The hemodynamic environment of the pulmonary bifurcation is of great importance for
adult patients with repaired tetralogy of Fallot (rTOF) due to possible complications in the
pulmonary valve and narrowing of the left pulmonary artery (LPA). The aim of this study
was to computationally investigate the effect of geometrical variability and flow split on
blood flow characteristics in the pulmonary trunk of patient-specific models. Data from
a cohort of seven patients was used retrospectively and the pulmonary hemodynamics
was investigated using averaged and MRI-derived patient-specific boundary conditions
on the individualized models, as well as a statistical mean geometry. Geometrical analysis
showed that curvature and tortuosity are higher in the LPA branch, compared to the right
pulmonary artery (RPA), resulting in complex flow patterns in the LPA. The computational
analysis also demonstrated high time-averaged wall shear stress (TAWSS) at the outer
wall of the LPA and the wall of the RPA proximal to the junction. Similar TAWSS patterns
were observed for averaged boundary conditions, except for a significantly modified
flow split assigned at the outlets. Overall, this study enhances our understanding about
the flow development in the pulmonary bifurcation of rTOF patients and associates
some morphological characteristics with hemodynamic parameters, highlighting the
importance of patient-specificity in the models. To confirm these findings, further studies
are required with a bigger cohort of patients