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Computational fluid dynamics-driven optimization of Fontan surgery from patient-specific data: A pilot study.

Saurabh S Nair1, Arun Gopalakrishnan2, Anoop Ayyappan3

  • 1Department of Medical Devices Engineering, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India.

Annals of Pediatric Cardiology
|February 23, 2026
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Summary

Patient-specific computational fluid dynamics (CFD) analysis aids in planning Fontan surgeries by optimizing surgical pathways for reduced energy loss and improved hepatic flow. This approach enhances outcomes for cavopulmonary connections in complex pediatric heart conditions.

Keywords:
Computational fluid dynamicsFontanhemodynamicsmagnetic resonance imagingtotal cavopulmonary connection

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Area of Science:

  • Cardiovascular Surgery
  • Medical Imaging
  • Computational Fluid Dynamics

Background:

  • Computational fluid dynamics (CFD) is crucial for assessing surgical hemodynamics, particularly in cavopulmonary connections where efficient flow path design minimizes energy loss.
  • Patient-specific anatomical variations in Fontan procedures present challenges for a one-size-fits-all surgical design.

Purpose of the Study:

  • To develop a patient-specific CFD methodology for predicting optimal surgical pathways in Fontan surgeries.
  • To achieve low energy loss and balanced hepatic flow distribution through CFD-based analysis.

Main Methods:

  • Three-dimensional vascular models were created from patient MRI data using MIMICS software.
  • Multiple surgical configurations were designed and simulated in ANSYS to evaluate power loss and hepatic flow distribution.

Main Results:

  • Patient-specific CFD analysis identified superior surgical configurations compared to the actual postoperative design.
  • Simulations in four patients revealed reduced power loss and improved pulmonary circulation flow distribution.

Conclusions:

  • Patient-specific CFD analysis is a feasible approach for planning Fontan surgeries.
  • This methodology shows potential for optimizing univentricular palliation across various stages, pending larger clinical validation.