Fontan operation as the current ultimate palliation of single ventricle defects results in significant late complications eventually leading to a failing circulation. It has been suggested that introducing a cavopulmonary assist device to serve the function of the missing subpulmonary ventricle could potentially stabilize the failing Fontan circulation. The objective of this study is to identify the desired operating region for a cavopulmonary blood pump that can offer a promising alternative treatment option for a wide range of failing Fontan patients . By integrating numerical analysis and available clinical information, the interaction of the cavopulmonary support (producing head pressure rise from 2-20mmHg) via the IVC and full assist configurations with a wide range of simulated adult failing patient cases was investigated; with IVC and full assist corresponding to the inferior venous return or the entire venous return, respectively, being routed through the device. We identified the desired hydraulic operating regions for a cavopulmonary assist device by clustering all head pressures and corresponding pump flows that result in hemodynamic improvement for each simulated failing Fontan physiology. The results presented here can serve as the performance criteria for designing cavopulmonary assist devices as well as evaluating off-label use of commercially available left-side blood pumps for failing Fontan cavopulmonary support.
Fontan operation as the current standard of care for the palliation of single ventricle defects results in significant late complications . Using a mechanical circulatory device that targets the right circulation to serve the function of the missing subpulmonary ventricle could potentially stabilize the failing Fontan circulation. We propose the hydraulic operating regions that should be targeted for designing cavopulmonary blood pumps . By integrating numerical analysis and available clinical information, the interaction of the cavopulmonary support (producing head pressure rise from 2-20mmHg) via the IVC and full assist configurations with a wide range of simulated adult failing patient cases was investigated; with IVC and full assist corresponding to the inferior venous return or the entire venous return, respectively, being routed through the device. We identified the desired hydraulic operating regions for a cavopulmonary assist device by clustering all head pressures and corresponding pump flows that result in hemodynamic improvement for each simulated failing Fontan physiology. The results show that a suitable cavopulmonary assist device could increase cardiac index by 5-45\% and decrease the IVC pressure by 5-70\% depending on the patient's pre-support hemodynamic state and surgical configuration of the cavopulmonary assist device (IVC or full support). The presented flow-pressure operating regions can serve as the performance criteria for designing cavopulmonary assist devices as well as evaluating off-label use of commercially available left-side blood pumps for failing Fontan cavopulmonary support.
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ultimate
standard of care for the
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eventually leading to a failing circulation. It has been suggested that introducing a cavopulmonary assist device
. Using a mechanical circulatory device that targets the right circulation
R
The objective of this study is to identify the desired operating region for a cavopulmonary blood pump that can offer a promising alternative treatment option for a wide range of failing Fontan patients
We propose the hydraulic operating regions that should be targeted for designing cavopulmonary blood pumps
R
presented here
show that a suitable cavopulmonary assist device could increase cardiac index by 5-45\% and decrease the IVC pressure by 5-70\% depending on the patient's pre-support hemodynamic state and surgical configuration of the cavopulmonary assist device (IVC or full support). The presented flow-pressure operating regions