordovas KG, Urbania TH, Alley MT, Higgins CB (2010) Bicuspid aortic valve: four-dimensional MR evaluation of ascending aortic systolic flow patterns. Radiology 255(1):53–61CrossRefGoogle Scholar
- 3.Issa RI (1986) Solution of the implicitly discretised fluid flow equations by operator-splitting. J Comput Phys 62(1):40–65CrossRefMATHMathSciNetGoogle Scholar
- 4.Issa RI, Gosman AD, Watkins AP (1986) The computation of compressible and incompressible recirculating flows by a non-iterative implicit scheme. J Comput Phys 62(1):66–82CrossRefMATHMathSciNetGoogle Scholar
- 5.Kilner PJ, Yang GZ, Mohiaddin RH, Firmin DN, Longmore DB (1993) Helical and retrograde secondary flow patterns in the aortic arch studied by three-directional magnetic resonance velocity mapping. Circulation 88(5 Pt 1):2235–2247CrossRefGoogle Scholar
- 6.Redaelli A, Bothorel H, Votta E, Soncini M, Morbiducci U, Del Gaudio C, Balducci A, Grigioni M (2004) 3-D simulation of the St. Jude Medical bileaflet valve opening process: fluid-structure interaction study and experimental validation. J Heart Valve Dis 13(5):804–813Google Scholar
- 7.Wood NB, Weston SJ, Kilner PJ, Gosman AD, Firmin DN (2001) Combined MR imaging and CFD simulation of flow in the human descending aorta. J Magn Reson Imaging 13(5):699–713CrossRefGoogle Scholar