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Investigation of a novel method for improving hemodynamics of Fontan circuit using an experimental model
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  • Suneet Bhansali,
  • Tsusheel Kumar,
  • Maya Crawford Crawford,
  • Nikhil R. Katre
Suneet Bhansali
NYU Langone Health

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Tsusheel Kumar
NYU Langone Health
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Maya Crawford Crawford
Northeastern University Department of Biology
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Nikhil R. Katre
Veol Medical Technologies Pvt Ltd Navi Mumbai India
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Background: The study objective was to test underlying physical laws behind a proposed novel device for failing Fontan and investigate whether the device could be implemented theoretically to improve hemodynamics in failing Fontan circulation. Methods: A 4-arm setup was designed and fabricated to simulate an actual Fontan circuit in the form of a junction of the superior and inferior vena cavae (SVC, IVC) with the right and left pulmonary arteries (RPA, LPA). A provision for placement of an oscillating ball along the RPA-LPA path to push fluid away from SVC and IVC was created. The rate of ball oscillations and initial pressure of fluid on SVC and IVC limbs were varied. The pressure-drop times in the vena cavae limbs were measured at varying ball oscillations and resistances in the RPA-LPA pathway. The test was considered positive if increasing oscillations of the ball allowed for quicker pressure drop in the SVC and IVC limbs indicating quicker discharge of fluid through the RPA and LPA. 48 different experiments were conducted to simulate different physical conditions and the results were plotted and analyzed to draw a conclusion. Results: The time required for pressure drop in the experiment without ball was the least across all set of readings. This meant that placing an oscillating ball along the RPA -LPA path created obstruction to flow rather than enhance it. Increasing rate of ball oscillations increased degree of obstruction to flow. Conclusion: The proposed interventional method is unsuitable for improving hemodynamics in failing Fontan circulation.