Performance evaluation of a pediatric viscous impeller pump for Fontan cavopulmonary assist

Giridharan, Guruprasad A.; Koenig, Steven C.; Kennington, Jeffrey R.; Sobieski, Michael A.; Chen, Jun; Frankel, Steven; Rodefeld, Mark D.

doi:10.1016/j.jtcvs.2012.01.082

Cited by 70 publications

(52 citation statements)

References 26 publications

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“…Preliminary studies by computer simulation and mock-circulation with a catheter-based viscous impeller pump (VIP) to augment cavo-pulmonary flow and simultaneously reduce systemic vascular resistance as well as improve cardiac output shows promising results. A VIP augmented four-way TCPC flow and restored systemic pressures and flows to biventricular values with low hemolysis risk on pediatric scales [18].…”

Section: Fontan Physiology Pvr and Exercisementioning

confidence: 97%

The Fontan Circulation: The Known, the Unknown and the Plausible

Louw

Gewillig

2013

Curr Pediatr Rep

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The Fontan circulation is used as palliative surgery in the functionally univentricular heart. Due to the advances made in prenatal diagnosis, cardiac surgery, technology, and monitoring in complex congenital heart disease, survival rates have improved significantly. For this group of patients, the physiology and pathology remain challenging and eluding, even more so in the long-term follow-up. In the last decade pulmonary vascular resistance has been shown to be of utmost importance regarding cardiac output both at rest and during exercise. The aim of this article is to review the most recently published data, namely new concepts and our current understanding regarding the physiology; performance during exercise; the value of imaging modalities; and chronic liver pathology in the Fontan circulation.

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Section: Fontan Physiology Pvr and Exercisementioning

confidence: 97%

The Fontan Circulation: The Known, the Unknown and the Plausible

Louw

Gewillig

2013

Curr Pediatr Rep

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“…This device is inserted transvenous and is placed at the junction of the SVC/IVC and PAs (67). As the device rotates, the right sided pressure is augmented and cardiac output is improved (68). It could be used in the failing Fontan, specifically for patients with failing physiology.…”

Section: Future Directionsmentioning

confidence: 99%

An overview of mechanical circulatory support in single-ventricle patients

et al. 2018

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The population of people with a single-ventricle is continually increasing due to improvements across the spectrum of medical care. Unfortunately, a proportion of these patients will develop heart failure.Often, for these patients, mechanical circulatory support (MCS) represents the only available treatment option. While single-ventricle patients currently represent a small proportion of the total number of patients who receive MCS, as the single-ventricle patient population increases, this number will increase as well.Outcomes for these complex single-ventricle patients who require MCS has begun to be evaluated. When considering the entire population, survival to hospital discharge is 30-50%, though this must be considered with the significant heterogeneity of the single-ventricle patient population. Patients with a single-ventricle have unique anatomy, mechanisms of failure, indications for MCS and the type of support utilized. This has made the interpretation and the generalizability of the limited available data difficult. It is likely that some subsets will have a significantly worse prognosis and others a better one. Unfortunately, with these limited data, indications of a favorable or poor outcome have not yet been elucidated. Though currently, a database has been constructed to address this issue. While the outcomes for these complex patients is unclear, at least in some situations, they are poor. However, significant advances may provide improvements going forward, including new devices, computer simulations and 3D printed models. The most important factor, however, will be the increased experience gained by the heart failure team to improve patient selection, timing, device and configuration selection and operative approach.

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“…A viscous impeller pump was introduced by Rodefeld et al for mechanical circulatory support in Fontan patients. Subsequent studies successfully compared CFD, PIV, and mock circuit results to assess blood damage, pressure rise, and cardiac function[63–65], and have compared left vs. right heart support in simulations and mock circulatory loops[66]. Mock circulatory experiments also examined the effect of adding a valve in the Fontan conduit in the presence of respiration, showing little change in cycle-averaged pressure, though the valve did function with higher pulmonary vascular resistance.…”

Section: Single Ventriclesmentioning

confidence: 99%

Computational modeling and engineering in pediatric and congenital heart disease

Marsden¹,

Feinstein

2015

Current Opinion in Pediatrics

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Purpose of review Recent methodological advances in computational simulations are enabling increasingly realistic simulations of hemodynamics and physiology, driving increased clinical utility. We review recent developments in the use of computational simulations in pediatric and congenital heart disease, describe the clinical impact in modeling in single ventricle patients, and provide an overview of emerging areas. Recent Findings Multiscale modeling combining patient specific hemodynamics with reduced order (i.e. mathematically and computationally simplified) circulatory models has become the defacto standard for modeling local hemodynamics and “global” circulatory physiology. We review recent advances that have enabled faster solutions, discuss new methods, (e.g. fluid structure interaction and uncertainty quantification), which lend realism both computationally and clinically to results, highlight novel computationally-derived surgical methods for single ventricle patients, and discuss areas in which modeling has begun to exert its influence including Kawasaki disease, fetal circulation, tetralogy of Fallot, (and pulmonary tree), and circulatory support. Summary Computational modeling is emerging as a crucial tool for clinical decision-making and evaluation of novel surgical methods and interventions in pediatric cardiology and beyond. Continued development of modeling methods, with an eye towards clinical needs, will enable clinical adoption in a wide range of pediatric and congenital heart diseases.

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Performance evaluation of a pediatric viscous impeller pump for Fontan cavopulmonary assist

Cited by 70 publications

References 26 publications

The Fontan Circulation: The Known, the Unknown and the Plausible

The Fontan Circulation: The Known, the Unknown and the Plausible

An overview of mechanical circulatory support in single-ventricle patients

Computational modeling and engineering in pediatric and congenital heart disease

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