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Fontan Surgical Planning: Previous Accomplishments, Current Challenges, and Future Directions.

Phillip M Trusty1, Timothy C Slesnick2, Zhenglun Alan Wei1,3

  • 1Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA.

Journal of Cardiovascular Translational Research
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PubMed
Summary

Fontan surgical planning currently assesses hemodynamics and anatomy but needs post-operative data validation. Future automation will improve patient-specific hemodynamic modeling for Fontan procedures.

Keywords:
FontanHepatic flow distributionPatient specificPre-operative planningSurgical planning

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Area of Science:

  • Cardiovascular Surgery
  • Medical Imaging
  • Computational Fluid Dynamics

Background:

  • Fontan surgery is a complex palliative procedure for single-ventricle congenital heart defects.
  • Accurate pre-operative assessment is crucial for optimizing surgical outcomes.
  • Current surgical planning provides hemodynamic insights and anatomical constraints.

Purpose of the Study:

  • To evaluate the current state and future directions of Fontan surgical planning.
  • To highlight the need for post-operative data validation in surgical planning models.
  • To emphasize the potential of automated planning for improved clinical decision-making.

Main Methods:

  • Hemodynamic assessment of pre-operative conditions.
  • Identification of anatomical constraints for surgical options.
  • Post-operative prediction modeling based on boundary conditions.

Main Results:

  • Current surgical planning offers accurate pre-operative hemodynamic assessment.
  • Post-operative predictions are decent when pre- and post-operative conditions are similar.
  • Validation with post-operative data is essential for accuracy assessment and methodological improvement.

Conclusions:

  • Fontan surgical planning requires post-operative data validation to refine accuracy.
  • Automation of surgical planning will enhance clinical adoption and reduce reliance on individual expertise.
  • Improved post-operative physiologic predictions will establish Fontan surgical planning as a key tool for patient-specific hemodynamic modeling.