Fontan Physiology Revisited

Furst, Branko

doi:10.1213/ane.0000000000001083

Cited by 5 publications

(2 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Based on a systematic research of circulation models, Branko Furst, M.D., professor of anesthesiology, Albany Medical College, Albany, New York, USA, found that this old pressure-propulsion paradigm no longer stands up to the rigor of scientific evidence. [196][197][198][199][200] A comprehensive review of the literature explored in his 2014 monograph (second edition in 2020), The Heart and Circulation: An Integrative Model, 201 and later summarized in a review article, 197 demonstrate that numerous phenomena, ranging from basic cardiovascular physiology to embryology, comparative anatomy and clinical medicine, contradict the conventional pressurepropulsion model. These anomalous findings call for a reappraisal of the mechanistic, solely physicalist view of the cardiovascular system that is so deeply ingrained in the collective scientific, medical, and popular psyche.…”

Section: The Heart and Circulationmentioning

confidence: 99%

Anthroposophic Medicine: A Short Monograph and Narrative Review—Foundations, Essential Characteristics, Scientific Basis, Safety, Effectiveness and Misconceptions

Bartelme

2020

Glob Adv Health Med

View full text Add to dashboard Cite

Introduction Anthroposophic medicine is a form of integrative medicine that originated in Europe but is not well known in the US. It is comprehensive and heterogenous in scope and remains provocative and controversial in many academic circles. Assessment of the nature and potential contribution of anthroposophic medicine to whole person care and global health seems appropriate. Methods Because of the heterogenous and multifaceted character of anthroposophic medicine, a narrative review format was chosen. A Health Technology Assessment of anthroposophic medicine in 2006 was reviewed and used as a starting point. A Medline search from 2006 to July 2020 was performed using various search terms and restricted to English. Books, articles, reviews and websites were assessed for clinical relevance and interest to the general reader. Abstracts of German language articles were reviewed when available. Reference lists of articles and the author’s personal references were also consulted. Results The literature on anthroposophic medicine is vast, providing new ways of thinking, a holistic view of the world, and many integrating concepts useful in medicine. In the last ∼20 years there has been a growing research base and implementation of many anthroposophical concepts in the integrated care of patients. Books and articles relevant to describing the foundations, scientific status, safety, effectiveness and criticisms of anthroposophic medicine are discussed. Discussion An objective and comprehensive analysis of anthroposophic medicine finds it provocative, stimulating and potentially fruitful as an integrative system for whole person care, including under-recognized life processes and psychospiritual aspects of human beings. It has a legitimate, new type of scientific status as well as documented safety and effectiveness in some areas of its multimodal approach. Criticisms and controversies of anthroposophic medicine are often a result of lack of familiarity with its methods and approach and/or come from historically fixed ideas of what constitutes legitimate science.

show abstract

Section: The Heart and Circulationmentioning

confidence: 99%

Anthroposophic Medicine: A Short Monograph and Narrative Review—Foundations, Essential Characteristics, Scientific Basis, Safety, Effectiveness and Misconceptions

Bartelme

2020

Glob Adv Health Med

View full text Add to dashboard Cite

show abstract

“…This is due to the multitude of morphologies and the variations of the procedures themselves (3). Venous return physiology in patients with history of Fontan surgery remains less understood and is variably being attributed to active ventricle function (4,5), to breathing and exercise (5)(6)(7)(8), or even to a different cardiovascular model seeing the heart as an impedance pump generating pressure (9). This complicated interplay between geometry and physiology has opened many questions of singleventricle circulation, and the parameters influencing hemodynamics in patients with Fontan history are not yet fully understood.…”

mentioning

confidence: 99%

Respiration Dependency of Caval Blood Flow in Patients with Fontan Circulation: Quantification Using 5D Flow MRI

Bastkowski

Bindermann

Brockmeier³

et al. 2019

Radiology: Cardiothoracic Imaging

View full text Add to dashboard Cite

To measure respiration-dependent blood flow in the total cavopulmonary connection (TCPC) of patients with Fontan circulation by using free-running, fully self-gated five-dimensional (5D) flow MRI. Materials and Methods:From July to November 2018, 10 volunteers (six female volunteers, mean age, 25.1 years 6 4.4 [standard deviation]) and six patients with Fontan circulation (two female patients, mean age, 19.7 years 6 7.5) with a TCPC were examined by using a cardiac-and respiration-resolved three-directional and three-dimensional phase-contrast MRI sequence (hereafter, 5D flow MRI). This prospective study was conducted with approval of the local ethics committee, and written informed consent was obtained from all participants and/or their representative. 5D flow data were acquired during free breathing. Data were reconstructed into 15-20 heart phases and four respiratory phases: end-expiration, inspiration, end-inspiration, and expiration. Respiration-dependent stroke volumes (SVs) and particle traces were analyzed from the caval circulation of volunteers and patients with Fontan circulation. Statistical analysis was performed by using parametric tests and scatterplots. Results:The respiration dependency of caval blood flow was evaluated in all participants and was significantly elevated in patients with Fontan circulation as compared with volunteers. In patients, SV in the inferior vena cava (IVC) showed variations of 120% between inspiration and expiration (P = .002). The flow distribution in the IVC and superior vena cava among the four respiratory phases was differentiated by 20% (range, 9%-30%) and 4% (range, 0%-13%), respectively. Conclusion:Hemodynamic parameters (volume flow and blood flow distribution) throughout the cardiac and respiratory cycle can be measured using a single scan, potentially providing further insights into the Fontan circulation.

show abstract

Single Ventricle Physiology

Furst¹

2019

The Heart and Circulation

View full text Add to dashboard Cite

Fontan Physiology Revisited

Cited by 5 publications

References 3 publications

Anthroposophic Medicine: A Short Monograph and Narrative Review—Foundations, Essential Characteristics, Scientific Basis, Safety, Effectiveness and Misconceptions

Anthroposophic Medicine: A Short Monograph and Narrative Review—Foundations, Essential Characteristics, Scientific Basis, Safety, Effectiveness and Misconceptions

Respiration Dependency of Caval Blood Flow in Patients with Fontan Circulation: Quantification Using 5D Flow MRI

Single Ventricle Physiology

Contact Info

Product

Resources

About