Evaluation of Hemodynamic Performance of Total Cavopulmonary Connection (TCPC) with Porous Inserts

Summary

Infants born with univentricular heart disease undergo Fontan surgery in order to establish separate systemic and pulmonary circulations. This surgery results in better blood circulation across a single ventricle that supplies oxygenated blood to the body and passively returns venous blood to the lungs through the total cavopulmonary connection (TCPC). Reducing the pressure drop across the TCPC during Fontan circulation helps in reducing the work load of univentricular heart and various designs have been proposed for this purpose. The goal of this work is to analyze the effect of placing a porous insert at an appropriate position in the pulmonary artery, on the pressure drop across the TCPC. A 3D computational model of a total TCPC connection provided with a porous insert is developed and solved by finite volume method, under assumptions of steady, laminar and Newtonian flows. The effects of the porous medium properties - porosity and permeability - across the connection, are analyzed. Compared to the no-porous medium case, TCPC with the porous medium insert, exhibits a maximum reduction of 27% in energy loss for the flow range studied. The porous medium employed in TCPC connection lowers the energy dissipation by curtailing the flow recirculation zones across the connection. The influences of the diameter of the blood vessel, total cardiac output, and the thickness, permeability and position of porous media, on energy loss are analyzed. The criteria to select the porous medium properties and position for a given Fontan geometry are also determined. This article is protected by copyright. All rights reserved.

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