In Vitro and In Silico Analysis of Entrainment Characterization in Injection Jet-Assisted Fontan Circulation

Fontan circulation is a fragile system in which imperfections at any of multiple levels may compromise the quality of life, produce secondary pathophysiology, and shorten life span. Increased inferior vena caval pressure itself may play a role in “Fontan failure”. This study describes a mock flow lo...

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Main Authors: Arka Das, Ray O. Prather, Anthony Damon, Michael Farias, Alain Kassab, Eduardo Divo, William DeCampli
Format: Article
Language:English
Published: MDPI AG 2025-05-01
Series:Bioengineering
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Online Access:https://www.mdpi.com/2306-5354/12/5/555
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author Arka Das
Ray O. Prather
Anthony Damon
Michael Farias
Alain Kassab
Eduardo Divo
William DeCampli
author_facet Arka Das
Ray O. Prather
Anthony Damon
Michael Farias
Alain Kassab
Eduardo Divo
William DeCampli
author_sort Arka Das
collection DOAJ
description Fontan circulation is a fragile system in which imperfections at any of multiple levels may compromise the quality of life, produce secondary pathophysiology, and shorten life span. Increased inferior vena caval pressure itself may play a role in “Fontan failure”. This study describes a mock flow loop model (MFL) designed to quantitatively estimate pulmonary flow entrainment induced by continuous and pulsed flow injections. A patient generic 3D-printed phantom model of the total cavopulmonary connection (TCPC) with average dimensions matching those of a 2–4-year-old patient was inserted in an MFL derived from a reduced lumped parameter model (LPM) representing cardiovascular circulation. The LPM comprises four 2-element Windkessel compartments (compliance and resistance), approximating the upper and lower systemic circulations and the right and left pulmonary circulations. The prescribed cardiac output is about 2.3 L/min for a body surface area of <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><mn>0.675</mn><msup><mrow><mrow><mo> </mo><mi mathvariant="normal">m</mi></mrow></mrow><mn>2</mn></msup></mrow></semantics></math></inline-formula>. The injections originate from an external pump through a 7–9 fr catheter, following a strict protocol suggested by the clinical team, featuring a variation in injection rate (flow rate), injection volume, and injection modality (continuous or pulsed). The key measurements in this study are the flow rates sampled at the distal pulmonary arteries, as well as at the upper and lower body boundaries. These measurements were then used to calculate effective entrainment as the difference between the measured and expected flow rates, as well as jet relaxation (rise and fall time of injection). The results show that for continuous or pulsed injections, varying the total volume injected has no significant influence on the entrainment rate across all injection rates. On the other hand, for both injection modalities, increasing the injection rate results in a reduction in entrainment that is consistent across all injected volumes. This study demonstrates the effectiveness of a high-speed injection jet entraining a slow co-flow while determining the potential for fluid buildup, which could ultimately cause an increase in caval pressure. To avoid the increase in caval pressure due to mass accumulation, we added a fenestration to our proposed injection jet shunt-assisted Fontan models. It was found that for a set of well-defined parameters, the jet not only can be beneficial to the local flow, but any adverse effect can be obviated by careful tuning. These results were also cross-validated with similar in silico findings.
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spelling doaj-art-0dfb217c97154cf1bb35f9683aa4fb752025-08-20T01:56:25ZengMDPI AGBioengineering2306-53542025-05-0112555510.3390/bioengineering12050555In Vitro and In Silico Analysis of Entrainment Characterization in Injection Jet-Assisted Fontan CirculationArka Das0Ray O. Prather1Anthony Damon2Michael Farias3Alain Kassab4Eduardo Divo5William DeCampli6Department of Mechanical Engineering, Embry-Riddle Aeronautical University, Daytona Beach, FL 32114, USADepartment of Mechanical Engineering, Embry-Riddle Aeronautical University, Daytona Beach, FL 32114, USADepartment of Mechanical Engineering, Embry-Riddle Aeronautical University, Daytona Beach, FL 32114, USADepartment of Cardiology, Boston Children’s Hospital, Boston, MA 02115, USADepartment of Mechanical and Aerospace Engineering, University of Central Florida, Orlando, FL 32816, USADepartment of Mechanical Engineering, Embry-Riddle Aeronautical University, Daytona Beach, FL 32114, USAThe Heart Institute at Orlando Health Arnold Palmer Hospital for Children, Orlando, FL 32806, USAFontan circulation is a fragile system in which imperfections at any of multiple levels may compromise the quality of life, produce secondary pathophysiology, and shorten life span. Increased inferior vena caval pressure itself may play a role in “Fontan failure”. This study describes a mock flow loop model (MFL) designed to quantitatively estimate pulmonary flow entrainment induced by continuous and pulsed flow injections. A patient generic 3D-printed phantom model of the total cavopulmonary connection (TCPC) with average dimensions matching those of a 2–4-year-old patient was inserted in an MFL derived from a reduced lumped parameter model (LPM) representing cardiovascular circulation. The LPM comprises four 2-element Windkessel compartments (compliance and resistance), approximating the upper and lower systemic circulations and the right and left pulmonary circulations. The prescribed cardiac output is about 2.3 L/min for a body surface area of <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><mn>0.675</mn><msup><mrow><mrow><mo> </mo><mi mathvariant="normal">m</mi></mrow></mrow><mn>2</mn></msup></mrow></semantics></math></inline-formula>. The injections originate from an external pump through a 7–9 fr catheter, following a strict protocol suggested by the clinical team, featuring a variation in injection rate (flow rate), injection volume, and injection modality (continuous or pulsed). The key measurements in this study are the flow rates sampled at the distal pulmonary arteries, as well as at the upper and lower body boundaries. These measurements were then used to calculate effective entrainment as the difference between the measured and expected flow rates, as well as jet relaxation (rise and fall time of injection). The results show that for continuous or pulsed injections, varying the total volume injected has no significant influence on the entrainment rate across all injection rates. On the other hand, for both injection modalities, increasing the injection rate results in a reduction in entrainment that is consistent across all injected volumes. This study demonstrates the effectiveness of a high-speed injection jet entraining a slow co-flow while determining the potential for fluid buildup, which could ultimately cause an increase in caval pressure. To avoid the increase in caval pressure due to mass accumulation, we added a fenestration to our proposed injection jet shunt-assisted Fontan models. It was found that for a set of well-defined parameters, the jet not only can be beneficial to the local flow, but any adverse effect can be obviated by careful tuning. These results were also cross-validated with similar in silico findings.https://www.mdpi.com/2306-5354/12/5/555congenital heart defectsingle ventricle defectFontan physiologyin vitro modelingin silico modelingentrainment characteristics
spellingShingle Arka Das
Ray O. Prather
Anthony Damon
Michael Farias
Alain Kassab
Eduardo Divo
William DeCampli
In Vitro and In Silico Analysis of Entrainment Characterization in Injection Jet-Assisted Fontan Circulation
Bioengineering
congenital heart defect
single ventricle defect
Fontan physiology
in vitro modeling
in silico modeling
entrainment characteristics
title In Vitro and In Silico Analysis of Entrainment Characterization in Injection Jet-Assisted Fontan Circulation
title_full In Vitro and In Silico Analysis of Entrainment Characterization in Injection Jet-Assisted Fontan Circulation
title_fullStr In Vitro and In Silico Analysis of Entrainment Characterization in Injection Jet-Assisted Fontan Circulation
title_full_unstemmed In Vitro and In Silico Analysis of Entrainment Characterization in Injection Jet-Assisted Fontan Circulation
title_short In Vitro and In Silico Analysis of Entrainment Characterization in Injection Jet-Assisted Fontan Circulation
title_sort in vitro and in silico analysis of entrainment characterization in injection jet assisted fontan circulation
topic congenital heart defect
single ventricle defect
Fontan physiology
in vitro modeling
in silico modeling
entrainment characteristics
url https://www.mdpi.com/2306-5354/12/5/555
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