Fontan Surgical Planning: Previous Accomplishments, Current Challenges, and Future Directions

J Cardiovasc Transl Res. 2018 Apr;11(2):133-144. doi: 10.1007/s12265-018-9786-0. Epub 2018 Jan 16.

Abstract

The ultimate goal of Fontan surgical planning is to provide additional insights into the clinical decision-making process. In its current state, surgical planning offers an accurate hemodynamic assessment of the pre-operative condition, provides anatomical constraints for potential surgical options, and produces decent post-operative predictions if boundary conditions are similar enough between the pre-operative and post-operative states. Moving forward, validation with post-operative data is a necessary step in order to assess the accuracy of surgical planning and determine which methodological improvements are needed. Future efforts to automate the surgical planning process will reduce the individual expertise needed and encourage use in the clinic by clinicians. As post-operative physiologic predictions improve, Fontan surgical planning will become an more effective tool to accurately model patient-specific hemodynamics.

Keywords: Fontan; Hepatic flow distribution; Patient specific; Pre-operative planning; Surgical planning.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Clinical Decision-Making
  • Fontan Procedure / adverse effects
  • Fontan Procedure / methods*
  • Heart Defects, Congenital / diagnostic imaging*
  • Heart Defects, Congenital / pathology
  • Heart Defects, Congenital / physiopathology
  • Heart Defects, Congenital / surgery*
  • Hemodynamics
  • Humans
  • Models, Cardiovascular*
  • Patient Selection
  • Patient-Centered Care / methods
  • Patient-Specific Modeling*
  • Surgery, Computer-Assisted / adverse effects
  • Surgery, Computer-Assisted / methods*
  • Time-to-Treatment
  • Ventricular Function