Computational fluid dynamics-driven optimization of Fontan surgery from patient-specific data: A pilot study.

Background: Computational fluid dynamics (CFD) has been utilized to investigate the hemodynamic performance of surgical procedures, leading to enhanced outcomes. Efficient flow path design with minimal energy losses is significant for cavopulmonary connections. The wide variety of patient anatomies makes it challenging to create a universal design for all Fontan patients. Objective: This pilot study aims to develop a methodology for predicting passage with low energy loss and balanced hepatic flow distribution using patient-specific CFD-based analysis for Fontan surgeries. Methodology: A three-dimensional vascular model was reconstructed from magnetic resonance imaging data of a Fontan patient using MIMICS software. Multiple surgical configurations were designed and simulated using ANSYS to evaluate power loss and hepatic flow distribution. Results: Ten patients postbidirectional Glenn who were evaluated for extracardiac Fontan completion below the age of 15 years were considered for the study. Three surgical options were derived for four patients, and the power loss across the and flow distribution into the pulmonary circulation were estimated to obtain the ideal surgical pathway. Results from the pilot study suggest that patient-specific CFD-based surgical planning can aid in designing a more effective flow path. The designed configurations performed better than the actual postoperative configuration. Conclusion: This study demonstrates the feasibility of patient-specific CFD analysis in planning Fontan surgeries. The approach shows promise for broader application across different stages of univentricular palliation, though validation through larger clinical studies is required.