Importance of Pre-Operative Hemodynamics in the Surgical Planning of Complex Single Ventricle Patients

Unbalanced distribution of hepatic blood flow to the lungs in single ventricle patients can result in the formation of harmful arterial-venous shunts. Careful planning of the hepatic baffle placement to optimize its distribution can help to minimize this risk. The combination of in vivo imaging, a computational fluids solver, and a state-of-the-art virtual surgery interface have successfully been demonstrated to assist in this planning step. In the present study, we analyze the effect of the patient-derived flow boundary conditions on the optimal solutions obtained from the simulations for a particular set of complex cases with interrupted inferior vena cava. By considering two patients with similar anatomical configurations but drastically different hemodynamics, we see that differences in the percentage of cardiac output carried by each of the inflow vessels can drastically alter the optimal surgical approach.