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Full-Text Articles in Engineering
Target Flow-Pressure Operating Range For Designing A Failing Fontan Cavopulmonary Support Device, Masoud Farahmand, Minoo N. Kavarana, Phillip M. Trusty, Ethan Kung
Target Flow-Pressure Operating Range For Designing A Failing Fontan Cavopulmonary Support Device, Masoud Farahmand, Minoo N. Kavarana, Phillip M. Trusty, Ethan Kung
Publications
Fontan operation as the current standard of care for the palliation of single ventricle defects results in significant late complications. Using a mechanical circulatory device for the right circulation to serve the function of the missing subpulmonary ventricle could potentially stabilize the failing Fontan circulation. This study aims to elucidate the hydraulic operating regions that should be targeted for designing cavopulmonary blood pumps. By integrating numerical analysis and available clinical information, the interaction of the cavopulmonary support via the IVC and full assist configurations with a wide range of simulated adult failing scenarios was investigated; with IVC and full assist …
Computational Modeling Of Pathophysiologic Responses To Exercise In Fontan Patients, Ethan Kung, James C. Perry, Christopher Davis, Francesco Migliavacca, Giancarlo Pennati, Alessandro Giardini, Tain-Yen Hsia, Alison Marsden
Computational Modeling Of Pathophysiologic Responses To Exercise In Fontan Patients, Ethan Kung, James C. Perry, Christopher Davis, Francesco Migliavacca, Giancarlo Pennati, Alessandro Giardini, Tain-Yen Hsia, Alison Marsden
Publications
Reduced exercise capacity is nearly universal among Fontan patients. Although many factors have emerged as possible contributors, the degree to which each impacts the overall hemodynamics is largely unknown. Computational modeling provides a means to test hypotheses of causes of exercise intolerance via precisely controlled virtual experiments and measurements. We quantified the physiological impacts of commonly encountered, clinically relevant dysfunctions introduced to the exercising Fontan system via a previously developed lumped-parameter model of Fontan exercise. Elevated pulmonary arterial pressure was observed in all cases of dysfunction, correlated with lowered cardiac output (CO), and often mediated by elevated atrial pressure. Pulmonary …
A Simulation Protocol For Exercise Physiology In Fontan Patients Using A Closed Loop Lumped-Parameter Model, Ethan Kung, Giancarlo Pennati, Francesco Migliavacca, Tian-Yen Hsia, Richard Figliola, Alison Marsden, Alessandro Giardini
A Simulation Protocol For Exercise Physiology In Fontan Patients Using A Closed Loop Lumped-Parameter Model, Ethan Kung, Giancarlo Pennati, Francesco Migliavacca, Tian-Yen Hsia, Richard Figliola, Alison Marsden, Alessandro Giardini
Publications
Background: Reduced exercise capacity is nearly universal among Fontan patients, though its etiology is not yet fully understood. While previous computational studies have attempted to model Fontan exercise, they did not fully account for global physiologic mechanisms nor directly compare results against clinical and physiologic data. Methods: In this study, we developed a protocol to simulate Fontan lower-body exercise using a closed-loop lumped-parameter model describing the entire circulation. We analyzed clinical exercise data from a cohort of Fontan patients, incorporated previous clinical findings from literature, quantified a comprehensive list of physiological changes during exercise, translated them into a computational model …