Patient-Specific Image Reconstruction and CFD Modeling of the Right Heart for the Repaired Tetralogy of Fallot
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The growing clinical interest in the right side of the heart (RH) stems from recognising that its structure and function alterations bear prognostic significance in various congenital and acquired heart conditions, including Tetralogy of Fallot. Recognising the impact of these diseases on blood dynamics, Computational Fluid Dynamics (CFD) emerges as a valuable tool for non-invasive and quantitative analysis of hemodynamic parameters, thereby enhancing comprehension of RH functionality. This study presents a comprehensive, patient-specific image-driven CFD (ID-CFD) model of the beating RH, encompassing both chambers and valves. The patient-specific cardiac 3D mesh and movement were reconstructed using the Multi-Series Morphing-based (MSMorph) technique[1]. This method integrates information from multi-view cardiac cine-MRI acquisitions, leveraging registration-based and morphing-based algorithms to accurately reconstruct crucial cardiac features and complete contraction and relaxation motion. ID-CFD simulations were performed through the C++ library lifex[2], solving the Navier-Stokes equations within an Arbitrary Lagrangian-Eulerian framework. Valves are represented as immersed surfaces using the Resistive Immersed Implicit Surface (RIIS) method. Validation against ground truth and a standard method ensures the accuracy of the reconstruction, and the resulting CFD analyses provide insights into the hemodynamics of healthy and clinically relevant scenarios. This approach demonstrates promise in addressing specific clinical inquiries with confidence. [1] Renzi, F., Vergara, C., et al.. Accurate and Efficient 3D Reconstruction of Right Heart Shape and Motion from Multi-Series Cine-MRI. bioRxiv, 2023, 2023.06. 28.546872 [2] Africa PC. lifex: A flexible, high performance library for the numerical solution of complex finite element problems. \textit{SoftwareX} 20, 2022 Dec, 101252