Hemodynamics of bioprosthetic pulmonary valves in patients with repaired Tetralogy of Fallot – A computational study

Tetralogy of Fallot is a congenital disease that causes abnormalities in the heart, resulting in poorly oxygenated blood flow to the body. Although patients during infancy undergo repair surgery, most require repeat pulmonary valve replacements due to structural valve deterioration. Thus, cardiologists are interested in increasing the longevity of pulmonary valve implants. One potential factor that may improve valve longevity is the valve implant angle with respect to the pulmonary arteries. Therefore, in this study, we implemented a reduced degree-of-freedom fluid-structure interaction (FSI) model of the pulmonary valve with a sharp-interface immersed boundary flow solver. With this model, we characterize the relationships between implant valve angulations and valve longevity and demonstrate that optimal valve angulations result in improved hemodynamic and valve leaflet performances. To assess these outcomes, metrics such as flow distributions to the pulmonary branch arteries, tri-leaflet motion, and pulmonary artery wall shear stresses are analyzed.