RESUMEN
Children born with only one functional ventricle must typically undergo a series of three surgeries to obtain the so-called Fontan circulation in which the blood coming from the body passively flows from the Vena Cavae (VCs) to the Pulmonary Arteries (PAs) through the Total Cavopulmonary Connection (TCPC). The circulation is inherently inefficient due to the lack of a subpulmonary ventricle. Survivors face the risk of circulatory sequelae and eventual failure for the duration of their lives. Current efforts are focused on improving the outcomes of Fontan palliation, either passively by optimizing the TCPC, or actively by using mechanical support. We are working on a chronic implant that would be placed at the junction of the TCPC, and would provide the necessary pressure augmentation to re-establish a circulation that recapitulates a normal two-ventricle circulation. This implant is based on the Von Karman viscous pump and consists of a vaned impeller that rotates inside the TCPC. To evaluate the performance of such a device, and to study the flow features induced by the presence of the pump, Computational Fluid Dynamics (CFD) is used. CFD has become an important tool to understand hemodynamics owing to the possibility of simulating quickly a large number of designs and flow conditions without any harm for patients. The transitional and unsteady nature of the flow can make accurate simulations challenging. We developed and in-house high order Large Eddy Simulation (LES) solver coupled to a recent Immersed Boundary Method (IBM) to handle complex geometries. Multiblock capability is added to the solver to allow for efficient simulations of complex patient specific geometries. Blood simulations are performed in a complex patient specific TCPC geometry. In this study, simulations without mechanical assist are performed, as well as after virtual implantation of the temporary and chronic implants being developed. Instantaneous flow structures, hepatic factor distribution, and statistical data are presented for all three cases.
RESUMEN
Univentricular heart disease is the leading cause of death from any birth defect in the first year of life. Typically, patients have to undergo three open heart surgical procedures within the first few years of their lives to eventually directly connect the superior and inferior vena cavae to the left and right pulmonary arteries forming the Total Cavopulmonary Connection or TCPC. The end result is a weak circulation where the single working ventricle pumps oxygenated blood to the body and de-oxygenated blood flows passively through the TCPC into the lungs. The fluid dynamics of the TCPC junction involve confined impinging jets resulting in a highly unstable flow, significant mechanical energy dissipation, and undesirable pressure loss. Understanding and predicting such flows is important for improving the surgical procedure and for the design of mechanical cavopulmonary assist devices. In this study, Dynamic Mode Decomposition (DMD) is used to analyze previously obtained Stereoscopic Particle Imaging Velocimetry (SPIV) data and Large Eddy Simulation (LES) results for an idealized TCPC. Analysis of the DMD modes from the SPIV and LES serve to both highlight the unsteady vortical dynamics and the qualitative agreement between measurements and simulations.
RESUMEN
A hybrid large eddy simulation (LES) and immersed boundary method (IBM) computational approach is used to make quantitative predictions of flow field statistics within the Food and Drug Administration's (FDA) idealized medical device. An in-house code is used, hereafter (W enoHemo™ ), that combines high-order finite-difference schemes on structured staggered Cartesian grids with an IBM to facilitate flow over or through complex stationary or rotating geometries and employs a subgrid-scale (SGS) turbulence model that more naturally handles transitional flows [2]. Predictions of velocity and wall shear stress statistics are compared with previously published experimental measurements from Hariharan et al. [6] for the four Reynolds numbers considered.