Fontan Surgical Planning: Previous Accomplishments, Current Challenges, and Future Directions

• Type of Material: Article
• Authors: Phillip M. Trusty, Georgia Institute of Technology; Timothy C. Slesnick, Emory University; Zhenglun Alan Wei, Georgia Institute of Technology; Jarek Rossignac, Georgia Institute of Technology; Kirk R Kanter, Emory University; Mark A. Fogel, Children's Hospital of Philadelphia; Ajit Yoganathan, Emory University
• Language: English
• Date: 2018-04-01
• Publisher: Springer (part of Springer Nature): Springer Open Choice Hybrid Journals
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © �Springer Science+Business Media, LLC, part of Springer Nature 2018
• Final Published Version (URL): http://dx.doi.org/10.1007/s12265-018-9786-0
• Title of Journal or Parent Work: Journal of Cardiovascular Translational Research
• ISSN: 1937-5387
• Volume: 11
• Issue: 2
• Start Page: 133
• End Page: 144
• Grant/Funding Information: This work was funded by NHLBI Grants HL67622 and HL098252 as well as an American Heart Association Predoctoral fellowship 17PRE33630117.
• Keywords: Life Sciences & Biomedicine; Fontan; Medicine, Research & Experimental; Science & Technology; Research & Experimental Medicine; BLOOD-FLOW; SINGLE-VENTRICLE PATIENTS; Cardiac & Cardiovascular Systems; GEOMETRY; Patient specific; PULMONARY ARTERIOVENOUS-MALFORMATION; COMPUTATIONAL FLUID-DYNAMICS; TOTAL CAVOPULMONARY CONNECTION; EFFICIENCY; SIMULATIONS; Surgical planning; Cardiovascular System & Cardiology; Hepatic flow distribution; OPERATION; Pre-operative planning; CIRCULATION
• Research Categories: Engineering, Biomedical; Health Sciences, Medicine and Surgery

Abstract

The ultimate goal of Fontan surgical planning is to provide additional insights into the clinical decision-making process. In its current state, surgical planning offers an accurate hemodynamic assessment of the pre-operative condition, provides anatomical constraints for potential surgical options, and produces decent post-operative predictions if boundary conditions are similar enough between the pre-operative and post-operative states. Moving forward, validation with post-operative data is a necessary step in order to assess the accuracy of surgical planning and determine which methodological improvements are needed. Future efforts to automate the surgical planning process will reduce the individual expertise needed and encourage use in the clinic by clinicians. As post-operative physiologic predictions improve, Fontan surgical planning will become an more effective tool to accurately model patient-specific hemodynamics.