Key result
Changing to a quiescent standing position from a horizontal position led to altered patterns of blood flow in regional and global haemodynamics in a personalized computational model.
Why the study?
Computational blood flow models are needed to predict Fontan operation outcomes and optimize total cavopulmonary connection configurations to reduce postoperative complications.
A personalized two-scale haemodynamic model can accurately simulate Fontan circulation and demonstrate postural changes in blood flow that correlate with exercise intolerance.
Postural flow shifts in Fontan models may underlie exercise intolerance; leaves open prospective clinical validation.
Palliation of congenital single ventricle heart defects suggests multi-stage surgical interventions that divert blood flow from the inferior and superior vena cava directly to the right and left pulmonary arteries, skipping the right ventricle. Such system with cavopulmonary anastomoses and single left ventricle is called Fontan circulation, and the region of reconnection is called the total cavopulmonary connection (TCPC). Computational blood flow models allow clinicians to predict the results of the Fontan operation, to choose an optimal configuration of TCPC and thus to reduce negative postoperative consequences. We propose a two-scale (1D3D) haemodynamic model of systemic circulation for a patient who has underwent Fontan surgical operation. We use CT and 4D flow MRI data to personalize the model. The model is tuned to patient’s data and is able to represent measured time-averaged flow rates at the inlets and outlets of TCPC, as well as pressure in TCPC for the patient in horizontal position.We demonstrate that changing to quiescent standing position leads to other patterns of blood flow in regional (TCPC) and global haemodynamics. This confirms clinical data on exercise intolerance of Fontan patients.
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Dobroserdova et al. (2021) studied Fontan circulation (n=1). Quiescent standing position vs. Horizontal position was evaluated on Patterns of blood flow in regional (TCPC) and global haemodynamics. Changing to a quiescent standing position from a horizontal position led to altered patterns of blood flow in regional and global haemodynamics in a personalized computational model.
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