Computational fluid dynamics of the airways after left-upper pulmonary lobectomy: A case study
| Autor: | Marta Tullio, Rosaria Carrinola, Francesca Pennati, Lorenzo Aliboni, Andrea Aliverti, Alessandro Palleschi |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Spirometry
medicine.medical_specialty 0206 medical engineering Airflow Biomedical Engineering Bronchi 02 engineering and technology computational fluid dynamics 030204 cardiovascular system & hematology Computational fluid dynamics law.invention Pulmonary function testing 03 medical and health sciences 0302 clinical medicine law Internal medicine imaged-based Fluid dynamics medicine Research Article ‐ Applications Humans Computer Simulation Molecular Biology Lung Research Article ‐ Application medicine.diagnostic_test business.industry pulmonary lobectomy Applied Mathematics 020601 biomedical engineering Lobe Trachea medicine.anatomical_structure Computational Theory and Mathematics imaged‐based tracheobronchial tree modeling Modeling and Simulation Ventilation (architecture) Cardiology Hydrodynamics Current (fluid) business Software |
| Zdroj: | International Journal for Numerical Methods in Biomedical Engineering |
| Popis: | Pulmonary lobectomy is the gold standard intervention for lung cancer removal and consists of the complete resection of the affected lung lobe, which, coupled with the re‐adaptation of the remaining thoracic structures, decreases the postoperative pulmonary function of the patient. Current clinical practice, based on spirometry and cardiopulmonary exercise tests, does not consider local changes, providing an average at‐the‐mouth estimation of residual functionality. Computational Fluid Dynamics (CFD) has proved a valuable solution to obtain quantitative and local information about airways airflow dynamics. A CFD investigation was performed on the airway tree of a left‐upper pulmonary lobectomy patient, to quantify the effects of the postoperative alterations. The patient‐specific bronchial models were reconstructed from pre‐ and postoperative CT scans. A parametric laryngeal model was merged to the geometries to account for physiological‐like inlet conditions. Numerical simulations were performed in Fluent. The postoperative configuration revealed fluid dynamic variations in terms of global velocity (+23%), wall pressure (+48%), and wall shear stress (+39%). Local flow disturbances emerged at the resection site: a high‐velocity peak of 4.92 m/s was found at the left‐lower lobe entrance, with a local increase of pressure at the suture zone (18 Pa). The magnitude of pressure and secondary flows increased in the trachea and flow dynamics variations were observed also in the contralateral lung, causing altered lobar ventilation. The results confirmed that CFD is a patient‐specific approach for a quantitative evaluation of fluid dynamics parameters and local ventilation providing additional information with respect to current clinical approaches. Quantitative and clinically relevant information were provided for a left‐upper lobectomy patient, using a subject‐specific computational approach. The reconstruction of the airway tree revealed severe anatomical distortions after surgery. Numerical simulations demonstrated highly disturbed fluid dynamics conditions in the whole structure with respect to the preoperative condition. At the resection site and at the trachea, local increases of velocity, secondary flows, pressure, and wall shear stress were found. Consequences were observed also in the contralateral lung, determining altered lobar ventilation. |
| Databáze: | OpenAIRE |
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