Background: Single ventricle congenital heart defects with cyanotic mixing between
systemic and pulmonary circulations afflict 2 per 1000 live births. Following the atriopulmonary
connection proposed by Fontan and Baudet in 1971, the present procedure is the
total cavopulmonary connection (TCPC), where the superior vena cava (SVC) and inferior
vena cava (IVC) are sutured to the left pulmonary artery (LPA) and right pulmonary
artery (RPA). However, surgeon preference dictates the implementation of the extra-cardiac
and intra-atrial varieties of the TCPC. Overall efficiency and hemodynamic advantage of the
competing methodologies have not been determined. Hypothesis: It is hypothesized that
an understanding of the experimental fluid dynamic differences between various Fontan
surgical methodologies in the TCPC allows for power loss evaluation toward improved surgical
planning and design. Methods: Toward such analysis, a previously developed data
processing methodology is applied to create an anatomic database of single ventricle patients
from in vivo magnetic resonance imaging (MRI) to examine the gamut of TCPC
anatomies. From stereolithographic models of representative cases, pressure and flow data
are used to quantify control volume power loss to measure overall efficiency. particle image
velocimetry (PIV) is employed to detail flow structures in the vasculature. Results are
validated with dye injection flow visualization and 3-D phase contrast magnetic resonance
imaging (PC-MRI) velocimetry, highlighting flow phenomena that cannot be captured with
in vivo MRI due to prohibitively long scanning times. Preliminary results illustrate the
variation of control volume power loss over several TCPC anatomies with varying flow
conditions, the application of PIV, and validation approaches with 3-D PC-MRI velocimetry.
Data from control volume power loss evaluation demonstrate a correlation with TCPC
anatomy, providing added clinical knowledge of optimal TCPC design. Findings from PIV
and 3-D PC-MRI velocimetry reveal a means for quantitatively comparing flow structure.
Dye injection flow visualization offers qualitative insight into limitations of the selected velocimetry techniques.Ph.D.Committee Chair: Yoganathan, Ajit P.; Committee Member: Fogel, Mark A.; Committee Member: Oshinski, John N.; Committee Member: Parks, W. James; Committee Member: Skrinjar, Oska
