Effect of caval waveform on energy dissipation of failing fontan patients

This study is a first attempt towards investigating and quantifying hemodynamics in "failing" Fontan patients. Higher energy losses in 1DO TCPC found for the "failing" Fontan patient compared to the functional Fontan at the same normalized cardiac output originates due to the fluctuating IVC and SVC waveforms. Since the influence of TCPC hydrodynamic power loss on cardiac output is quite significant (sensitivity = -0.88 L/Min/Woods Unit) [4] the energy efficiency of the waveform topology becomes a significant hemodynamic parameter which correlates with cardiac malfunction and postoperative complications [5]. Future efforts will expand the limited real-time data through additional clinical studies for improved understanding throughout the disease timeline. The robustness of a new outlet boundary condition in satisfying the mass convergence even with severe and rapidly varying diastolic retrograde flow at multiple branches is found to be suitable for "failing" Fontan analysis. This outlet boundary condition is also applicable to the broader cardiovascular studies where backflow at boundaries cannot be neglected, such as early cardiac development [6], coronary perfusion and cardiopulmonary bypass [2]. Failing-functional Fontan analysis may also shed light to the consequences of the phrenic nerve injury since despite the surgical plication these defects pose similar perturbed hemodynamics such as those seen in failing Fontan circulation [7].