Evidence map›Paper›PMID 24507891›Full record

ArticleThe Journal of thoracic and cardiovascular surgery2014

Fontan hemodynamics from 100 patient-specific cardiac magnetic resonance studies: a computational fluid dynamics analysis.

Christopher M Haggerty, Maria Restrepo, Elaine Tang, Diane A de Zélicourt, Kartik S Sundareswaran, Lucia Mirabella, James Bethel, Kevin K Whitehead, Mark A Fogel, Ajit P Yoganathan

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Journal of thoracic and cardiovascular surgery, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 52 papers.

0numbers the graph read from it
0cells of the map it votes in
52citing papers in PubMed
6.2field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

52 citing papers in PubMed, 103 citations in OpenAlex.

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  6. Applications of Computational Fluid Dynamics in Congenital Heart Disease: A Review.Journal of cardiovascular development and disease · 2025
    Review
  7. Biomechanics and clinical implications of Fontan upsizing.Computers in biology and medicine · 2024
    Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 5 institutions in 2 countries.

Christopher M HaggertyWallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology & Emory University, Atlanta, Ga.
Maria RestrepoWallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology & Emory University, Atlanta, Ga.
Elaine TangWallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology & Emory University, Atlanta, Ga.
Diane A de ZélicourtWallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology & Emory University, Atlanta, Ga; Interface Group, Institute of Physiology, University of Zürich, Zürich, Switzerland.
Kartik S SundareswaranWallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology & Emory University, Atlanta, Ga.
Lucia MirabellaWallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology & Emory University, Atlanta, Ga.
James BethelWestat, Inc, Rockville, Md.
Kevin K WhiteheadDivision of Cardiology, Children's Hospital of Philadelphia, Philadelphia, Pa.
Mark A FogelDivision of Cardiology, Children's Hospital of Philadelphia, Philadelphia, Pa.
Ajit P YoganathanWallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology & Emory University, Atlanta, Ga. Electronic address: ajit.yoganathan@bme.gatech.edu.
Georgia Institute of Technology · USThe Wallace H. Coulter Department of Biomedical Engineering · USChildren's Hospital of Philadelphia · USUniversity of Zurich · CHWestat (United States) · US

Funding

Improving Flow Dynamics in Fontan SurgeriesR01HL067622 · NHLBI · GEORGIA INSTITUTE OF TECHNOLOGY · PI YOGANATHAN, AJIT P · 2002 to 2006
$5.2M
Understanding mechanisms of Fontan failure and key predictors for patient outcomeR01HL098252 · NHLBI · GEORGIA INSTITUTE OF TECHNOLOGY · PI YOGANATHAN, AJIT P · 2010 to 2013
$3.0M
NHLBI NIH HHS R01 HL067622NHLBI NIH HHS R01 HL098252NHLBI NIH HHS R01HL098252NHLBI NIH HHS R01HL67622
6 · The paper itself

Abstract

objectivesThis study sought to quantify average hemodynamic metrics of the Fontan connection as reference for future investigations, compare connection types (intra-atrial vs extracardiac), and identify functional correlates using computational fluid dynamics in a large patient-specific cohort. Fontan hemodynamics, particularly power losses, are hypothesized to vary considerably among patients with a single ventricle and adversely affect systemic hemodynamics and ventricular function if suboptimal.

methodsFontan connection models were created from cardiac magnetic resonance scans for 100 patients. Phase velocity cardiac magnetic resonance in the aorta, vena cavae, and pulmonary arteries was used to prescribe patient-specific time-averaged flow boundary conditions for computational fluid dynamics with a customized, validated solver. Comparison with 4-dimensional cardiac magnetic resonance velocity data from selected patients was used to provide additional verification of simulations. Indexed Fontan power loss, connection resistance, and hepatic flow distribution were quantified and correlated with systemic patient characteristics.

resultsIndexed power loss varied by 2 orders of magnitude, whereas, on average, Fontan resistance was 15% to 20% of published values of pulmonary vascular resistance in single ventricles. A significant inverse relationship was observed between indexed power loss and both systemic venous flow and cardiac index. Comparison by connection type showed no differences between intra-atrial and extracardiac connections. Instead, the least efficient connections revealed adverse consequences from localized Fontan pathway stenosis.

conclusionsFontan power loss varies from patient to patient, and elevated levels are correlated with lower systemic flow and cardiac index. Fontan connection type does not influence hemodynamic efficiency, but an undersized or stenosed Fontan pathway or pulmonary arteries can be highly dissipative.

Indexed as

HemodynamicsModels, CardiovascularChildFemaleFontan ProcedureHeart Defects, CongenitalHemorheologyHumansMagnetic Resonance ImagingMale

Identifiers

PMID24507891
PMCPMC6815671
OpenAlexW2112960218

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.