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Frontiers in Physiology
Article . 2022 . Peer-reviewed
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Article . 2022
License: CC BY
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Frontiers in Physiology
Article . 2022
Data sources: DOAJ
https://dx.doi.org/10.48550/ar...
Article . 2022
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Optimal Fenestration of the Fontan Circulation

Authors: Zan Ahmad; Lynn H. Jin; Lynn H. Jin; Daniel J. Penny; Craig G. Rusin; Charles S. Peskin; Charles Puelz; +1 Authors

Optimal Fenestration of the Fontan Circulation

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

fenestration, Physiology, oxygen transport, FOS: Biological sciences, Fontan circulation, QP1-981, Quantitative Biology - Tissues and Organs, hemodynamics, Tissues and Organs (q-bio.TO), compartmental model

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    influence
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
8
Top 10%
Average
Top 10%
Green
gold