Research Of Pulmonary Artery Flow Simulation In Patients After Bidirectional Glenn Shunt Based On Cardiac Magnetic Resonance

OBJECTIVE:Bidirectional Glenn Shunt(BDG)is a commonly used surgery for the treatment of the children with congenital heart disease.It is one stage of the preferred surgeries in clinic for the therapy of one side of ventricular malformations,dysfunction,or single ventricle.Noninvasive assessment of postoperative pulmonary hemodynamics and the local hemodynamic characteristics of the anastomosis is critical for the preparation of Fontan surgery Meanwhile,it will also be benefit for the surgical procedure design.METHODS: 1.Cardiac magnetic resonance and cardiac catheterization were performed in 20 patients underwent BDG,analyze the pulmonary flow data obtained from cardiac magnetic resonance and the pulmonary pressures obtained from cardiac catheterization,investigate the correlation between the flow data and pressure.2.The 25 patient-specific images of cardiac magnetic resonance were obtained.By using these data,three-dimensional geometric models were created.Combined with the pulmonary resistance model constructed by the porous medium,the hemodynamic analysis of BDG and the optimal range of energy loss were performed by applying the technique of computational fluid dynamics and virtual surgeries.RESULTS: 1.Cardiac magnetic resonance can be used to accurately assess the pulmonary artery development and hemodynamics of BDG.Pulmonary artery pressure can be evaluated by observe the aortopulmonary collateral flow and superior vena cava mean velocity.2.The energy loss can be calculated by the analysis of the CFD results.To disclose the relationship among the pulmonary artery,the optimal range of energy loss is of great significance to the guidance for clinical surgery.CONCLUSION:The combined method of medicine and engineering was used in the present study.The medical image based CFD and CAD were applied to noninvasively evaluate the pulmonary artery hemodynamics and the development of the pulmonary artery for Fontan surgery.In order to performing the patient-specific surgery,the improvement of BDG has laid a solid research foundation for future.