Hemodynamic assessment of virtual surgery options for a failing Fontan using lumped parameter simulation

Image processing, virtual anatomy-editing tools, and computational solvers (CFD) offer unique opportunities for pre-operatively modeling and evaluating surgical repairs of congenital heart disease, such as single ventricle defects. In a recent case, three patient-specific Fontan models were evaluated using CFD. To better understand their impact on entire circulation, we extend this work by performing lumped parameter simulations with a circuit analog of the cardiovascular system. For the relatively small range of resting Fontan resistances evaluated (0.66-1.30 WU), large decreases in cardiac output (12%) and systemic arterial pressure (9%), and a slight increase in mean systemic venous pressure (2%) were observed. In summary, the inclusion of 1D lumped parameter modeling to existing surgical planning methodologies may allow researchers and clinicians to better understand the impact of Fontan hemodynamics on the rest of the body.