{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T06:01:18Z","timestamp":1789624878257,"version":"build-2803163510"},"reference-count":25,"publisher":"The Royal Society","issue":"177","license":[{"start":{"date-parts":[[2021,4,1]],"date-time":"2021-04-01T00:00:00Z","timestamp":1617235200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/royalsociety.org\/journals\/ethics-policies\/data-sharing-mining\/"}],"funder":[{"DOI":"10.13039\/501100002996","name":"Hartstichting","doi-asserted-by":"crossref","award":["CVON2017-08-RADAR"],"award-info":[{"award-number":["CVON2017-08-RADAR"]}],"id":[{"id":"10.13039\/501100002996","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100002996","name":"Hartstichting","doi-asserted-by":"crossref","award":["T2018-083"],"award-info":[{"award-number":["T2018-083"]}],"id":[{"id":"10.13039\/501100002996","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Stichting Hartekind"},{"name":"Netherlands Organization for Scientific Research","award":["016.196.346"],"award-info":[{"award-number":["016.196.346"]}]}],"content-domain":{"domain":["royalsocietypublishing.org"],"crossmark-restriction":true},"short-container-title":["J. R. Soc. Interface."],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:p>\n            Fontan patients require a balanced hepatic blood flow distribution (HFD) to prevent pulmonary arteriovenous malformations. Currently, HFD is quantified by tracking Fontan conduit flow, assuming hepatic venous (HV) flow to be uniformly distributed within the Fontan conduit. However, this assumption may be unvalid leading to inaccuracies in HFD quantification with potential clinical impact. The aim of this study was to (i) assess the mixing of HV flow and inferior vena caval (IVC) flow within the Fontan conduit and (ii) quantify HFD by directly tracking HV flow and quantitatively comparing results with the conventional approach. Patient-specific, time-resolved computational fluid dynamic models of 15 total cavopulmonary connections were generated, including the HV and subhepatic IVC. Mixing of HV and IVC flow, on a scale between 0 (no mixing) and 1 (perfect mixing), was assessed at the caudal and cranial Fontan conduit. HFD was quantified by tracking particles from the caudal (HFD\n            <jats:sub>caudal conduit<\/jats:sub>\n            ) and cranial (HFD\n            <jats:sub>cranial conduit<\/jats:sub>\n            ) conduit and from the hepatic veins (HFD\n            <jats:sub>HV<\/jats:sub>\n            ). HV flow was non-uniformly distributed at both the caudal (mean mixing 0.66 \u00b1 0.13) and cranial (mean 0.79 \u00b1 0.11) level within the Fontan conduit. On a cohort level, differences in HFD between methods were significant but small; HFD\n            <jats:sub>HV<\/jats:sub>\n            (51.0 \u00b1 20.6%) versus HFD\n            <jats:sub>caudal conduit<\/jats:sub>\n            (48.2 \u00b1 21.9%,\n            <jats:italic>p<\/jats:italic>\n            = 0.033) or HFD\n            <jats:sub>cranial conduit<\/jats:sub>\n            (48.0 \u00b1 21.9%,\n            <jats:italic>p<\/jats:italic>\n            = 0.044). However, individual absolute differences of 8.2\u201314.9% in HFD were observed in 4\/15 patients. HV flow is non-uniformly distributed within the Fontan conduit. Substantial individual inaccuracies in HFD quantification were observed in a subset of patients with potential clinical impact.\n          <\/jats:p>","DOI":"10.1098\/rsif.2020.1027","type":"journal-article","created":{"date-parts":[[2021,4,7]],"date-time":"2021-04-07T07:05:29Z","timestamp":1617779129000},"update-policy":"https:\/\/doi.org\/10.1098\/crossmark-policy","source":"Crossref","is-referenced-by-count":15,"title":["Non-uniform mixing of hepatic venous flow and inferior vena cava flow in the Fontan conduit"],"prefix":"10.1098","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1804-3220","authenticated-orcid":true,"given":"Friso M.","family":"Rijnberg","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00e9line F. S.","family":"van der Woude","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Biomedical Engineering, Erasmus MC, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans C.","family":"van Assen","sequence":"additional","affiliation":[{"name":"Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joe F.","family":"Juffermans","sequence":"additional","affiliation":[{"name":"Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark G.","family":"Hazekamp","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monique R. M.","family":"Jongbloed","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Anatomy and Embryology, Leiden University Medical Center, Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7568-5513","authenticated-orcid":true,"given":"Sasa","family":"Kenjeres","sequence":"additional","affiliation":[{"name":"Department of Chemical Engineering, Faculty of Applied Sciences, Delft University of Technology and J. M. Burgerscentrum Research School for Fluid Mechanics, Delft, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hildo J.","family":"Lamb","sequence":"additional","affiliation":[{"name":"Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos J. M.","family":"Westenberg","sequence":"additional","affiliation":[{"name":"Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jolanda J.","family":"Wentzel","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Biomedical Engineering, Erasmus MC, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arno A. W.","family":"Roest","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology, Leiden University Medical Center, Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"175","published-online":{"date-parts":[[2021,4,7]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.117.033359"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1586\/14779072.2014.912132"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2013.11.060"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2014.08.069"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ppedcard.2010.09.005"},{"key":"e_1_3_6_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12265-018-9786-0"},{"key":"e_1_3_6_8_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.12120778"},{"key":"e_1_3_6_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00247-016-3654-3"},{"key":"e_1_3_6_10_2","doi-asserted-by":"publisher","DOI":"10.1148\/ryct.2019190005"},{"key":"e_1_3_6_11_2","doi-asserted-by":"publisher","DOI":"10.1115\/1.4045110"},{"key":"e_1_3_6_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/jmri.26583"},{"key":"e_1_3_6_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2010.06.009"},{"key":"e_1_3_6_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2016.03.019"},{"key":"e_1_3_6_15_2","doi-asserted-by":"publisher","DOI":"10.1115\/1.4023089"},{"key":"e_1_3_6_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2006.01.015"},{"key":"e_1_3_6_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11517-008-0420-1"},{"key":"e_1_3_6_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2019.06.063"},{"key":"e_1_3_6_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10439-020-02527-8"},{"key":"e_1_3_6_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2011.06.042"},{"key":"e_1_3_6_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2013.12.010"},{"key":"e_1_3_6_22_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10554-014-0442-8"},{"key":"e_1_3_6_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2009.03.019"},{"issue":"19","key":"e_1_3_6_24_2","first-page":"III148","article-title":"Effects of respiration and gravity on infradiaphragmatic venous flow in normal and Fontan patients","volume":"102","author":"Hsia TY","year":"2000","unstructured":"Hsia TY, Khambadkone S, Redington AN, Migliavacca F, Deanfield JE, de Leval MR. 2000 Effects of respiration and gravity on infradiaphragmatic venous flow in normal and Fontan patients. 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