3D-1D simulation of flow in Fontan operation: Effects of antegrade flow on flow pulsations

This study considers blood ow in total cavopulmonary connection (tcpc)morphology created in fontan surgical procedure in patients with a single ventricle heartdisease. ordinary process of tcpc operation reduces pulmonary blood ow pulsatilitysince the right ventricle being bypassed. this reduction may limit the long term outcomeof fontan circulation. there is an idea of increasing pulmonary ow pulsations by keepingmain pulmonary artery (mpa) partially open while it was closed in ordinary tcpcoperation. the purpose of the present study is to verify the eects of antegrade flow(af) coming through stenosed mpa on pulmonary ow pulsations. the 3d geometryis reconstructed from ct angiography scan of a patient who has undergone an ordinarytcpc procedure. the stenosed mpa or pulmonary stenosis (ps) is virtually added tothe original geometry. we applied a 3d-1d coupled method to simulate blood ow in thissituation more precisely. the results show that adding af increases pulsatility index (pi)in both left and right pulmonary artery (lpa and rpa respectively). moreover, addingaf leads to an increase in energy loss. it also increases the pulmonary-to-systemic owratio leading to increase in total cardiac ow rate and hence heart power