Computational Investigation of Patient-Specific Self-Powered Fontan Circulations

Ni, Marcus; Prather, Ray; Beggs, Kyle; Rodriguez, Giovanna; Quinn, Rachel Afi; Divo, Eduardo; Fogel, Mark A.; Kassab, Alain J.; DeCampli, William M.

doi:10.1615/tfec2018.bio.024756

Cited by 2 publications

(1 citation statement)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In principle, the high velocity "nozzle" flow would transfer momentum to the surrounding Fontan circulation flow by the mechanism of entrainment, effectively lowering IVC pressure upstream of the jet [25][26][27][28][29][30][31]. This concept was first investigated in a computational multi-scale model for a small number of conditions and geometric configurations in which entrainment was demonstrated, but with only a small decrease in IVC pressure [32][33][34][35][36][37][38][39][40][41][42][43].…”

Section: Introductionmentioning

confidence: 99%

Parametric Investigation of an Injection-Jet Self-Powered Fontan Circulation

Prather

Das²,

Farias

et al. 2021

Preprint

Self Cite

View full text Add to dashboard Cite

Rationale: Approximately 1/2500 babies are born with only one functioning ventricle and the Fontan is the third and, ideally final staged palliative operation for these patients. This altered circulation is prone to failure with survival rates below 50% into adulthood in some series. Chronically elevated inferior vena cava (IVC) pressure is implicated as one cause of the mortality and morbidity in this population.Objective: An injection jet shunt (IJS) drawing blood-flow directly from the aortic arch to significantly lower IVC pressure is proposed.Methods and Results: A computer-generated 3D model of a 2–4 year old patient with a fenestrated Fontan and a cardiac output of 2.3L/min was generated. The detailed 3D pulsatile hemodynamics are resolved in a zero-dimensional lumped parameter network tightly-coupled to a 3D computational fluid dynamics model accounting for non-Newtonian blood rheology and resolving turbulence using large eddy simulation. IVC pressure and systemic oxygen saturation were tracked for various IJS-assisted Fontan configurations, altering design parameters such as shunt and fenestration diameters and locations.A baseline “failing” Fontan with 4mm fenestration was tuned to elevated IVC pressure ($+17.8mmHg$). Enlargement of the fenestration to 8mm resulted in a 3mmHg IVC pressure drop but an unacceptable reduction in systemic oxygen saturation below 80%. Addition of an IJS with a 2mm nozzle and minor volume load to the ventricle improved the IVC pressure drop to 3.2mmHg while increasing systemic oxygen saturation above 80%.Conclusions: The salutary effects of the IJS to effectively lower IVC pressure while retaining acceptable levels of oxygen saturation are successfully demonstrated.

show abstract

Section: Introductionmentioning

confidence: 99%

Parametric Investigation of an Injection-Jet Self-Powered Fontan Circulation

Prather

Das²,

Farias

et al. 2021

Preprint

Self Cite

View full text Add to dashboard Cite

show abstract

Parametric investigation of an injection-jet self-powered Fontan circulation

Prather

Das

Farias

et al. 2022

Sci Rep

Self Cite

View full text Add to dashboard Cite

Approximately $$1/2500$$ 1 / 2500 babies are born with only one functioning ventricle and the Fontan is the third and, ideally final staged palliative operation for these patients. This altered circulation is prone to failure with survival rates below $$50\%$$ 50 % into adulthood. Chronically elevated inferior vena cava (IVC) pressure is implicated as one cause of the mortality and morbidity in this population. An injection jet shunt (IJS) drawing blood-flow directly from the aortic arch to significantly lower IVC pressure is proposed. A computer-generated 3D model of a 2–4 year old patient with a fenestrated Fontan and a cardiac output of 2.3 L/min was generated. The detailed 3D pulsatile hemodynamics are resolved in a zero-dimensional lumped parameter network tightly-coupled to a 3D computational fluid dynamics model accounting for non-Newtonian blood rheology and resolving turbulence using large eddy simulation. IVC pressure and systemic oxygen saturation were tracked for various IJS-assisted Fontan configurations, altering design parameters such as shunt and fenestration diameters and locations. A baseline “failing” Fontan with a 4 mm fenestration was tuned to have an elevated IVC pressure (+ 17.8 mmHg). Enlargement of the fenestration to 8 mm resulted in a 3 mmHg IVC pressure drop but an unacceptable reduction in systemic oxygen saturation below 80%. Addition of an IJS with a 2 mm nozzle and minor volume load to the ventricle improved the IVC pressure drop to 3.2 mmHg while increasing systemic oxygen saturation above 80%. The salutary effects of the IJS to effectively lower IVC pressure while retaining acceptable levels of oxygen saturation are successfully demonstrated.

show abstract

Computational Investigation of Patient-Specific Self-Powered Fontan Circulations

Cited by 2 publications

References 0 publications

Parametric Investigation of an Injection-Jet Self-Powered Fontan Circulation

Parametric Investigation of an Injection-Jet Self-Powered Fontan Circulation

Parametric investigation of an injection-jet self-powered Fontan circulation

Contact Info

Product

Resources

About