Inflow Typology and Ventricular Geometry Determine Efficiency of Filling in the Hypoplastic Left Heart Adelaide de Vecchi, PhD, David A. Nordsletten,

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Inflow Typology and Ventricular Geometry Determine Efficiency of Filling in the Hypoplastic Left Heart Adelaide de Vecchi, PhD, David A. Nordsletten, PhD, Espen W. Remme, PhD, Hannah Bellsham-Revell, MD, Gerald Greil, MD, John M. Simpson, MD, Reza Razavi, MD, Nicolas P. Smith, PhD The Annals of Thoracic Surgery Volume 94, Issue 5, Pages 1562-1569 (November 2012) DOI: 10.1016/j.athoracsur.2012.05.122 Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Workflow is shown for the computer model generated from magnetic resonance imaging (MRI) data. The Annals of Thoracic Surgery 2012 94, 1562-1569DOI: (10.1016/j.athoracsur.2012.05.122) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Blood streamlines (anterior view) after stage I at (A, D, G, J) early, (B, E, H, K) middle, and (C, F, I, L) end diastole. The myocardium is colored by displacement magnitude. Patient 1: (A) 60%, (B) 80%, and (C) 100%. Patient 2: (D) 32%, (E) 78%, and (F) 100%. Patient 3: (G) 55%, (H) 80%, and (I) 100%. Patient 4: (J) 40%, (K) 78%, and (L) 100%. The Annals of Thoracic Surgery 2012 94, 1562-1569DOI: (10.1016/j.athoracsur.2012.05.122) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Total kinetic energy and rate of viscous energy per unit volume is shown in patients after stage I with (A, C) fused inflow (FI) and (B, D) in those with biphasic (BP) inflow. (LV = left ventricle.) The Annals of Thoracic Surgery 2012 94, 1562-1569DOI: (10.1016/j.athoracsur.2012.05.122) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Rate of kinetic energy per unit volume and intraventricular pressure gradients is shown after stage I in patients with (A, C) fused inflow (FI) and with (B, D) biphasic (BP) inflow. (LV = left ventricle.) The Annals of Thoracic Surgery 2012 94, 1562-1569DOI: (10.1016/j.athoracsur.2012.05.122) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 5 Patients after stage II compared with those after stage I and those with a normal left ventricle (LV). Rate of kinetic energy per unit volume and intraventricular pressure gradients in are shown in (A, C) patient 3 and (B, D) patient 4. The Annals of Thoracic Surgery 2012 94, 1562-1569DOI: (10.1016/j.athoracsur.2012.05.122) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions