Improving Flow Dynamics in Fontan Surgeries

Summary

Principal Investigator: AJIT P contact YOGANATHAN
Abstract: Description (provided by applicant): The incidence of congenital heart defects is 1 percent with 20 percent of these incidences corresponding to complex congenital lesions with only one effective pumping chamber; the latter are termed single ventricle heart defects. These statistics show that 2 babies out of every 1,000 births will be born with a single ventricle. Surgical treatment for these defects consists of bypassing the right side of the heart and connecting the systemic and pulmonary circulations in series with the univentricular pump. Patients who survive surgery require lifelong, intensive medical attention. Cardiologists report that the 20 percent of their caseload consisting of such patients requires over 50 percent of their time; this underscores the gravity of problems in patients as well as the need for improvements in existing treatment methods. The current surgical procedure of choice for patients with a single ventricle is the total cavopulmonary connection (TCPC). The central hypothesis for this Multi-Institutional BRP Project is that development of pre-operative computer-based surgical design methods will advance the state-of-the-art in clinical treatment of single-ventricle patients and improve their quality of life. The development of these methods will be guided by six specific aims: (i) development of baseline TCPC surgical templates based on fluid dynamic assessments of various TCPC configurations; (ii) study the impact of graft materials on local fluid dynamics following TCPC; (iii) compile anatomic and materials databases for validating computer-based surgical planning and design protocols; (iv) improve surgical planning and design through development of computer-based simulation tools facilitating prediction of potential post-operative flow conditions in any given patient; (v) investigate improvements in post-TCPC hemodynamics achieved by treating congenital abnormalities associated with the ascending aorta; (vi) determine the feasibility of reducing post-TCPC central venous pressure using a pressure regulator/pump.
Funding Period: 2002-07-01 - 2009-06-30
more information: NIH RePORT

Top Publications

  1. pmc Functional analysis of Fontan energy dissipation
    Lakshmi P Dasi
    Wallace H Coulter School of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA 30332 0535, USA
    J Biomech 41:2246-52. 2008
  2. ncbi Effect of high altitude exposure on the hemodynamics of the bidirectional Glenn physiology: modeling incremented pulmonary vascular resistance and heart rate
    Carolina Vallecilla
    Group of Biomedical Engineering, Universidad de Los Andes, Bogota, Colombia
    J Biomech 47:1846-52. 2014
  3. pmc Simulating hemodynamics of the Fontan Y-graft based on patient-specific in vivo connections
    Christopher M Haggerty
    Wallace H Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA 30332, USA
    J Thorac Cardiovasc Surg 145:663-70. 2013
  4. pmc Cannulation strategy for aortic arch reconstruction using deep hypothermic circulatory arrest
    Diane de Zelicourt
    Wallace H Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, Georgia 30332 0535, USA
    Ann Thorac Surg 94:614-20. 2012
  5. pmc Preliminary clinical experience with a bifurcated Y-graft Fontan procedure--a feasibility study
    Kirk R Kanter
    Division of Cardiothoracic Surgery, Department of Surgery, Emory University School of Medicine and Children s Healthcare of Atlanta at Egleston, Atlanta, GA 30322, USA
    J Thorac Cardiovasc Surg 144:383-9. 2012
  6. pmc Comparing pre- and post-operative Fontan hemodynamic simulations: implications for the reliability of surgical planning
    Christopher M Haggerty
    Wallace H Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, 313 Ferst Drive, Atlanta, GA 30332, USA
    Ann Biomed Eng 40:2639-51. 2012
  7. pmc Effect of flow pulsatility on modeling the hemodynamics in the total cavopulmonary connection
    Reza H Khiabani
    Wallace H Coulter School of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, 30332 0535, USA
    J Biomech 45:2376-81. 2012
  8. pmc Numerical and experimental investigation of pulsatile hemodynamics in the total cavopulmonary connection
    Elaine Tang
    School of Chemical and Biomolecular Engineering, Georgia Institute of Technology, Atlanta, GA 30332, United States
    J Biomech 46:373-82. 2013
  9. pmc Haemodynamic comparison of a novel flow-divider Optiflo geometry and a traditional total cavopulmonary connection
    Kalpi Desai
    Wallace H Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA 30332, USA
    Interact Cardiovasc Thorac Surg 17:1-7. 2013
  10. ncbi Magnetic resonance imaging-guided surgical design: can we optimise the Fontan operation?
    Christopher M Haggerty
    1 The Wallace H Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, United States of America
    Cardiol Young 23:818-23. 2013

Scientific Experts

  • Kerem Pekkan
  • Kevin K Whitehead
  • Rachel B Clipp
  • Ajit P Yoganathan
  • Mark A Fogel
  • Kartik S Sundareswaran
  • Christopher M Haggerty
  • Diane de Zelicourt
  • Lakshmi P Dasi
  • Kirk R Kanter
  • Diane A de Zélicourt
  • Maria Restrepo
  • Mark Fogel
  • Elaine Tang
  • Shiva Sharma
  • Kirk Kanter
  • Jarek Rossignac
  • Reza H Khiabani
  • David H Frakes
  • Fotis Sotiropoulos
  • Thomas L Spray
  • W James Parks
  • Kartik Sundareswaran
  • Resmi KrishnankuttyRema
  • Hiroumi D Kitajima
  • Dennis D Soerensen
  • Lucia Mirabella
  • Carolina Vallecilla
  • Kalpi Desai
  • Mikhail Lara
  • Marc Horner
  • Resmi Krishnankutty
  • Chang Wang
  • Mark J T Smith
  • James Parks
  • Anne Marie Valente
  • James Bethel
  • Nestor Sandoval
  • Juan Carlos Briceno
  • Doff B McElhinney
  • Francis Fynn-Thompson
  • Jessica Kanter
  • Andrew J Powell
  • Philsub Jung
  • Prahlad G Menon
  • Philip Mannor
  • Brian S Whited
  • Jarek R Rossignac
  • J William Gaynor
  • Onur Dur
  • Chia Yuan Chen
  • Colleen Sherwin
  • John N Oshinski
  • Pedro J Delnido
  • Hiroumi D Katajima
  • Thomas Spray
  • Gopinath Jayaprakash
  • Brian Whited
  • Ashish Kulkarni
  • David Kim
  • Ajay Parihar
  • Jennifer F Sabatier
  • S Mark Fogel
  • Lisa Wills
  • Joseph Forbess
  • David Frakes
  • Hiroumi Kitajima

Detail Information

Publications44

  1. pmc Functional analysis of Fontan energy dissipation
    Lakshmi P Dasi
    Wallace H Coulter School of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA 30332 0535, USA
    J Biomech 41:2246-52. 2008
    ..Further studies with larger sample sizes are necessary for incorporating finer geometrical parameters such as vessel curvatures and offsets...
  2. ncbi Effect of high altitude exposure on the hemodynamics of the bidirectional Glenn physiology: modeling incremented pulmonary vascular resistance and heart rate
    Carolina Vallecilla
    Group of Biomedical Engineering, Universidad de Los Andes, Bogota, Colombia
    J Biomech 47:1846-52. 2014
    ..The presented mathematical model provides a framework to estimate the hemodynamic performance of BDG patients at different PVR increments. ..
  3. pmc Simulating hemodynamics of the Fontan Y-graft based on patient-specific in vivo connections
    Christopher M Haggerty
    Wallace H Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA 30332, USA
    J Thorac Cardiovasc Surg 145:663-70. 2013
    ..This study conducted numerical simulations to evaluate this hypothesis using postoperative data from 5 patients...
  4. pmc Cannulation strategy for aortic arch reconstruction using deep hypothermic circulatory arrest
    Diane de Zelicourt
    Wallace H Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, Georgia 30332 0535, USA
    Ann Thorac Surg 94:614-20. 2012
    ..In this study, we use computational fluid dynamics to investigate the effect of different cannulation strategies in neonates...
  5. pmc Preliminary clinical experience with a bifurcated Y-graft Fontan procedure--a feasibility study
    Kirk R Kanter
    Division of Cardiothoracic Surgery, Department of Surgery, Emory University School of Medicine and Children s Healthcare of Atlanta at Egleston, Atlanta, GA 30322, USA
    J Thorac Cardiovasc Surg 144:383-9. 2012
    ..Optimizing flow and diminishing power loss in the Fontan circuit can improve hemodynamic efficiency, potentially improving the long-term outcomes. Computerized modeling has predicted improved energetics with a Y-graft Fontan...
  6. pmc Comparing pre- and post-operative Fontan hemodynamic simulations: implications for the reliability of surgical planning
    Christopher M Haggerty
    Wallace H Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, 313 Ferst Drive, Atlanta, GA 30332, USA
    Ann Biomed Eng 40:2639-51. 2012
    ..These results demonstrate that surgical planning can be a useful tool for single ventricle cardiothoracic surgery with the ability to deliver significant clinical impact...
  7. pmc Effect of flow pulsatility on modeling the hemodynamics in the total cavopulmonary connection
    Reza H Khiabani
    Wallace H Coulter School of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, 30332 0535, USA
    J Biomech 45:2376-81. 2012
    ..In addition, when wPI<50, the relative error was less than 20%. A correlation was introduced to relate wPI to the relative error in predicting the flow metrics with non-pulsatile flow conditions...
  8. pmc Numerical and experimental investigation of pulsatile hemodynamics in the total cavopulmonary connection
    Elaine Tang
    School of Chemical and Biomolecular Engineering, Georgia Institute of Technology, Atlanta, GA 30332, United States
    J Biomech 46:373-82. 2013
    ..The results demonstrated the complexity of the pulsatile TCPC flow fields and the validity of the numerical approach in simulating pulsatile TCPC flow dynamics in both idealized and complex patient specific models...
  9. pmc Haemodynamic comparison of a novel flow-divider Optiflo geometry and a traditional total cavopulmonary connection
    Kalpi Desai
    Wallace H Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA 30332, USA
    Interact Cardiovasc Thorac Surg 17:1-7. 2013
    ..The use of a bifurcated graft as the Fontan baffle (i.e. the 'Optiflo') has previously been proposed on the basis of theoretically improved flow efficiency; however, anatomical constraints may limit its effectiveness in some patients...
  10. ncbi Magnetic resonance imaging-guided surgical design: can we optimise the Fontan operation?
    Christopher M Haggerty
    1 The Wallace H Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, United States of America
    Cardiol Young 23:818-23. 2013
    ..This review provides a brief overview of these methods, presents preliminary results of their clinical usage, and offers insights into its potential future directions...
  11. pmc Fontan pathway growth: a quantitative evaluation of lateral tunnel and extracardiac cavopulmonary connections using serial cardiac magnetic resonance
    Maria Restrepo
    The Wallace H Coulter Department of Biomedical Engineering at Georgia Institute of Technology and Emory University, Atlanta, Georgia
    Ann Thorac Surg 97:916-22. 2014
    ..The LT is formed partially by atrial wall and is assumed to have growth potential, but the extent and nature of LT pathway growth have not been well characterized. A quantitative analysis was performed to evaluate this issue...
  12. pmc Geometric characterization of patient-specific total cavopulmonary connections and its relationship to hemodynamics
    Elaine Tang
    School of Chemical and Biomolecular Engineering, Georgia Institute of Technology, Atlanta, Georgia
    JACC Cardiovasc Imaging 7:215-24. 2014
    ..Hepatic flow distribution correlated with caval offset, pulmonary flow distribution, and the angle between FP and SVC. These correlations can have important implications for future connection design and patient follow-up. ..
  13. pmc Larger aortic reconstruction corresponds to diminished left pulmonary artery size in patients with single-ventricle physiology
    Lakshmi P Dasi
    Wallace H Coulter School of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA 30332 0535, USA
    J Thorac Cardiovasc Surg 139:557-61. 2010
    ..Pulmonary artery size is a crucial determinant of hemodynamic energy loss in total cavopulmonary connections. We investigated the effect of aortic arch reconstruction on left pulmonary artery size based on their anatomic proximity...
  14. pmc Pulmonary hepatic flow distribution in total cavopulmonary connections: extracardiac versus intracardiac
    Lakshmi P Dasi
    Department of Mechanical Engineering and School of Biomedical Engineering, Colorado State University, Fort Collins, Colo, USA
    J Thorac Cardiovasc Surg 141:207-14. 2011
    ..We studied the effect of total cavopulmonary connection geometry and the effect of increased cardiac output on distribution of inferior vena caval return to the lungs...
  15. pmc Individualized computer-based surgical planning to address pulmonary arteriovenous malformations in patients with a single ventricle with an interrupted inferior vena cava and azygous continuation
    Diane A de Zélicourt
    Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA 30332 0535, USA
    J Thorac Cardiovasc Surg 141:1170-7. 2011
    ..The current study combines virtual surgery and numeric simulations to identify potential surgical strategies for patients with an interrupted inferior vena cava...
  16. ncbi Hemodynamics of the hepatic venous three-vessel confluences using particle image velocimetry
    Mikhail Lara
    Biomedical Engineering Department, Carnegie Mellon University, Pittsburgh, PA 15217, USA
    Ann Biomed Eng 39:2398-416. 2011
    ....
  17. pmc Visualization of flow structures in Fontan patients using 3-dimensional phase contrast magnetic resonance imaging
    Kartik S Sundareswaran
    Wallace H Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, USA
    J Thorac Cardiovasc Surg 143:1108-16. 2012
    ..Our objective was to analyze 3-dimensional (3D) blood flow patterns within the total cavopulmonary connection (TCPC) using in vivo phase contrast magnetic resonance imaging (PC MRI)...
  18. pmc Hemodynamic performance of stage-2 univentricular reconstruction: Glenn vs. hemi-Fontan templates
    Kerem Pekkan
    Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, PA, USA
    Ann Biomed Eng 37:50-63. 2009
    ..These results can impact the surgical design and planning of the staged TCPC reconstruction...
  19. ncbi Flow study of an extracardiac connection with persistent left superior vena cava
    Diane A de Zélicourt
    Wallace H Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA 30332 0535, USA
    J Thorac Cardiovasc Surg 131:785-91. 2006
    ..Additionally, it demonstrates the potential use of computational designs and simulations as surgical planning tools...
  20. pmc Correction of pulmonary arteriovenous malformation using image-based surgical planning
    Kartik S Sundareswaran
    Wallace H Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, Georgia 30332 0535, USA
    JACC Cardiovasc Imaging 2:1024-30. 2009
    ..Finally, efficiency metrics (e.g., pressure decrease and hepatic flow distribution) are weighted against surgical feasibility to determine the optimal surgical option...
  21. pmc Blood flow distribution in a large series of patients having the Fontan operation: a cardiac magnetic resonance velocity mapping study
    Kevin K Whitehead
    Division of Cardiology, Children s Hospital of Philadelphia, Philadelphia, PA 19104, USA
    J Thorac Cardiovasc Surg 138:96-102. 2009
    ..No large series exists that establishes the flow distributions in Fontan patients, which would be an important resource for everyday clinical use and may affect future surgical reconstruction...
  22. pmc Fontan hemodynamics: importance of pulmonary artery diameter
    Lakshmi P Dasi
    Wallace H Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA 30332 0535, USA
    J Thorac Cardiovasc Surg 137:560-4. 2009
    ..We quantify the geometric and hemodynamic characteristics of extracardiac and lateral tunnel Fontan surgical options and correlate certain anatomic characteristics with their hemodynamic efficiency and patient cardiac index...
  23. ncbi Nonlinear power loss during exercise in single-ventricle patients after the Fontan: insights from computational fluid dynamics
    Kevin K Whitehead
    Children s Hospital of Philadelphia, Division of Cardiology, Main Hospital, 2 Floor, 34 and Civic Center Blvd, Philadelphia, PA 19104, USA
    Circulation 116:I165-71. 2007
    ..PL through the TCPC may play a role in single-ventricle physiology and is a function of cardiac output. We hypothesized that PL through the TCPC increases significantly under exercise flow conditions...
  24. ncbi Progress in the CFD modeling of flow instabilities in anatomical total cavopulmonary connections
    Chang Wang
    Wallace H Coulter School of Biomedical Engineering, Georgia Institute of Technology, Room 2119 U A Whitaker Building, 313 Ferst Dr, Atlanta, GA 30332 0535, USA
    Ann Biomed Eng 35:1840-56. 2007
    ....
  25. ncbi Introduction of a new optimized total cavopulmonary connection
    Dennis D Soerensen
    Wallace H Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia 30332 0535, USA
    Ann Thorac Surg 83:2182-90. 2007
    ..quot; Featuring bifurcated vena cava (superior venacava to inferior vena cava SVC/IVC), it was designed to lower the fluid mechanical power losses in the connection and to ensure proper hepatic blood perfusion to both lungs...
  26. ncbi Impaired power output and cardiac index with hypoplastic left heart syndrome: a magnetic resonance imaging study
    Kartik S Sundareswaran
    Wallace H Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, Georgia 30332 0535, USA
    Ann Thorac Surg 82:1267-75; discussion 1275-7. 2006
    ..Using noninvasive phase contrast magnetic resonance imaging (PC MRI), we examined cardiac mechanics in children with HLHS and compared the results to other single-ventricle defects...
  27. ncbi Total cavopulmonary connection flow with functional left pulmonary artery stenosis: angioplasty and fenestration in vitro
    Kerem Pekkan
    Wallace H Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA 30332 0535, USA
    Circulation 112:3264-71. 2005
    ..The goal of this study was to quantify and evaluate the hemodynamic impact of LPA stenosis and to judge interventional strategies aimed at treating it...
  28. ncbi In vitro flow analysis of a patient-specific intraatrial total cavopulmonary connection
    Diane A de Zélicourt
    Wallace H Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia 30332 0535, USA
    Ann Thorac Surg 79:2094-102. 2005
    ..Although most experimental and numerical investigations have mainly focused on somewhat simplified geometries, investigation of the flow field of true anatomic configurations is necessary for a true understanding...
  29. ncbi New techniques for the reconstruction of complex vascular anatomies from MRI images
    David H Frakes
    Wallace H Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, Georgia, USA
    J Cardiovasc Magn Reson 7:425-32. 2005
    ..The proposed methodology enables a powerful tool allowing physicians to analyze and manipulate highly accurate and clearly presented vascular structures in an interactive medium...
  30. ncbi Single-step stereolithography of complex anatomical models for optical flow measurements
    Diane de Zelicourt
    Cardiovascular Fluid Mechanics Laboratory, Wallace H Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University School of Medicine, Atlanta, GA 30332 0535, USA
    J Biomech Eng 127:204-7. 2005
    ..The effect of RP machining grooves, surface quality, and hydrodynamic performance measurements as compared with the smooth glass models are also quantified...
  31. ncbi Anatomically realistic patient-specific surgical planning of complex congenital heart defects using MRI and CFD
    Kartik S Sundareswaran
    Wallace H Coulter Department of Biomedical Engineering, Georgia Tech, Atlanta, GA
    Conf Proc IEEE Eng Med Biol Soc 2007:202-5. 2007
    ..This framework provides the surgeon to envision numerous scenarios of possible surgical options, and accordingly predict the post operative hemodynamics...
  32. ncbi Quantitative analysis of extracardiac versus intraatrial Fontan anatomic geometries
    Resmi KrishnankuttyRema
    Wallace H Coulter School of Biomedical Engineering, Georgia Institute of Technology, Atlanta, Georgia 30332 0535, USA
    Ann Thorac Surg 85:810-7. 2008
    ..In this study we present quantitative comparison of the geometric characteristics of the extracardiac and intraatrial Fontan anatomies, the two commonly used TCPC procedures...
  33. ncbi A new method for registration-based medical image interpolation
    David H Frakes
    4 D Imaging, Inc, Atlanta, GA30332, USA
    IEEE Trans Med Imaging 27:370-7. 2008
    ..Experimental results show that the new method achieves good quality, while offering dramatic improvement in efficiency relative to the best competing method...
  34. pmc Hemodynamic energy dissipation in the cardiovascular system: generalized theoretical analysis on disease states
    Lakshmi P Dasi
    Wallace H Coulter School of Biomedical Engineering, Georgia Institute of Technology and Emory University, Room 2119, U A Whitaker Building, 313 Ferst Drive, Atlanta, GA 30332 0535, USA
    Ann Biomed Eng 37:661-73. 2009
    ..New indices allowing disease-specific subject-to-subject comparisons and disease-to-disease hemodynamic evaluation (quantifying the hemodynamic severity of one vascular disease type to the other) are presented based on this formalism...
  35. pmc Optimum fuzzy filters for phase-contrast magnetic resonance imaging segmentation
    Kartik S Sundareswaran
    Wallace H Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, Georgia, USA
    J Magn Reson Imaging 29:155-65. 2009
    ..To develop and validate a multidimensional segmentation and filtering methodology for accurate blood flow velocity field reconstruction from phase-contrast magnetic resonance imaging (PC MRI)...
  36. ncbi Impedance boundary conditions for the pulmonary vasculature including the effects of geometry, compliance, and respiration
    Rachel B Clipp
    North Carolina State University, Raleigh, NC 27695, USA
    IEEE Trans Biomed Eng 56:862-70. 2009
    ..4224 and 0.7270 mmHg, respectively...
  37. ncbi Neonatal aortic arch hemodynamics and perfusion during cardiopulmonary bypass
    Kerem Pekkan
    Department of Biomedical Engineering, Carnegie Mellon University, 2100 Doherty Hall, Pittsburgh, PA 15213 3890, USA
    J Biomech Eng 130:061012. 2008
    ..Coupled to a lumped-parameter model the 3D hemodynamic characteristics will aid the surgical decision making process of the perfusion strategies in complex congenital heart surgeries...
  38. pmc The total cavopulmonary connection resistance: a significant impact on single ventricle hemodynamics at rest and exercise
    Kartik S Sundareswaran
    Wallace H Coulter Department of Biomedical Engineering, School of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA 30332 0535, USA
    Am J Physiol Heart Circ Physiol 295:H2427-35. 2008
    ..In conclusion, TCPC resistance has a significant impact on resting hemodynamics and the exercise capacity of patients with a SV physiology...
  39. ncbi Patient-specific surgical planning and hemodynamic computational fluid dynamics optimization through free-form haptic anatomy editing tool (SURGEM)
    Kerem Pekkan
    Biomedical Engineering, Carnegie Mellon University, Pittsburgh, PA, USA
    Med Biol Eng Comput 46:1139-52. 2008
    ..Using SURGEM, more than 30 new anatomical designs (or candidate configurations) are created, and the corresponding user times presented. CFD performances for eight of these candidate configurations are also presented...
  40. pmc In vitro hemodynamic investigation of the embryonic aortic arch at late gestation
    Kerem Pekkan
    Department of Biomedical and Mechanical Engineering, Carnegie Mellon University, PA, USA
    J Biomech 41:1697-706. 2008
    ..Intravascular flow patterns spatially correlated with abnormal vascular structures consistent with the paradigm that abnormal intravascular flow patterns associated with congenital heart disease influence vascular growth and function...
  41. ncbi Physics-driven CFD modeling of complex anatomical cardiovascular flows-a TCPC case study
    Kerem Pekkan
    Wallace H Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, USA
    Ann Biomed Eng 33:284-300. 2005
    ..A successful prediction requires a two-pronged, physics-based approach, which integrates high-resolution CFD tools and high-resolution laboratory measurements...