Optimal Conduit Size of the Extracardiac Fontan Operation Based on Energy Loss and Flow Stagnation

Computational fluid dynamics in Fontan patients to evaluate power loss during simulated exercise

“…The role of Ploss in the Fontan pathway has been subject to debate. Factors contributing to power loss include geometric properties and flow splits 4 5. In this study, we created patient-specific models that reflect the variations in TCPC geometries and flow patterns.…”

“…While the mechanisms of exercise intolerance are not completely understood, it has been suggested that it may be related to power loss (Ploss) inside the TCPC baffle. Previous studies demonstrated that the anatomy of TCPC significantly affects Ploss 4 5. Furthermore, Ploss increases nonlinearly during exercise 4.…”

Patient-Specific Surgical Planning, Where Do We Stand? The Example of the Fontan Procedure

“…However, as highlighted both in idealized 14 and patient-specific 43 configurations, bigger is not always better as excessive vessel dimensions favor the onset of flow stagnation regions and potential thrombosis. The challenge arises from the fact that the notion of ''excessive'' is not purely geometric but also depends on flow rates.…”

“…A total of fourteen options were investigated (Fig. 3b), looking into the impact of the Fontan baffle type (extra-cardiac vs. intra-atrial) and offset (Options 1 through 9), as well as more innovative solutions such as different combination of hepatic and AZ flows (Options 10-12) and options dividing the hepatic flow in two branches (Option [13][14]. 3D reconstructions of the patient's heart and great vessels (Fig.…”

Outcomes of Stent Implantation for Obstruction of Intracardiac Lateral Tunnel Fontan Pathways

“…As shown previously, catheterizations tend to underestimate the magnitude of physiological deficits in similar patients. [16][17][18] Exercise tolerance is abnormal in Fontan patients because of a combination of factors, 19,20 one of which may be energy loss in the LT. [21][22][23][24][25] Accordingly, any benefits derived from LT stenting are likely related to reduction in the resistance of and consequent energy loss across the LT.…”