Christopher M. Haggerty, BS, Kirk R

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Presentation transcript:

Simulating hemodynamics of the Fontan Y-graft based on patient-specific in vivo connections Christopher M. Haggerty, BS, Kirk R. Kanter, MD, Maria Restrepo, BS, Diane A. de Zélicourt, PhD, W. James Parks, MD, Jarek Rossignac, PhD, Mark A. Fogel, MD, Ajit P. Yoganathan, PhD The Journal of Thoracic and Cardiovascular Surgery Volume 145, Issue 3, Pages 663-670 (March 2013) DOI: 10.1016/j.jtcvs.2012.03.076 Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Patient YCPCs (top row; with photograph of bifurcated polytetrafluoroethylene graft) and virtually modeled t-junction (middle row) and offset (bottom row) TCPC controls for all 5 patients. YCPC, Y-graft cavopulmonary connection; TCPC, total cavopulmonary connection. The Journal of Thoracic and Cardiovascular Surgery 2013 145, 663-670DOI: (10.1016/j.jtcvs.2012.03.076) Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Mean, maximum, and minimum values of connection resistance (A) and flow distribution (B) for each connection (YCPC, TCPC, offset) and flow condition (1×, 2×, 3×) investigated. YCPC, Y-graft cavopulmonary connection; TCPC, total cavopulmonary connection; HFD, hepatic flow distribution; LPA, left pulmonary artery. The Journal of Thoracic and Cardiovascular Surgery 2013 145, 663-670DOI: (10.1016/j.jtcvs.2012.03.076) Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Comparison of YCPC and TCPC hemodynamics for patients 1 (A), 2 (B; representative image), and 5 (C). The resting velocity streamlines (top row), 3× velocity streamlines (middle row), and viscous dissipation contours (bottom row) are shown in each case. YCPC, Y-graft cavopulmonary connection; TCPC, total cavopulmonary connection. The Journal of Thoracic and Cardiovascular Surgery 2013 145, 663-670DOI: (10.1016/j.jtcvs.2012.03.076) Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Velocity streamlines (A), vortex core isosurfaces (Q = 800 [top], 13,000 [bottom]) (B), and viscous dissipation contours localized to the vortex isosurfaces (C) for patients 3 (top, rest) and 4 (bottom, 3×). The Journal of Thoracic and Cardiovascular Surgery 2013 145, 663-670DOI: (10.1016/j.jtcvs.2012.03.076) Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions

Figure 5 Streamlines color coded by vessel of origin (red, superior vena cava; blue, inferior vena cava) for (A) the patient 5 offset TCPC (ie, the failed connection before surgical revision) and (B) the postrevision YCPC. YCPC, Y-graft cavopulmonary connection; TCPC, total cavopulmonary connection. The Journal of Thoracic and Cardiovascular Surgery 2013 145, 663-670DOI: (10.1016/j.jtcvs.2012.03.076) Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions