Patient-Specific Modeling of Hemodynamics: Supporting Surgical Planning in a Fontan Circulation Correction

  • Theodorus M. J. van BakelEmail author
  • Kevin D. Lau
  • Jennifer Hirsch-Romano
  • Santi Trimarchi
  • Adam L. Dorfman
  • C. Alberto Figueroa
Original Article


Computational fluid dynamics (CFD) is a modeling technique that enables calculation of the behavior of fluid flows in complex geometries. In cardiovascular medicine, CFD methods are being used to calculate patient-specific hemodynamics for a variety of applications, such as disease research, noninvasive diagnostics, medical device evaluation, and surgical planning. This paper provides a concise overview of the methods to perform patient-specific computational analyses using clinical data, followed by a case study where CFD-supported surgical planning is presented in a patient with Fontan circulation complicated by unilateral pulmonary arteriovenous malformations. In closing, the challenges for implementation and adoption of CFD modeling in clinical practice are discussed.


Computational fluid dynamics Patient-specific modeling Hemodynamics Surgical planning Pulmonary arteriovenous malformations Single ventricle 







Azygos vein


Computer-aided design


Computational fluid dynamics


Computed tomography


Cavopulmonary anastomosis


Fontan conduit


Fluid structure interaction


Hepatic vein


Hepatic venous flow


High performance computing


Inferior vena cava


Left pulmonary artery


Left innominate vein


Magnetic resonance angiography


Pulmonary arteriovenous malformation


Phase-contrast MRI


Pulse wave velocity


Right innominate vein


Right pulmonary artery



The authors gratefully acknowledge financial support from the European Research Council under the European Union’s Seventh Framework Programme (FP/2007-2013)/ERC Grant Agreement No. 307532, the Edward B. Diethrich Professorship, the Bob and Ann Aikens Aortic Grants Program, and the Frankel Cardiovascular Center. Computing resources were provided by the National Science Foundation via grant 1531752 MRI: Acquisition of Conflux, A Novel Platform for Data-Driven Computational Physics (Tech. Monitor: Ed Walker).

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest related to the contents of the manuscript.

Ethics Approval and Consent to Participate

All procedures followed were in accordance with the ethical standards of the institutional review board (University of Michigan record number HUM00136247) and with the Helsinki Declaration of 1975 and its later amendments. The need for patient consent for the preparation of this manuscript was waived.


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© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of SurgeryUniversity of MichiganAnn ArborUSA
  2. 2.University of Michigan C.S. Mott Children’s Hospital Congenital Heart CenterAnn ArborUSA
  3. 3.Policlinico San Donato IRCCS, Thoracic Aortic Research CenterSan Donato MilaneseItaly
  4. 4.Department of Biomedical EngineeringUniversity of MichiganAnn ArborUSA

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