Blood flow simulations in the pulmonary bifurcation for the assessment of valve replacement in adult patients with congenital heart disease

Adult patients with congenital heart disease comprise a growing population with complex cardiac conditions, among other ageing-associated diseases. This particular group of patients may undergo multiple surgical procedures in their lifetime, a significant number of which involves pulmonary valve replacement (PVR). The clinical decision for such surgical intervention is currently relying on symptoms, including arrhythmias, and measures of right ventricular dilatation, at e.g. 80-90 mL/m2 end-systolic and 150-160 mL/m2 end-diastolic volumes [1,2]. However, there is no common consensus on the reliability of these criteria, and more accurate and timely assessment for PVR treatment is necessary. The overall objective of this work is to investigate the altered haemodynamic environment in the adult with congenital heart defect, including pre- and post-operative conditions. Here, we show computational results in the pulmonary bifurcation with the scope to establish a novel and reliable metric for pulmonary valve replacement.