PERFUSION-CONTRACTILITY MATCHlNG DURING FONTAN CIRCULATION

Szabó, Gábor; Buhmann, Volker; Graf, Andy; Melnitchuk, S.; Hagl, S.; Vahl, Christian F.

doi:10.1515/bmte.2002.47.s1b.912

Cited by 3 publications

(5 citation statements)

References 4 publications

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“…ii. Approaches for handling of venous coronary flow, which drains into the RA, were analyzed and classified into two groups depending on whether the main PA was Mean (SD): 22.4 (1.5) Nawa et al 12 Mean (SD): 10.6 (1.75) Szabo et al 13 No data Szabo et al 14 Mean (SD): 22.3 (5.2) Tanoue et al 15 Mean (SD): 16.8 (2.7) Ovine Gandolfo et al 16 Range: 42.0-48.0 Koçyıldırım et al 17 Mean (SD): 65.0 (4.1) Myers et al 18 Mean (SD): 7.2 (1.1) Riemer et al 19 Range: 42.0-48.0 Rodefeld et al 20 Mean: 56.5; range: 33.0-78.6 Rodefeld et al 21 Mean (SD): 5.6 (1.5) Swartz et al 22 Mean (SD): 56.6 (5.7) Tsuda et al 23 Range: 47.0-57.0 Wang et al 24 Range: 35.0-45.0 Wang et al 25 Range: 35.0-45.0 Wang et al 26 Range: 35.0-45.0 Porcine Derk et al 27 Mean:50.7; range 44.0-61.0 Kanakis et al 28 Mean (SD): 43.0 (3.8) Klautz et al 29 Mean (SD): 28.3 (7.9) Macé et al 30 Mean (SD): 31.4 (4.0) Sinha et al 31 Mean: 25.0 Wei et al 32 Mean (SD): 8.8 (0.9)…”

Section: Surgical Classificationmentioning

confidence: 99%

“…Studies with excessive volume loading to maintain baseline levels in hemodynamics [10][11][12]30 were excluded from statistical analysis. 28 Kaku et al 10 BT Kocyildirim et al 17 Wang et al 25 Macé et al 11 CPB, VF, BT Macé et al 30 CPB, VF, BT Nawa et al 12 Szabo et al 13 Szabo et al 14 With MCS Derk et al 27,a Jarvik 2000 (Jarvik Heart Inc; New York, NY, USA)…”

Section: Hemodynamic Parametersmentioning

confidence: 99%

“…In this study, we found that the connection of the caval veins to the main PA (Y/T shape) is the most common approach (n ¼ 18), followed by the connection to the right PA (cross-like shape; n ¼ 5). Creating a bidirectional cavopulmonary anastomosis (¼Glenn anastomosis) in sheep is surgically more challenging than connecting the SVC to the pulmonary trunk as the 10 Coronary flow ejected in PA (n ¼ 9) Derk et al 27 Kanakis et al 28 Gandolfo et al 16 Klautz et al 29 Riemer et al 19 Kocyildirım et al 17 Swartz et al 22 Macé et al 11 Tsuda et al 23 Myers et al 18 Wang et al 24 Rodefeld et al 20 Wang et al 25 Rodefeld et al 21 Wang et al 26 Szabo et al 13 Wei et al 32 Szabo et al 14 Tanoue et al 15 ASD (n ¼ 2)…”

Section: Surgical Creation Of An Extracardiac Tcpcmentioning

confidence: 99%

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Approaches to Establish Extracardiac Total Cavopulmonary Connections in Animal Models—A Review

Granegger

Valencia

Quandt

et al. 2019

World J Pediatr Congenit Heart Surg

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BACKGROUND Long-term survival of patients with a single ventricle palliated with a Fontan procedure is still limited. No curative treatment options are available. To investigate the pathophysiology and potential treatment options, such as mechanical circulatory support (MCS), appropriate large animal models are required. The aim of this review was to analyze all full-text manuscripts presenting approaches for an extracardiac total cavopulmonary connection (TCPC) animal model to identify the feasibility and limitations in the acute and chronic setting. METHODS A literature search was performed for fulltext publications presenting large animal models with extracardiac TCPCs on Pubmed and Embase. Out of 454 reviewed papers, 23 manuscripts fulfilled the inclusion criteria. Surgical procedures were categorized and hemodynamic changes at the transition from the biventricular to the univentricular condition analyzed. RESULTS Surgical procedures varied especially regarding coronary venous flow handling and anatomic shape of the TCPC. In most studies (n = 14), the main pulmonary artery was clamped and the coronary venous flow redirected by additional surgical interventions. Only in five reports, the caval veins were connected to the right pulmonary artery to create a true TCPC shape, whereas in all others (n = 18), the veins were connected to the main pulmonary artery. An elevated pulmonary vascular resistance was identified as a limiting hemodynamic factor for TCPC completion in healthy animals. CONCLUSIONS A variety of acute TCPC animal models were successfully established with and without MCS, reflecting the most important hemodynamic features of a Fontan circulation; however, chronic animal models were not reported.

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Section: Surgical Classificationmentioning

confidence: 99%

Section: Hemodynamic Parametersmentioning

confidence: 99%

Section: Surgical Creation Of An Extracardiac Tcpcmentioning

confidence: 99%

See 1 more Smart Citation

Approaches to Establish Extracardiac Total Cavopulmonary Connections in Animal Models—A Review

Granegger

Valencia

Quandt

et al. 2019

World J Pediatr Congenit Heart Surg

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“…The authors observed a significant drop in coronary blood flow and left ventricular ejection fraction when the coronary sinus pressure was above 15 mmHg [42]. In 2002, Szabo et al confirmed these results with a canine TCPC model and highlighted the importance of the balance between coronary artery and coronary sinus perfusion pressures for single-ventricular function [43].…”

Section: Single-ventricle Failurementioning

confidence: 92%

Role and Applications of Experimental Animal Models of Fontan Circulation

Jalal,

Langouet,

Dib

et al. 2024

JCM

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Over the last four decades, the Fontan operation has been the treatment of choice for children born with complex congenital heart diseases and a single-ventricle physiology. However, therapeutic options remain limited and despite ongoing improvements in initial surgical repair, patients still experience a multiplicity of cardiovascular complications. The causes for cardiovascular failure are multifactorial and include systemic ventricular dysfunction, pulmonary vascular resistance, atrioventricular valve regurgitation, arrhythmia, development of collaterals, protein-losing enteropathy, hepatic dysfunction, and plastic bronchitis, among others. The mechanisms leading to these late complications remain to be fully elucidated. Experimental animal models have been developed as preclinical steps that enable a better understanding of the underlying pathophysiology. They furthermore play a key role in the evaluation of the efficacy and safety of new medical devices prior to their use in human clinical studies. However, these experimental models have several limitations. In this review, we aim to provide an overview of the evolution and progress of the various types of experimental animal models used in the Fontan procedure published to date in the literature. A special focus is placed on experimental studies performed on animal models of the Fontan procedure with or without mechanical circulatory support as well as a description of their impact in the evolution of the Fontan design. We also highlight the contribution of animal models to our understanding of the pathophysiology and assess forthcoming developments that may improve the contribution of animal models for the testing of new therapeutic solutions.

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“…This compensatory mechanism does not exist in the Fontan circulation and leads to decreased CO and stroke work. 13, 14 It should be emphasized that the driving force of the circulating blood volume between the systemic and pulmonary veins is the pressure gradient between central venous pressure and the left atrium (LA), assisted mechanically by the thoracic muscles and respiratory function. 5 Ventricular function and contractility in the SV patient are often depressed, thought to be because of abnormal pre-Fontan development when the ventricle is subjected to large volumes and often high pressures following PA banding, leading to ventricular hypertrophy and dilation.…”

Section: Staged Surgical Palliationmentioning

confidence: 99%

The Adult With a Fontan: A Panacea Without a Cure?

Lastinger

Zaidi

2013

Circ J

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The univentricular heart includes a spectrum of complex cardiac defects that are managed by staged palliative surgical procedures, ultimately resulting in a Fontan procedure. Since 1971, when it was first developed, the procedure has undergone several variations. These patients require lifelong management, including a thorough knowledge of their anatomic substrate, hemodynamic status, management of rhythm and ventricular function, together with multi-organ evaluation. As these patients enter middle age, there is increasing awareness of long-term complications and mortality. This review highlights the concept behind the staged surgical palliations, the unique single ventricle physiology and the long-term complications in this complex cohort of patients. (Circ J 2013; 77: 2672 -2681

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PERFUSION-CONTRACTILITY MATCHlNG DURING FONTAN CIRCULATION

Cited by 3 publications

References 4 publications

Approaches to Establish Extracardiac Total Cavopulmonary Connections in Animal Models—A Review

Approaches to Establish Extracardiac Total Cavopulmonary Connections in Animal Models—A Review

Role and Applications of Experimental Animal Models of Fontan Circulation

The Adult With a Fontan: A Panacea Without a Cure?

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