Mechanical Engineering Faculty Publications

Document Type

Article

Publication Date

8-19-2026

Abstract

Objective: Late Fontan failure and attrition is an increasingly prevalent problem for which there is no primary therapy. A Fontan circulation is a circulation that lacks a subpulmonary pump. We are developing a technology that can safely and reliably restore subpulmonary pump function in a Fontan circulation to reverse the Fontan paradox and maintain normal circulatory health.

Methods: A rotary pump scaled for adolescent and adult use was developed for implantation to physiologically augment flow in the total cavopulmonary connection (TCPC). Design objectives include 30/70% SVC/IVC inflow draw over a broad range of performance, and no obstruction in the event of device failure. Hydrodynamic and hemodynamic performance were characterized in vitro in a Fontan mock circulatory loop using blood analog. Hemolysis was characterized in blood.

Results: The pump augments TCPC flow (SVC/IVC inflow; LPA/RPA outflow) at +6-10 mmHg, ranging to +18 mmHg at 3K RPM. Performance is consistent over a wide range of cardiac output. Power requirement is low (1W) at +6 mmHg pressure rise. Hemolysis is comparable to other commercially available pumps. Cavitation or suction was not observed. In the stalled condition (0 RPM), gradient is ≤1 mmHg.

Conclusions: A Fontan pump can safely reverse the Fontan paradox. Features include a fail-safe contingency that is clinically manageable. The technology may prevent progression of Fontan failure in the setting of preserved systemic ventricular systolic function. As a surgical strategy of long-term biventricular health maintenance, it may improve quality and duration of life for patients with single ventricle heart disease.

Comments

Publication Title

The Journal of thoracic and cardiovascular surgery

DOI

10.1016/j.jtcvs.2026.08.004

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Available for download on Thursday, August 26, 2027

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