Hemolysis induced by PMIVSD occluder

Smoothed particle hydrodynamics based FSI simulation of the native and mechanical heart valves in a patient-specific aortic model

The failure of the aortic heart valve is common, resulting in deterioration of the pumping function of the heart. For the end stage valve failure, bi-leaflet mechanical valve (most popular artificial valve) is implanted. However, due to its non-physiological behaviour, a significant alteration is observed in the normal haemodynamics of the aorta. While in-vivo experimentation of a human heart valve (native and artificial) is a formidable task, in-silico study using computational fluid dynamics (CFD) with fluid structure interaction (FSI) is an effective and economic tool for investigating the haemodynamics of natural and artificial heart valves. In the present work, a haemodynamic model of a natural and mechanical heart valve has been developed using meshless particle-based smoothed particle hydrodynamics (SPH). In order to further enhance its clinical relevance, this study employs a patient-specific vascular geometry and presents a successful validation against traditional finite volume method and 4D magnetic resonance imaging (MRI) data. The results have demonstrated that SPH is ideally suited to simulate the heart valve function due to its Lagrangian description of motion, which is a favourable feature for FSI. In addition, a novel methodology for the estimation of the wall shear stress (WSS) and other related haemodynamic parameters have been proposed from the SPH perspective. Finally, a detailed comparison of the haemodynamic parameters has been carried out for both native and mechanical aortic valve, with a particular emphasis on the clinical risks associated with the mechanical valve.

Post myocardial infarction ventricular septal rupture-protracted hemolysis due to missed additional ventricular septal defect

Hemolysis is a known and usually self-limiting complication of transcatheter device closure of post-myocardial infarction ventricular septal rupture (VSR). Multiple defects, serpiginous pathways, friable margins, left ventricular aneurysms, and improper size of the device have been described as causes for persistent residual shunt across the device. We report a case of protracted hemolysis after device closure of VSR requiring surgical intervention. During device retrieval and patch closure, a muscular band was observed dividing the VSR into two, allowing residual shunt across the second defect.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12055-022-01470-8.

Comprehensive Management Considerations of Select Noncardiac Organ Systems in the Cardiac Intensive Care Unit

As the acuity and complexity of pediatric patients with congenital cardiac disease have increased, there are many noncardiac issues that may be present in these patients. These noncardiac problems may affect clinical outcomes in the cardiac intensive care unit and must be recognized and managed. The Pediatric Cardiac Intensive Care Society sought to provide an expert review of some of the most common challenges of the respiratory, gastrointestinal, hematological, renal, and endocrine systems in pediatric cardiac patients. This review provides a brief overview of literature available and common practices.