Why the study?
Post-operative Fontan outcomes are linked to graft shape, but systematic in vitro validation is needed to investigate the accuracy and efficiency of computational fluid dynamics simulations for predicting Fontan hemodynamics.
Does computational fluid dynamics (CFD) simulation accurately predict indexed power loss and hepatic flow distribution in Fontan models compared to an in vitro flow loop?
Does computational fluid dynamics (CFD) simulation accurately predict indexed power loss and hepatic flow distribution in Fontan models compared to an in vitro flow loop?
p-value: p=0.0002
CFD simulations can accurately predict Fontan hemodynamics when validated against an in vitro flow loop, though prediction accuracy for hepatic flow distribution is significantly affected by mesh size.
Mesh sensitivity affects hepatic flow predictions in Fontan CFD; leaves open standardization and in vivo validation before clinical use.
Background Post-operative outcomes of the Fontan operation have been linked to graft shape after implantation. Computational fluid dynamics (CFD) simulations are used to explore different surgical options. The objective of this study is to perform a systematic in vitro validation for investigating the accuracy and efficiency of CFD simulation to predict Fontan hemodynamics. Methods CFD simulations were performed to measure indexed power loss (iPL) and hepatic flow distribution (HFD) in 10 patient-specific Fontan models, with varying mesh and numerical solvers. The results were compared with a novel in vitro flow loop setup with 3D printed Fontan models. A high-resolution differential pressure sensor was used to measure the pressure drop for validating iPL predictions. Microparticles with particle filtering system were used to measure HFD. The computational time was measured for a representative Fontan model with different mesh sizes and numerical solvers. Results When compared to in vitro setup, variations in CFD mesh sizes had significant effect on HFD (p = 0.0002) but no significant impact on iPL (p = 0.069). Numerical solvers had no significant impact in both iPL (p = 0.50) and HFD (P = 0.55). A transient solver with 0.5 mm mesh size requires computational time 100 times more than a steady solver with 2.5 mm mesh size to generate similar results. Conclusions The predictive value of CFD for Fontan planning can be validated against an in vitro flow loop. The prediction accuracy can be affected by the mesh size, model shape complexity and flow competition.
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Liu et al. (2021) studied Fontan circulation (n=10). Computational fluid dynamics (CFD) simulation with varying mesh sizes and numerical solvers vs. In vitro flow loop setup with 3D printed Fontan models was evaluated on Hepatic flow distribution (HFD) and indexed power loss (iPL) (p=0.0002).
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