Transient Hemodynamic Changes upon Changing a BCPA into a TCPC in Staged Fontan Operation: A Computational Model Study

<table>Simulated variations in pulmonary flow rate (<svg height="18.4" id="M168" style="vertical-align:-5.03984pt" version="1.1" viewbox="0 0 65.012497 18.4" width="65.012497" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink">
<g transform="matrix(.017,-0,0,-.017,.062,11.4)"><path d="M745 361q0 -134 -83.5 -233t-214.5 -130l16 -11q97 -67 250 -132l-8 -23q-76 3 -131 16q-81 19 -242 125l-20 13q-129 8 -209 91t-80 208q0 160 116 271t289 111q136 0 226.5 -83t90.5 -223zM645 356q0 127 -57.5 201.5t-169.5 74.5q-126 0 -210.5 -104.5t-84.5 -248.5
q0 -97 46 -166.5t129 -87.5l84 15l29 -19q104 21 169 121.5t65 213.5z" id="x1D444"></path></g>
<g transform="matrix(.012,-0,0,-.012,13.113,15.475)"><path d="M169 380l92 53q26 16 49 16q80 0 128.5 -56t48.5 -133q0 -108 -72.5 -180.5t-176.5 -91.5q-38 1 -69 18v-131q0 -57 13 -70t71 -18v-27h-236v27q49 5 61 17t12 61v452q0 48 -9.5 58.5t-56.5 16.5v24q66 11 145 43v-79zM169 346v-270q37 -39 94 -39q63 0 101.5 50
t38.5 134q0 78 -38.5 123t-95.5 45q-45 0 -100 -43z" id="x70"></path></g><g transform="matrix(.012,-0,0,-.012,19.228,15.475)"><path d="M518 50v-26q-32 -4 -77 -16l-37 -11t-33 -9l-6 6v71q-56 -42 -74 -52q-43 -25 -77 -25q-55 0 -89.5 36.5t-34.5 112.5v196q0 38 -6.5 48.5t-26.5 15.5l-28 6v23q19 1 72 7q59 9 71 11q-3 -31 -3 -145v-135q0 -113 88 -113q59 0 108 48v234q0 38 -8 49t-34 15l-36 6v23
q44 2 90 8q37 4 67 10v-334q0 -37 8.5 -47t38.5 -12z" id="x75"></path></g><g transform="matrix(.012,-0,0,-.012,25.594,15.475)"><path d="M238 0h-223v26q48 5 60 17t12 61v473q0 50 -10.5 60.5t-58.5 15.5v24q73 8 148 35v-608q0 -49 11.5 -61t60.5 -17v-26z" id="x6C"></path></g><g transform="matrix(.012,-0,0,-.012,28.605,15.475)"><path d="M500 -125h-500v50h500v-50z" id="x5F"></path></g><g transform="matrix(.012,-0,0,-.012,34.554,15.475)"><path d="M592 498l-30 -3q-13 63 -31 89q-13 19 -33.5 25.5t-75.5 6.5h-70v-493q0 -60 16 -75.5t86 -19.5v-28h-286v28q68 4 83.5 19.5t15.5 75.5v493h-62q-60 0 -83 -7t-33 -24q-12 -17 -32 -90h-29q10 116 12 180h20q10 -16 21 -20.5t34 -4.5h395q19 0 28.5 5t21.5 20h21
q2 -89 11 -177z" id="x54"></path></g><g transform="matrix(.012,-0,0,-.012,41.812,15.475)"><path d="M614 175l29 -10q-33 -109 -57 -154q-121 -26 -184 -26q-90 0 -160.5 29t-112.5 77t-63.5 105.5t-21.5 119.5q0 157 108 253t277 96q36 0 71.5 -5t69 -13.5t36.5 -8.5q15 -102 20 -150l-29 -8q-20 79 -66.5 114t-128.5 35q-119 0 -187.5 -86t-68.5 -207
q0 -140 73.5 -227.5t188.5 -87.5q73 0 119.5 37.5t86.5 116.5z" id="x43"></path></g><g transform="matrix(.012,-0,0,-.012,49.725,15.475)"><path d="M46 650h247q112 0 169 -41q64 -49 64 -141q0 -91 -56.5 -143t-138.5 -62q-23 -3 -45 -1l-74 19v-157q0 -63 15.5 -77t83.5 -19v-28h-271v28q60 5 74 20t14 77v400q0 65 -12.5 79t-69.5 18v28zM212 559v-245q31 -12 73 -12q59 0 102 38t43 124q0 77 -42.5 115.5
t-108.5 38.5q-44 0 -56 -12q-11 -8 -11 -47z" id="x50"></path></g><g transform="matrix(.012,-0,0,-.012,56.424,15.475)"><path d="M614 175l29 -10q-33 -109 -57 -154q-121 -26 -184 -26q-90 0 -160.5 29t-112.5 77t-63.5 105.5t-21.5 119.5q0 157 108 253t277 96q36 0 71.5 -5t69 -13.5t36.5 -8.5q15 -102 20 -150l-29 -8q-20 79 -66.5 114t-128.5 35q-119 0 -187.5 -86t-68.5 -207
q0 -140 73.5 -227.5t188.5 -87.5q73 0 119.5 37.5t86.5 116.5z" id="x43"></path></g>
</svg>) with cardiovascular properties (a) and the severity of mitral valve regurgitation (b) after the TCPC operation.</table>

The Scientific World Journal

fig7

Figure 7

Figure 7: Transient Hemodynamic Changes upon Changing a BCPA into a TCPC in Staged Fontan Operation: A Computational Model Study 