A COMPUTATIONAL PULSATILE MODEL OF THE BIDIRECTIONAL CAVOPULMONARY ANASTOMOSIS - THE INFLUENCE OF PULMONARY FORWARD FLOW

The bidirectional cavopulmonary anastomosis (BCPA or bidirectional Gle nn) is an operation to treat congenital heart diseases of the right he art by diverting the systemic venous return from the superior vena cav a to both lungs. The main goal is to provide the correct perfusion to both lungs avoiding an excessive increase in systemic venous pressure. On of the factors which can affect the clinical outcome of the surgic ally reconstructed circulation is the amount of pulsatile blood flow c oming from the main pulmonary artery. The purpose of this work is to a nalyse the influence of this factor on the BCPA hemodynamics. A 3-D fi nite element model of the BCPA has been developed to reproduce the flo w of the surgically reconstructed district. Geometry and hemodynamic d ata have been taken from angiocardiogram and catheterization reports, respectively. On the basis of the developed 3-D model, four simulation s, have been performed with increasing pulsatile blood flow rate from the main pulmonary artery. The results show that hemodynamics in th pu lmonary arteries are greatly influenced by the amount of flow through the native main pulmonary artery and that the flow from the superior v ena cava allows to have a similar distribution of the blood to both lu ngs, with a little predilection for the left side, in agreement with c linical postoperative data.