Abstract
Objectives: To study the effects of a self-powered Fontan circulation in both idealized Fontan models and patient-specific models. Methods: In silico, a conduit with a nozzle was introduced from ascending aorta into the anastomosis of superior vena cava and pulmonary artery. Computational fluid dynamics (CFD) simulation was applied to calculate the fluid fields of models. Three 3-dimentional idealized models with different offsets were reconstructed by computer-aided design to evaluate the effects of the self-powered conduit. Furthermore, to validate the effects in patient-specific models, the conduit was introduced to three reconstructed models with different offsets. Results: The pressures at superior venae cavae and inferior venae cavae were decreased in both idealized models (0.4 mmHg) and patient-specific models (0.7 mmHg). In idealized models, the flows to left lungs were decreased (70%) by the jets from the conduits. However, in patient-specific models, the reductions of blood to the left lungs were relatively limited (30%) comparing to idealized models. Conclusions: CFD simulation was applied to analyze the effectiveness of the Fontan self-powered conduit. This self-powered conduit may help to decrease the venae cavae pressures and increase the flow to pulmonary arteries.
Highlights
It was observed that all the conduits inserted from different points could drop the pressures at the superior vena cava (SVC) and IVCs by approximately 0.3 mmHg
The pressure drops between the venae cavae and pulmonary arteries became negative (changed from 0.2 mmHg to −0.9 mmHg) after adding the conduits
The features of this study include the following: (1) extracardiac Fontan with different offsets were included; (2) different insert positions were simulated; (3) the conduit could provide kinetic energy for the circulation, reducing the pressure of the venae cavae, which could increase the flow of pulmonary arteries without increasing pressures at the venae cavae; (4) both the spatial structures and feasibility of inserting a single conduit were taken into account, which makes the self-powered Fontan procedure applicable in clinical practice
Summary
To study the effects of a self-powered Fontan circulation in both idealized Fontan models and patient-specific models. Three 3-dimentional idealized models with different offsets were reconstructed by computer-aided design to evaluate the effects of the self-powered conduit. To validate the effects in patient-specific models, the conduit was introduced to three reconstructed models with different offsets. The flows to left lungs were decreased (70%) by the jets from the conduits. In patient-specific models, the reductions of blood to the left lungs were relatively limited (30%) comparing to idealized models. Conclusions: CFD simulation was applied to analyze the effectiveness of the Fontan self-powered conduit. This self-powered conduit may help to decrease the venae cavae pressures and increase the flow to pulmonary arteries
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