Applications of computational fluid dynamics to congenital heart diseases: a practical review for cardiovascular professionals

ABSTRACT

Introduction

The increased survival rate of patients with congenital heart disease (CHD) has made it likely that 70%–95% of infants with CHDs surviving into adulthood often require careful follow-up and (repeat) interventions. Patients with CHDs often have abnormal blood flow patterns, due to both primary cardiac defect and the consequent surgical or endovascular repair.

Area covered

Computational fluid dynamics (CFD) alone or coupled with advanced imaging tools can assess blood flow patterns of CHDs to both understand their pathophysiology and anticipate the results of surgical or interventional repair.

Expert opinion

CFD is a mathematical technique that quantifies and describes the characteristics of fluid flow using the laws of physics. Through dedicated software based on virtual reconstruction and simulation and patients’ real data coming from computed tomography, magnetic resonance imaging, and 3/4 D-ultrasound, reconstruction of models of circulation of most CHD can be accomplished. CFD can provide insights about the pathophysiology of coronary artery anomalies, interatrial shunts, coarctation of the aorta and aortic bicuspid valve, tetralogy of Fallot and univentricular heart, with the capability in some cases of simulating different types of surgical or interventional repair and tailoring the treatment on the basis of these findings.

KEYWORDS:

• Congenital heart disease
• computer simulations
• computational fluid dynamics
• pathophysiology
• therapy

Article highlights

• Patients affected by congenital heart disease are increasingly reaching the adulthood, usually having abnormalities of the cardiac blood flow patterns due to the cardiac abnormalities or/and the related surgery

• Assessment of the blood flow patterns can be very difficult, in particular in operated patients with current imaging tools

• Computational fluid dynamics alone or coupled with current imaging techniques can be used to understand the underlying pathophysiology of congenital heart disease

• Computational fluid dynamics alone or coupled with current imaging techniques can be used to model different types of surgical and interventional procedures, anticipating their results and helping in planning patient-tailored procedures

Acknowledgments

We thank Prof Aravinda Nanjundappa, Robert C. Byrd Clinical Training Center, Vascular Center of Excellence, West Virginia University, Charleston, WV, for the English language editing.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.