The Fontan procedure is a common palliative surgery for congenital single ventricle patients. In silico and in vitro patient-specific modeling approaches are widely utilized to investigate potential improvements of Fontan hemodynamics that are related to long-term complications. However, there is a lack of consensus regarding the use of non-Newtonian rheology, warranting a systematic investigation. This study conducted in silico patient-specific modeling for twelve Fontan patients, using a Newtonian and a non-Newtonian model for each patient. Differences were quantified by examining clinically relevant metrics: indexed power loss (iPL), indexed viscous dissipation rate (iVDR), hepatic flow distribution (HFD), and regions of low wall shear stress (AWSS). Four sets of "non-Newtonian importance factors" were calculated to explore their effectiveness in identifying the non-Newtonian effect. No statistical differences were observed in iPL, iVDR, and HFD between the two models at the population-level, but large inter-patient variations exist. Significant differences were detected regarding AWSS, and its correlations with non-Newtonian importance factors were discussed. Additionally, simulations using the non-Newtonian model were computationally faster than those using the Newtonian model. These findings distinguish good importance factors for identifying non-Newtonian rheology and encourage the use of a non-Newtonian model to assess Fontan hemodynamics.

中文翻译：

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非牛顿对 Fontan 血流动力学患者特异性建模的影响。

Fontan 手术是先天性单心室患者常见的姑息手术。计算机模拟和体外患者特异性建模方法被广泛用于研究与长期并发症相关的 Fontan 血流动力学的潜在改善。然而，对于非牛顿流变学的使用缺乏共识，需要进行系统研究。该研究针对十二名 Fontan 患者在计算机上进行了患者特异性建模，对每位患者使用了牛顿模型和非牛顿模型。通过检查临床相关指标来量化差异：指数功率损失 (iPL)、指数粘性耗散率 (iVDR)、肝血流分布 (HFD) 和低壁剪切应力区域 (AWSS)。四组“非牛顿重要性因子” 计算来探索它们在识别非牛顿效应方面的有效性。在人群水平上，两种模型之间的 iPL、iVDR 和 HFD 没有观察到统计学差异，但存在较大的患者间差异。检测到 AWSS 的显着差异，并讨论了其与非牛顿重要性因素的相关性。此外，使用非牛顿模型的模拟比使用牛顿模型的模拟计算速度更快。这些发现区分了识别非牛顿流变学的重要因素，并鼓励使用非牛顿模型来评估 Fontan 血流动力学。但存在很大的患者间差异。检测到 AWSS 的显着差异，并讨论了其与非牛顿重要性因素的相关性。此外，使用非牛顿模型的模拟比使用牛顿模型的模拟计算速度更快。这些发现区分了识别非牛顿流变学的重要因素，并鼓励使用非牛顿模型来评估 Fontan 血流动力学。但存在很大的患者间差异。检测到 AWSS 的显着差异，并讨论了其与非牛顿重要性因素的相关性。此外，使用非牛顿模型的模拟比使用牛顿模型的模拟计算速度更快。这些发现区分了识别非牛顿流变学的重要因素，并鼓励使用非牛顿模型来评估 Fontan 血流动力学。