Simulating hemodynamics of the Fontan Y-graft based on patient-specific in vivo connections.

The Journal of Thoracic and Cardiovascular Surgery
Christopher M HaggertyAjit P Yoganathan

Abstract

Using a bifurcated Y-graft as the Fontan baffle is hypothesized to streamline and improve flow dynamics through the total cavopulmonary connection (TCPC). This study conducted numerical simulations to evaluate this hypothesis using postoperative data from 5 patients. Patients were imaged with cardiac magnetic resonance or computed tomography after receiving a bifurcated aorto-iliac Y-graft as their Fontan conduit. Numerical simulations were performed using in vivo flow rates, as well as 2 levels of simulated exercise. Two TCPC models were virtually created for each patient to serve as the basis for hemodynamic comparison. Comparative metrics included connection flow resistance and inferior vena caval flow distribution. Results demonstrate good hemodynamic outcomes for the Y-graft options. The consistency of inferior vena caval flow distribution was improved over TCPC controls, whereas the connection resistances were generally no different from the TCPC values, except for 1 case in which there was a marked improvement under both resting and exercise conditions. Examination of the connection hemodynamics as they relate to surgical Y-graft implementation identified critical strategies and modifications that are needed to potential...Continue Reading

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Citations

Jul 11, 2012·Annals of Biomedical Engineering·Christopher M HaggertyAjit P Yoganathan
Apr 9, 2013·Interactive Cardiovascular and Thoracic Surgery·Kalpi DesaiAjit P Yoganathan
Feb 1, 2013·Journal of Biomechanical Engineering·Weiguang YangAlison L Marsden
Jan 10, 2014·Cardiology in the Young·Christopher M HaggertyMark A Fogel
Jun 6, 2014·The International Journal of Cardiovascular Imaging·Timothy C Slesnick, Ajit P Yoganathan
Feb 11, 2014·The Journal of Thoracic and Cardiovascular Surgery·Christopher M HaggertyAjit P Yoganathan
Feb 5, 2016·Biomechanics and Modeling in Mechanobiology·Weiguang YangIrene E Vignon-Clementel
Oct 4, 2015·The Annals of Thoracic Surgery·Maria RestrepoAjit P Yoganathan
Jul 18, 2015·Annals of Biomedical Engineering·Diane A de Zélicourt, Vartan Kurtcuoglu
Apr 7, 2015·Journal of Biomechanics·Alejandro Roldán-AlzateChristopher J François
Jan 27, 2015·The Annals of Thoracic Surgery·Christopher M HaggertyAjit P Yoganathan
Dec 3, 2014·The Journal of Thoracic and Cardiovascular Surgery·Elaine Tang, Ajit P Yoganathan
Dec 3, 2014·The Journal of Thoracic and Cardiovascular Surgery·Weiguang YangJeffrey A Feinstein
May 20, 2016·International Journal for Numerical Methods in Biomedical Engineering·Lucian ItuDorin Comaniciu
Jun 9, 2017·The Korean Journal of Thoracic and Cardiovascular Surgery·Jeong-Woo LeeJae Kon Ko
Apr 19, 2017·Journal of Biomechanical Engineering·Mike TreeAjit Yoganathan
Jul 27, 2014·American Journal of Physiology. Heart and Circulatory Physiology·Fuyou LiangHao Liu
Mar 11, 2020·Annals of Biomedical Engineering·Taro KariyaToshiaki Hisada
Aug 12, 2015·Current Opinion in Pediatrics·Alison L Marsden, Jeffrey A Feinstein
Aug 17, 2021·Seminars in Liver Disease·Luis TéllezAgustín Albillos

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