Effect of Somatic Growth on Fontan Conduits

Single ventricular defects are a type of congenital heart disease that can be treated through the Fontan Procedure, where a conduit is implanted connecting the inferior vena cava to the pulmonary artery (PA). Native vasculature grows over time, whereas the synthetic conduit does not. This study focused on growth of the PA over time, resulting in conduit shape and hemodynamic changes. Five patients were analyzed at two timepoints spanning a range of one to four years, all of which had 18-20 mm Fontan conduits. Each timepoint’s desired Fontan route was created into a 3D model through a process called segmentation using MRI scans in Scan IP software. Abaqus CAE software was utilized to simulate exercise pressure conditions and investigate changes in structure. Finally, growth mapping was performed and shape index and curvedness values were found using MATLAB software. Results demonstrated inconsistent growth patterns, meaning growth is likely not enough to explain anterior shifts in the Fontan route. Next steps include obtaining Computational Fluid Dynamics data on XFlow software for a thorough analysis on hemodynamic state. In the future, this research can inform patient-specific conduit placement and size to achieve ideal hemodynamics, thus enhancing the Fontan Procedure to improve patient outcomes.