Language
English
Publication Date
1-1-2022
Journal
Frontiers in Physiology
DOI
10.3389/fphys.2022.867995
PMID
35846014
PMCID
PMC9280082
PubMedCentral® Posted Date
6-30-2022
PubMedCentral® Full Text Version
Post-print
Abstract
In this paper, we develop a pulsatile compartmental model of the Fontan circulation and use it to explore the effects of a fenestration added to this physiology. A fenestration is a shunt between the systemic and pulmonary veins that is added either at the time of Fontan conversion or at a later time for the treatment of complications. This shunt increases cardiac output and decreases systemic venous pressure. However, these hemodynamic benefits are achieved at the expense of a decrease in the arterial oxygen saturation. The model developed in this paper incorporates fenestration size as a parameter and describes both blood flow and oxygen transport. It is calibrated to clinical data from Fontan patients, and we use it to study the impact of a fenestration on several hemodynamic variables, including systemic oxygen availability, effective oxygen availability, and systemic venous pressure. In certain scenarios corresponding to high-risk Fontan physiology, we demonstrate the existence of a range of fenestration sizes in which the systemic oxygen availability remains relatively constant while the systemic venous pressure decreases.
Keywords
Fontan circulation, compartmental model, hemodynamics, oxygen transport, fenestration
Published Open-Access
yes
Recommended Citation
Ahmad, Zan; Jin, Lynn H; Penny, Daniel J; et al., "Optimal Fenestration of the Fontan Circulation" (2022). Faculty and Staff Publications. 2989.
https://digitalcommons.library.tmc.edu/baylor_docs/2989