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

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Congenital Heart Disease 2023年第1期18卷 41-55页

作者： Jinlong Liu Jing Shi Weiru Luo Zhirong Tong Lefei Yang Peixuan Sun Tianyi Li Jun Du Qian Wang Institute of Pediatric Translational Medicine Shanghai Children’s Medical CenterSchool of MedicineShanghai Jiao Tong UniversityShanghaiChina Shanghai Engineering Research Center of Virtual Reality of Structural Heart Disease Shanghai Children’s Medical CenterSchool of MedicineShanghai Jiao Tong UniversityShanghaiChina Department of Imaging Diagnosis Center Shanghai Children's Medical CenterSchool of MedicineShanghai Jiao Tong UniversityShanghaiChina

Background:The assessment of renal function is important to the prognosis of patients needing Fontan palliation due to the reconstructed compromised *** 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 ***,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 *** technique of computational fluid dynamics(CFD)was utilized to explore the changes of RA hemodynamics under different possible blood flow *** relationship between the kidney perfusion and hemodynamic characteristics was ***:The calculated results indicated the declined tendency of the pressure and pressure drop as the flow rate *** 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 *** distribution of WSS was observed on the trunk of RA,and the lowest WSS was found at the distal of *** average WSS in RA dropped to around 50%as the flow rate reached one-third of its ***: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.

关键词： Renal artery Fontan palliation hemodynamics computational fluid dynamics surgical design

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