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Free, publicly-accessible full text available December 10, 2025
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Cruz-Uribe, AM; Garber, J; Arkula, C; Craig, G; Paul, B; Bouman, C (, 2024 European Workshop on Laser Ablation)
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Lior, Dan; Puelz, Charles; Edwards, Colin; Molossi, Silvana; Griffith, Boyce E.; Birla, Ravi K.; Rusin, Craig G. (, Annals of Biomedical Engineering)
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Beaucejour, Rossiny; Roebisch, Volker; Kochhar, Abhay; Moe, Craig G.; Hodge, Michael David; Olsson, Roy H. (, Journal of Microelectromechanical Systems)
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Ahmad, Zan; Jin, Lynn H.; Penny, Daniel J.; Rusin, Craig G.; Peskin, Charles S.; Puelz, Charles (, Frontiers in Physiology)In this paper, we develop a pulsatile compartmental model of the Fontan circulation and use it to explore the effects of a fenestration added to this physiology. A fenestration is a shunt between the systemic and pulmonary veins that is added either at the time of Fontan conversion or at a later time for the treatment of complications. This shunt increases cardiac output and decreases systemic venous pressure. However, these hemodynamic benefits are achieved at the expense of a decrease in the arterial oxygen saturation. The model developed in this paper incorporates fenestration size as a parameter and describes both blood flow and oxygen transport. It is calibrated to clinical data from Fontan patients, and we use it to study the impact of a fenestration on several hemodynamic variables, including systemic oxygen availability, effective oxygen availability, and systemic venous pressure. In certain scenarios corresponding to high-risk Fontan physiology, we demonstrate the existence of a range of fenestration sizes in which the systemic oxygen availability remains relatively constant while the systemic venous pressure decreases.more » « less
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