In-silico Estimation of Individual Lung Pulmonary Vascular Resistance in Children with Glenn Physiology: A Two-Center Study

Motivation: Individual lung pulmonary vascular resistance (PVR) estimates are needed to implement virtual Fontan surgical optimization, which aims to improve hepatic flow distribution to the lungs for children with a single functional ventricle. Goal(s): Compare PVR estimates across two centers using cardiac magnetic resonance (CMR) and catheterization (CATH) data. Approach: Utilize computational fluid dynamics (CFD) simulations to estimate the PVR of the left and right lungs from CMR and CATH data. Results: PVR estimates using the CFD pipeline strongly correlate to the clinical PVRs, with R2 > 0.95 and mean flow and pressure errors < 10% for both centers. Impact: Accurate PVR estimation can be performed on datasets from independent centers, which could allow for future virtual Fontan surgical planning to be adopted more broadly.