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Author Notes:

Ajit P. Yoganathan, Associate Chair, Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology & Emory University, Technology Enterprise Park, Suite 200, 387 Technology Circle, Atlanta, GA 30313-2412, Tel: +1 404-894-2849, Fax: +1 404-385-1268, ajit.yoganathan@bme.gatech.edu.

The authors acknowledge Veronica O'Connor and Ravi Doddasomayajula, from the Children's Hospital of Philadelphia, for their contributions on assisting with patient data collection.

There are no industry relationships to disclose.


Research Funding:

This study was supported by the National Heart, Lung, and Blood Institute Grants HL67622 and HL098252.


  • Science & Technology
  • Life Sciences & Biomedicine
  • Cardiac & Cardiovascular Systems
  • Radiology, Nuclear Medicine & Medical Imaging
  • Cardiovascular System & Cardiology
  • congenital heart defects
  • Fontan procedure
  • hemodynamics

Geometric Characterization of Patient-Specific Total Cavopulmonary Connections and its Relationship to Hemodynamics


Journal Title:

JACC: Cardiovascular Imaging


Volume 7, Number 3


, Pages 215-224

Type of Work:

Article | Post-print: After Peer Review


Total cavopulmonary connection (TCPC) geometries have great variability. Geometric features, such as diameter, connection angle, and distance between vessels, are hypothesized to affect the energetics and flow dynamics within the connection. This study aimed to identify important geometric characteristics that can influence TCPC hemodynamics. Anatomies from 108 consecutive patients were reconstructed from cardiac magnetic resonance (CMR) images and analyzed for their geometric features. Vessel flow rates were computed from phase contrast CMR. Computational fluid dynamics simulations were carried out to quantify the indexed power loss and hepatic flow distribution. TCPC indexed power loss correlated inversely with minimum Fontan pathway (FP), left pulmonary artery, and right pulmonary artery diameters. Cardiac index correlated with minimum FP diameter and superior vena cava (SVC) minimum/maximum diameter ratio. Hepatic flow distribution correlated with caval offset, pulmonary flow distribution, and the angle between FP and SVC. These correlations can have important implications for future connection design and patient follow-up.

Copyright information:

© 2014 by the American College of Cardiology Foundation.

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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