First-in-man use of the EXCOR Venous Cannula for combined cavopulmonary and systemic ventricular support in Fontan circulation failure

Karner, Barbara; Urganci, Erhan; Schlein, Johanna; Base, Eva; Greil, Sabine; Michel‐Behnke, Ina; Granegger, Marcus; Laufer, Günther; Zimpfer, Daniel

doi:10.1016/j.healun.2022.06.009

The Journal of Heart and Lung Transplantation

2022

DOI: 10.1016/j.healun.2022.06.009

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First-in-man use of the EXCOR Venous Cannula for combined cavopulmonary and systemic ventricular support in Fontan circulation failure

Barbara Karner

Erhan Urganci

Johanna Schlein

et al.

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Cited by 5 publications

(1 citation statement)

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“…9 Recently, first-in-man applications of the novel EXCOR Venous Cannula as Fontan-specific bicaval inflow cannula have been reported for both isolated subpulmonary and in combination with subaortic support. 10,11 While introduction of this system established standardized paracorporeal short- to medium-term MCS in Fontan failure, major efforts to develop intracorporeal cavopulmonary MCS devices for short- to mid-term minimally invasive, or long-term support have been undertaken in recent years.…”

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confidence: 99%

Anatomical Compliance of Cavopulmonary Assist Device Designs: A Virtual Fitting Study in Fontan Patients

Karner,

Escher,

Schorn

et al. 2023

ASAIO Journal

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Several device designs for cavopulmonary mechanical circulatory support (MCS) are under investigation, however, challenged by the Fontan population’s heterogeneity in size, cardiovascular and thoracic anatomy. This study aimed to preclinically assess the anatomical compliance of proposed device designs in silico. Representative double- and single-outlet cavopulmonary assist device (CPAD) designs were virtually implanted into CT imaging data of 10 patients previously palliated with total cavopulmonary connection (TCPC) for functionally univentricular hearts. Anatomical device compatibility was characterized concerning pump proximity to cardiovascular, respiratory and thoracic structures, as well as pump in- and outflow graft configuration. In 10 Fontan patients with a median age of 10.4 years (interquartile range [IQR] 5.0–15.3 years) and a median body surface area of 1.09 m2 (IQR 0.76–1.28 m2), implantation of a double-outlet CPAD was feasible in 1 patient (10%). In all other, adverse device intersection with the trachea and (neo-)aorta, or posterior pulmonary artery outflow graft kinking were observed. A single-outlet design permitted enhanced device mobilization adapting to individual anatomical conditions, resulting in device fit in nine of 10 patients (90%). Despite vast anatomical variations among single ventricle patients, a single-outlet device design may provide intracorporeal cavopulmonary MCS to a broad spectrum of failing Fontan patients.

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mentioning

confidence: 99%

Anatomical Compliance of Cavopulmonary Assist Device Designs: A Virtual Fitting Study in Fontan Patients

Karner,

Escher,

Schorn

et al. 2023

ASAIO Journal

Self Cite

View full text Add to dashboard Cite

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Special Considerations for Mechanical Circulatory Support or Device Therapy in Adult Congenital Heart Disease Heart Failure

Alonso-Gonzalez,

Agorrody

2024

Heart Failure Clinics

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Current Understanding and Future Directions of Transcatheter Devices to Assist Failing Fontan

Pradegan,

Lena,

Tessari

et al. 2024

Journal of the Society for Cardiovascular Angiography & Int

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First-in-man use of the EXCOR Venous Cannula for combined cavopulmonary and systemic ventricular support in Fontan circulation failure

Cited by 5 publications

References 5 publications

Anatomical Compliance of Cavopulmonary Assist Device Designs: A Virtual Fitting Study in Fontan Patients

Anatomical Compliance of Cavopulmonary Assist Device Designs: A Virtual Fitting Study in Fontan Patients

Special Considerations for Mechanical Circulatory Support or Device Therapy in Adult Congenital Heart Disease Heart Failure

Current Understanding and Future Directions of Transcatheter Devices to Assist Failing Fontan

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