1. Hepatic blood flow distribution and performance in conventional and novel Y-graft Fontan geometries: A case series computational fluid dynamics study 
Weiguang Yang, MS, Irene E. Vignon-Clementel, PhD, Guillaume Troianowski, MS, V. Mohan Reddy, MD, Jeffrey A. Feinstein, MD, MPH, Alison L. Marsden, PhD 
The Journal of Thoracic and Cardiovascular Surgery 
Volume 143, Issue 5, Pages (May 2012)
DOI: /j.jtcvs
Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

2. Figure 1
Original Glenn models and variations of Fontan geometries for 5 patients. The Y-graft includes a 20-mm trunk and two 15-mm branches. The size of the tube-shaped graft is 20 mm. Patients B and E have a stenosis in the left and right pulmonary arteries, respectively, denoted by arrows.
The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs )
Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

3. Figure 2
Visualization of the particle tracking in the model Y-graft II for patient B. Particle tracking is terminated when particles are washed from the model. LPA, Left pulmonary artery; RPA, right pulmonary artery.
The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs )
Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

4. Figure 3
Left, Hepatic flow distribution at rest. Right, Differences (percentage of the IVC flow) from the theoretical optima for each design at rest and exercise. Note that the theoretical optima for patient A at rest, 2×, and 3×, are 61/39, 70/30 and 72/28, respectively, and that a 50:50 split cannot be achieved in theory. IVC, Inferior vena cava; RPA, right pulmonary artery; LPA, left pulmonary artery.
The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs )
Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

5. Figure 4
Time-averaged velocity vectors in the Y-graft and T-junction models for patients A, D, and E. In the T-junction design for patient A, the SVC jet blocks the hepatic flow entering the LPA. In patient D, most SVC flow is directed to the RPA owing to a curved SVC. In patient E, Y-graft II improves the hepatic flow distribution by having a straight proximal branch for the RPA, in which the SVC jet blocks hepatic flow going to the RPA from the right branch, compared with Y-graft I. SVC, Superior vena cava; LPA, left pulmonary artery; RPA, right pulmonary artery.
The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs )
Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

6. Figure 5
Hepatic flow distribution changes with variations in pulmonary flow split. Patients’ original pulmonary flow splits are marked by the arrows at the x-axis. The table shows the averaged deviations with respect to the original hepatic flow distribution for a 25% change in pulmonary flow split. IVC, Inferior vena cava; RPA, right pulmonary artery.
The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs )
Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

7. Figure 6
Contours of time-averaged wall shear stress (dynes/cm2) at rest for patients A and C.
The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs )
Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

8. Figure 7
Averaged differences from the theoretical optima and power losses over 5 patients. The best performing of the Y-graft and offset designs for patients B and E are used. The differences between the Y-graft and T-junction designs are statistically significant (∗P < .05).
The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs )
Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

9. Figure 8
Based on conservation of mass, we have QRPA=QIVC·x+QSVC·y and QLPA=QIVC·(1−x)+QSVC·(1−y), where x is the fraction of hepatic flow going to the RPA and y is the fraction of SVC flow going to the RPA. SVC, Superior vena cava; IVC, inferior vena cava; RPA, right pulmonary artery; LPA, left pulmonary artery; Q, flow rate.
The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs )
Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions