Describing the Highly Three Dimensional Right Ventricle Flow

Visualization of the three-dimensional flow within the Right Ventricle (RV) is a challenging issue due to the fully three-dimensional geometry of the ventricular cavity. To date proper characterization and quantification of the RV flow still remains incomplete, and techniques that can be easily applied to current medical imaging are scarce. A method for simulating the highly complex, multi directional flow within the RV is presented by coupling 4D echocardiography imaging with numerical simulations based on the Immersed Boundaries Method (IBM). A novel formulation for accurately computing the space-time distribution of the blood residence time inside the cavity is introduced. Results showed an initial compact vortex forming past the tricuspid orifice at early diastole that quickly breaks into a weakly turbulent flow pattern and rearranges, during systole, into a peculiar stream-wise vortex spinning out towards the pulmonary orifice. This arrangement is maintained when the Ejection Fraction (EF) is reduced from 58 to 32%. The average blood transit time is found to scale almost inversely proportional to the EF. A careful analysis of the residence time permitted to assess the relative significance of the different flow components (from the direct flow, with a residence time less than one heartbeat, to the residual volume, that stagnates in the ventricle) and their distribution in space.