Patient-specific 0D–3D modeling of blood flow in newborns to predict risks of complications after surgery

Abstract

Abnormal developments of the cardiovascular system are common congenital malformations. Computational fluid dynamics and mathematical modeling can be used to perform quantitative predictive assessments of hemodynamic properties in varied conditions. This article addresses the development of a coupled 0D–3D model of blood flow in newborns to predict risks of complications after surgery. The 0D-model of systemic circulations is created by using the analogy between the blood flow in vessels and the flow of current through an electric circuit. A shunted section of the aorta and pulmonary artery is replaced with a 3D-model with two-way fluid-solid interaction (FSI).A section in a vessel with the aortic valve is examined in a separate 3D-model. Three-dimensional geometry is based on real CT-scans of a patient. The algorithm for coupling models of different levels relies on meeting the condition that pressures and volumetric blood flows are equal at the interaction boundary. We have developed an algorithm for identifying personal parameters from the results obtained by solving an optimization problem. Computational experiments with different individual geometry of the aorta and aortic valve made it possible to analyze blood flow velocities, near-wall stresses, flows, and valve deformations. Observable near-wall stresses can be considered risk factors that could cause calcification on valve leaflets and other valve diseases. Computational solutions in the “aorta – shunt – pulmonary artery” 3D-system allowed obtaining spatial distributions of velocities, pressures, near-wall stresses and other parameters that are significant in respect to probable pathology development. The developed approaches are primarily relevant for decision-making in surgical practice to predict risks of postoperative complications. In future, our plans are to develop the model so that it covers also saturation and oxygen exchange. This is necessary for assessing whether oxygen supply to the lungs is adequate.