Time: June 30, 14:00
S2 416-2

Titel: Computational modelling of fetal haemodynamics in Congenital Heart Disease

Abstract: 

In the fetus, the cardiovascular system differs from its postnatal counterpart because oxygenation occurs through the placenta rather than the lungs. To optimize oxygen delivery in this situation, there are vascular shunts that redistribute blood flow and close neonatally: the ductus arteriosus, which connects the pulmonary artery to the descending aorta; the ductus venosus, which allows a portion of the oxygenated blood returning from the placenta to bypass the liver and enter the inferior vena cava; and the foramen ovale, which connects the right and left atria. As a result, in the fetal circulation the pulmonary and systemic circulations are coupled rather than connected in series.

Consequently, several congenital cardiac abnormalities, such as transposition of the great arteries or aortic coarctation, can be compatible with fetal life despite being incompatible with normal postnatal circulation. Rather than causing immediate failure, these defects alter blood flow patterns and cardiovascular development, which is strongly influenced by haemodynamic stimuli. In this talk, I will discuss how lumped computational models and Doppler imaging can be used to understand the impact of congenital cardiovascular abnormalities on fetal circulation and development, and how adaptive remodelling mechanisms may compensate for these altered haemodynamic conditions.