Engineering Commons^™

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 …

Predictive Modeling Of The Virtual Hemi-Fontan Operation For Second Stage Single Ventricle Palliation: Two Patient-Specific Cases, Ethan Kung, Alessia Baretta, Catriona Baker, Gregory Arbia, Giovanni Biglino, Chiara Corsini, Silvia Schievano, Irene E. Vignon-Clementel, Gabriele Dubini, Giancarlo Pennati, Andrew Taylor, Adam Dorfman, Anthony M. Hlavacek, Alison L. Marsden, Tain-Yen Hsia, Francesco Migliavacca

Publications

Single ventricle hearts are congenital cardiovascular defects in which the heart has only one functional pumping chamber. The treatment for these conditions typically requires a three-staged operative process where Stage 1 is typically achieved by a shunt between the systemic and pulmonary arteries, and Stage 2 by connecting the superior venous return to the pulmonary circulation. Surgically, the Stage 2 circulation can be achieved through a procedure called the Hemi-Fontan, which reconstructs the right atrium and pulmonary artery to allow for an enlarged confluence with the superior vena cava.

Based on pre-operative data obtained from two patients prior to Stage …