ArticleIEEE transactions on bio-medical engineering2022
Surgical Planning and Optimization of Patient-Specific Fontan Grafts With Uncertain Post-Operative Boundary Conditions and Anastomosis Displacement.
Article in IEEE transactions on bio-medical engineering, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- The utility of 4D flow MRI and computational fluid dynamics in developing the fontan model enhances presurgical planning and ensures better outcomes: the first case report in Thailand.Journal of cardiothoracic surgery · 2026Article
- Article
- Significance of Reynolds Number Consistency in Non-Newtonian Hemodynamic Simulations: Insights from Fontan Circulation.Physics of fluids (Woodbury, N.Y. : 1994) · 2025Article
- Decoding uncertainty for clinical decision-making.Philosophical transactions. Series A, Mathematical, physical, and engineering sciences · 2025Article
- The impact of blood viscosity modeling on computational fluid dynamic simulations of pediatric patients with Fontan circulation.Physics of fluids (Woodbury, N.Y. : 1994) · 2024Article
- The convergent cavopulmonary connection: A novel and efficient configuration of Fontan to accommodate mechanical support.JTCVS open · 2023Article
- Virtual Reality Cardiac Surgical Planning Software (CorFix) for Designing Patient-Specific Vascular Grafts: Development and Pilot Usability Study.JMIR cardio · 2022Article
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Authors and funding
8 authors.
Funding
Abstract
objectiveFontan surgical planning involves designing grafts to perform optimized hemodynamic performance for the patient's long-term health benefit. The uncertainty of post-operative boundary conditions (BC) and graft anastomosis displacements can significantly affect optimized graft designs and lead to undesirable outcomes, especially for hepatic flow distribution (HFD). We aim to develop a computation framework to automatically optimize patient-specific Fontan grafts with the maximized possibility of keeping post-operative results within clinical acceptable thresholds.
methodsThe uncertainties of BC and anastomosis displacements were modeled using Gaussian distributions according to prior research studies. By parameterizing the Fontan grafts, we built surrogate models of hemodynamic parameters taking the design parameters and BC as input. A two-phase reliability-based robust optimization (RBRO) strategy was developed by combining deterministic optimization (DO) and optimization under uncertainty (OUU) to reduce computational cost.
resultsWe evaluated the performance of the RBRO framework by comparing it with the DO method in four cases of Fontan patients. The results showed that the surgical plans computed from the proposed method yield up to 79.2% improvement in the reliability of the HFD than those of the DO method ( ). The mean values of indexed power loss (iPL) and the percentage of non-physiologic wall shear stress (%WSS) for the optimized surgical plans met the clinically acceptable thresholds.
conclusionThis study demonstrated the effectiveness of our RBRO framework to address the uncertainties of BC and anastomosis displacements for Fontan surgical planning. SIGNIFICANCE: The technique developed in this paper demonstrates a significant improvement in the reliability of the predicted post-operative outcomes for Fontan surgical planning. This planning technique is immediately applicable as a building block to enable technology for optimal long-term outcomes for pediatric Fontan patients and can also be used in other pediatric and adult cardiac surgeries.
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