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2012 Pritzker Distinguished Lecturer Ajit P. Yoganathan

Utilizing Engineering Principles to Understand and Improve Single Ventricle Physiology: Patient Specific Surgical Planning for the Fontan Procedure

Ajit P. YoganathanThe Wallace H. Coulter Distinguished Faculty Chair
in Biomedical Engineering and Regents Professor
Wallace H. Coulter Department of Biomedical Engineering,
Georgia Institute of Technology and Emory University

Two in every one thousand births in the United States result in a baby born with a single ventricle (“half a heart”). The total cavopulmonary connection (TCPC) is the current procedure of choice for surgical palliation of single ventricle congenital heart disease.

Even though this has significantly improved the clinical treatment of these patients, they are still subject to long term complications. The hemodynamics/fluid dynamics in these patients is often very complex and subjected to instabilities. To better understand the fluid dynamics and predict patient outcomes, a multi-disciplinary approach—involving engineering, computing and medicinehas been used. In vivo patient-specific anatomy and flow boundary conditions have been obtained with magnetic resonance imaging and phase contrast MRI, respectively.

A computational virtual surgery tool has been developed to simulate a series of surgical options, whose hemodynamic performances are evaluated using computational fluid dynamics. The CFD solver has been previously validated in vitro using digital particle image velocimetry and energy loss measurements. This multidisciplinary approach has been used in prospective surgical planning to evaluate the performance of different surgical options on single ventricle/Fontan patients, especially in the most complex cases. These findings are providing pediatric cardiac surgeons and cardiologists with valuable surgical planning insights into improving patient outcomes.