{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:41:20Z","timestamp":1760028080309,"version":"3.37.3"},"reference-count":32,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2017,8,7]],"date-time":"2017-08-07T00:00:00Z","timestamp":1502064000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004359","name":"Vetenskapsr\u00e5det","doi-asserted-by":"publisher","award":["2016\u201001617"],"award-info":[{"award-number":["2016\u201001617"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007308","name":"Sveriges L\u00e4karf\u00f6rbund","doi-asserted-by":"publisher","award":["502641"],"award-info":[{"award-number":["502641"]}],"id":[{"id":"10.13039\/501100007308","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clin Physio Funct Imaging"],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Patients with complex congenital heart disease may need to be converted to a Fontan circulation with systemic venous return surgically connected to the pulmonary circulation. These patients frequently form aortopulmonary collaterals (<jats:styled-content style=\"fixed-case\">APC<\/jats:styled-content>), that is arterial inflows to the pulmonary artery vascular tree. The aim of this study was to develop a method to calculate the effect of <jats:styled-content style=\"fixed-case\">APC<\/jats:styled-content> on the pulmonary flow distribution based on magnetic resonance imaging (<jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content>) measurements and computational fluid dynamics simulations in order to enable prediction of interventional outcomes in Fontan patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patient\u2010specific models of 11 patients were constructed in a 3D\u2010design software based on <jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content> segmentations. <jats:styled-content style=\"fixed-case\">APC<\/jats:styled-content> flow was quantified as the difference between pulmonary venous flow and pulmonary artery flow, measured by <jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content>. A method was developed to include the modulating effect of the <jats:styled-content style=\"fixed-case\">APC<\/jats:styled-content> flow by calculating the patient\u2010specific relative pulmonary vascular resistance. Simulations, including interventions with a Y\u2010graft replacement and a stent dilatation, were validated against <jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content> results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The bias between simulated and <jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content>\u2010measured fraction of blood to the left lung was 2\u00b79\u00a0\u00b1\u00a05\u00b73%. Including the effects of the <jats:styled-content style=\"fixed-case\">APC<\/jats:styled-content> flow in the simulation (<jats:italic>n<\/jats:italic>\u00a0=\u00a06) reduced simulation error from 9\u00b78\u00a0\u00b1\u00a07\u00b70% to 5\u00b72\u00a0\u00b1\u00a06\u00b73%. Preliminary findings in two patients show that the effect of surgical and catheter interventions could be predicted using the demonstrated methods.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The work demonstrates a novel method to include <jats:styled-content style=\"fixed-case\">APC<\/jats:styled-content> flow in predictive simulations of Fontan hemodynamics. <jats:styled-content style=\"fixed-case\">APC<\/jats:styled-content> flow was found to have a significant contribution to the pulmonary flow distribution in Fontan patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cpf.12457","type":"journal-article","created":{"date-parts":[[2017,8,7]],"date-time":"2017-08-07T12:06:41Z","timestamp":1502107601000},"page":"622-629","source":"Crossref","is-referenced-by-count":7,"title":["Simulation of aortopulmonary collateral flow in Fontan patients for use in prediction of interventional 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