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

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.