Martin A. Cinelli Anthony J. Damon Levi A. Blumer Arka Das Eduardo Divo
Embry-Riddle Aeronautical University
The Fontan circulation is a fragile system in which imperfections at any one of multiple levels may compromise quality of life, produce secondary pathophysiology, and shorten life span. Despite positi..
The Fontan circulation is a fragile system in which imperfections at any one of multiple levels may compromise quality of life, produce secondary pathophysiology, and shorten life span. Despite positive outcomes over the years, the Fontan circulation still presents survival rates of less than 50%. Increased inferior vena caval (IVC) pressure itself may play some role in “Fontan failure”. We propose to augment energy in the Fontan circulation with an injection jet shunt (IJS) drawing flow directly from the aortic arch, balanced by a conduit-to-atrial fenestration to approximately preserve the ratio of pulmonary flow (Qp) to systemic flow (Qs). Currently to mitigate IVC pressures surgeons often implement an orifice, called fenestration, between the IVC and the right atrium which bypasses the lungs. The amount of pressure relief is proportional to the size of the fenestration. Preliminary experimental results closely validate the detailed in-silico findings. Benchtop study shows that increasing the fenestration size can incrementally drop the IVC pressure, the systemic oxygen saturation can be adversely affected. Enlargement of the fenestration to 7 mm results in a significant IVC pressure drop with a reduction in systemic oxygen saturation. Addition of an IJS to this Fontan model helps to preserve the IVC pressure drop while improves systemic oxygen saturation, hemodynamically insignificant volume load to the ventricle.