ArticleJournal of biomechanics2019
The effect of respiration-driven flow waveforms on hemodynamic metrics used in Fontan surgical planning.
Article in Journal of biomechanics, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 16 citations in OpenAlex.
- Non-Newtonian Effects on Patient-Specific Modeling of Fontan Hemodynamics.Annals of biomedical engineering · 2020Trial
- Computational Investigation of Anastomosis Options of a Right-Heart Pump to Patient Specific Pulmonary Arteries.Annals of biomedical engineering · 2022Article
- 4D flow cardiovascular magnetic resonance derived energetics in the Fontan circulation correlate with exercise capacity and CMR-derived liver fibrosis/congestion.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance · 2022Article
- Is Doppler Echocardiography Adequate for Surgical Planning of Single Ventricle Patients?Cardiovascular engineering and technology · 2021Article
- Engineering Perspective on Cardiovascular Simulations of Fontan Hemodynamics: Where Do We Stand with a Look Towards Clinical Application.Cardiovascular engineering and technology · 2021Article
- The Influence of Respiration on Blood Flow in the Fontan Circulation: Insights for Imaging-Based Clinical Evaluation of the Total Cavopulmonary Connection.Frontiers in cardiovascular medicine · 2021Review
- Article
- Impact of Free-Breathing Phase-Contrast MRI on Decision-Making in Fontan Surgical Planning.Journal of cardiovascular translational research · 2020Article
- Comparison of Fontan Surgical Options for Patients with Apicocaval Juxtaposition.Pediatric cardiology · 2020Article
- Analysis of Inlet Velocity Profiles in Numerical Assessment of Fontan Hemodynamics.Annals of biomedical engineering · 2019Article
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
Abstract
objectivePoor total cavopulmonary connection (TCPC) hemodynamics have been hypothesized to be associated with long-term complications in Fontan patients. Image-based Fontan surgical planning has shown great potential as a clinical tool because it can pre-operatively evaluate patient-specific hemodynamics. Current surgical planning paradigms commonly utilize cardiac-gated phase contrast magnetic resonance (MR) imaging to acquire vessel flows. These acquisitions are often taken under breath-held (BH) conditions and ignore the effect of respiration on blood flow waveforms. This study investigates the effect of respiration-driven flow waveforms on patient-specific hemodynamics using real-time MR acquisitions.
methodsPatient-specific TCPCs were reconstructed from cardiovascular MR images. Real-time phase contrast MR images were acquired under both free-breathing (FB) and breath-held conditions for 9 patients. Numerical simulations were employed to assess flow structures and hemodynamics used in Fontan surgical planning including hepatic flow distribution (HFD) and indexed power loss (iPL), which were then compared between FB and BH conditions.
resultsDifferences in TCPC flow structures between FB and BH conditions were observed throughout the respiratory cycle. However, the average differences (BH - FB values for each patient, which are then averaged) in iPL and HFD between these conditions were 0.002 ± 0.011 (p = 0.40) and 1 ± 3% (p = 0.28), respectively, indicating no significant difference in clinically important hemodynamic metrics.
conclusionsRespiration affects blood flow waveforms and flow structures, but might not significantly influence the values of iPL or HFD. Therefore, breath-held MR acquisition can be adequate for Fontan surgical planning when focusing on iPL and HFD.
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