Patients that undergo the arterial switch operation (ASO) to repair transposition of great arteries (TGA) can develop abnormal pulmonary trunk morphology with significant long-term complications. In this study, cardiovascular magnetic resonance was combined with computational fluid dynamics to investigate the impact of the postoperative layout on the pulmonary flow patterns. Three ASO patients were analyzed and compared to a volunteer control. Results showed the presence of anomalous shear layer instabilities, vortical and helical structures, and turbulent-like states in all patients, particularly as a consequence of the unnatural curvature of the pulmonary bifurcation. Streamlined, mostly laminar flow was instead found in the healthy subject. These findings shed light on the correlation between the post-ASO anatomy and the presence of altered flow features, and may be useful to improve surgical planning as well as the long-term care of TGA patients.
Computational Study of Pulmonary Flow Patterns After Repair of Transposition of Great Arteries
Manuscript received September 18, 2018; final manuscript received February 19, 2019; published online March 25, 2019. Assoc. Editor: Ching-Long Lin.
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Capuano, F., Loke, Y., Cronin, I., Olivieri, L. J., and Balaras, E. (March 25, 2019). "Computational Study of Pulmonary Flow Patterns After Repair of Transposition of Great Arteries." ASME. J Biomech Eng. May 2019; 141(5): 051008. https://doi.org/10.1115/1.4043034
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