Non-Newtonian Effects on Patient-Specific Modeling of Fontan Hemodynamics.
Zhenglun WeiShelly Singh-GryzbonPhillip M TrustyConnor HuddlestonYingnan ZhangMark A FogelAlessandro VenezianiShelly Singh-GryzbonPublished in: Annals of biomedical engineering (2020)
The Fontan procedure is a common palliative surgery for congenital single ventricle patients. In silico and in vitro patient-specific modeling approaches are widely utilized to investigate potential improvements of Fontan hemodynamics that are related to long-term complications. However, there is a lack of consensus regarding the use of non-Newtonian rheology, warranting a systematic investigation. This study conducted in silico patient-specific modeling for twelve Fontan patients, using a Newtonian and a non-Newtonian model for each patient. Differences were quantified by examining clinically relevant metrics: indexed power loss (iPL), indexed viscous dissipation rate (iVDR), hepatic flow distribution (HFD), and regions of low wall shear stress (AWSS). Four sets of "non-Newtonian importance factors" were calculated to explore their effectiveness in identifying the non-Newtonian effect. No statistical differences were observed in iPL, iVDR, and HFD between the two models at the population-level, but large inter-patient variations exist. Significant differences were detected regarding AWSS, and its correlations with non-Newtonian importance factors were discussed. Additionally, simulations using the non-Newtonian model were computationally faster than those using the Newtonian model. These findings distinguish good importance factors for identifying non-Newtonian rheology and encourage the use of a non-Newtonian model to assess Fontan hemodynamics.
Keyphrases
- end stage renal disease
- newly diagnosed
- ejection fraction
- chronic kidney disease
- minimally invasive
- prognostic factors
- high fat diet
- case report
- peritoneal dialysis
- palliative care
- risk assessment
- molecular docking
- heart failure
- pulmonary hypertension
- adipose tissue
- metabolic syndrome
- risk factors
- patient reported outcomes
- mitral valve
- coronary artery disease
- left ventricular
- climate change
- patient reported
- percutaneous coronary intervention
- coronary artery