the patterns of flow in the total extracardiac cavopulmonary connection

2004 ◽  
Vol 14 (S3) ◽  
pp. 53-56 ◽  
Author(s):  
antonio amodeo ◽  
mauro grigioni ◽  
giuseppe d'avenio ◽  
carla daniele ◽  
roberto m. di donato
Keyword(s):  
Right Ventricle ◽  
Clinical Outcomes ◽  
Right Atrium ◽  
Pulmonary Arteries ◽  
Total Cavopulmonary Connection ◽  
Remarkable Improvement ◽  
Dissipation Of Energy ◽  
Intracardiac Extension ◽  
The Right ◽  
Cavopulmonary Connection

more than 30 years ago, fontan and baudet proposed bypass of a dysfunctional right ventricle by connecting the pulmonary arteries directly to the right atrium, the so-called atriopulmonary anastomosis. since then, much experience has been accrued in the field of the functionally univentricular circulation. the proposed connections have been subjected to several modifications, aiming towards minimizing the losses of energy in the cavopulmonary system, and thereby improving the clinical outcomes. a remarkable improvement was achieved with the introduction of the concept of the total cavopulmonary connection, specifically the combination of a bi-directional glenn anastomosis with a tubular intracardiac extension from the inferior caval venous to the pulmonary arteries. this design was shown to avoid the dissipation of energy associated with the swirling patterns seen in the traditional atrio-pulmonary anastomosis.

Successful surgical repair of Uhl's anomaly

2002 ◽  
Vol 12 (2) ◽  
pp. 192-195 ◽  
Author(s):  
Nawal Azhari ◽  
Mervat Assaqqat ◽  
Ziad Bulbul
Keyword(s):  
Right Ventricle ◽  
Surgical Repair ◽  
Total Cavopulmonary Connection ◽  
Thromboembolic Stroke ◽  
Glenn Shunt ◽  
Bidirectional Glenn ◽  
Bidirectional Glenn Shunt ◽  
Patch Closure ◽  
The Right ◽  
Cavopulmonary Connection

We report a case of Uhl's anomaly in a 5-month-old cyanotic infant who presented with thromboembolic stroke and acute hemiparesis. The patient underwent successfully an initial surgical repair, which included exclusion of the right ventricle by patch closure of the tricuspid valve, atrial septectomy and construction of a bidirectional Glenn shunt. This was followed by successful construction of a total cavopulmonary connection.

Investigation of Vessel Growth and its Impact on Hemodynamics in Patients With Lateral Tunnel Total Cavopulmonary Connection

2012 ◽  
Author(s):  
Maria Restrepo ◽  
Lucia Mirabella ◽  
Elaine Tang ◽  
Chris Haggerty ◽  
Mark A. Fogel ◽  
...  
Keyword(s):  
Heart Defects ◽  
Fontan Procedure ◽  
Pulmonary Arteries ◽  
Vena Cava ◽  
Total Cavopulmonary Connection ◽  
Lateral Tunnel ◽  
Vessel Growth ◽  
Original Size ◽  
The Right ◽  
Cavopulmonary Connection

Single ventricle heart defects affect 2 per 1000 live births in the US and are lethal if left untreated. The Fontan procedure used to treat these defects consists of a series of palliative surgeries to create the total cavopulmonary connection (TCPC), which bypasses the right heart. In the last stage of this procedure, the inferior vena cava (IVC) is connected to the pulmonary arteries (PA) using one of the two approaches: the extra-cardiac (EC), where a synthetic graft is used as the conduit; and the lateral tunnel (LT) where part of the atrial wall is used along with a synthetic patch to create the conduit. The LT conduit is thought to grow in size in the long term because it is formed partially with biological tissue, as opposed to the EC conduit that retains its original size because it contains only synthetic material. The growth of the LT has not been yet quantified, especially in respect to the growth of other vessels forming the TCPC. Furthermore, the effect of this growth on the hemodynamics has not been elucidated. The objective of this study is to quantify the TCPC vessels growth in LT patients from serial magnetic resonance (MR) images, and to understand its effect on the connection hemodynamics using computational fluid dynamics (CFD).

Critical issues in studies of flow through the Fontan circuit after 10 years of investigation

2005 ◽  
Vol 15 (S3) ◽  
pp. 68-73 ◽  
Author(s):  
Mauro Grigioni ◽  
Giuseppe D'Avenio ◽  
Costantino Del Gaudio ◽  
Umberto Morbiducci
Keyword(s):  
Fluid Dynamics ◽  
Right Ventricle ◽  
Right Atrium ◽  
Pulmonary Arteries ◽  
Pressure Head ◽  
Terminal Part ◽  
Low Level ◽  
Critical Issues ◽  
Flow Through ◽  
The Right

Since the pioneering work of Fontan and Baudet, who suggested that a dysfunctional right ventricle could be bypassed by connecting the pulmonary arteries directly to the right atrium in the so-called atriopulmonary anastomosis, much experience has been gained in the field of the functionally univentricular circulation. In view of the continuing need to optimize the fluid dynamics of the connection, research on this topic remains very active. In particular, it is relevant to consider the power dissipated during flow across a connection of this type, due to the low level of the pressure head available for perfusion. The flow to the lungs in this setting is driven only by the low pressure in the caval veins, thus making it essential to minimize the losses of energy in the connection between the terminal part of the venous system and the pulmonary arteries.

Effect of Flow Pulsatility and Wall Compliance on the Energy Loss in the Total Cavopulmonary Connection

2013 ◽  
Author(s):  
Reza H. Khiabani ◽  
Sulisay Phonekeo ◽  
Harish Srinimukesh ◽  
Elaine Tang ◽  
Mark Fogel ◽  
...  
Keyword(s):  
Energy Loss ◽  
Wall Motion ◽  
Heart Defects ◽  
Superior Vena ◽  
Pulmonary Arteries ◽  
Vena Cava ◽  
Total Cavopulmonary Connection ◽  
Venous Flow ◽  
The Right ◽  
Cavopulmonary Connection

Single Ventricle Heart Defects (SVHD) are present in 2 per 1000 live births in the US. SVHD are characterized by cyanotic mixing between the de-oxygenated blood from the systemic circulation return and the oxygenated blood from the pulmonary arteries. In the current practice, surgical interventions on SVHD patients commonly result in the total cavopulmonary connection (TCPC) [1]. In this configuration the systemic venous returns (inferior vena cava, IVC, and superior vena cava, SVC) are directly routed to the right and left pulmonary arteries (RPA and LPA), bypassing the right heart. The resulting anatomy has complex and unsteady hemodynamics characterized by flow mixing and flow separation. Pulsation of the inlet venous flow during a cardiac cycle and wall motion may result in complex and unsteady flow patterns in the TCPC. Although vessel wall motion and different degrees of pulsatility have been observed in vivo, non-pulsatile (time-averaged) flow boundary conditions and rigid walls have traditionally been assumed in estimating the TCPC hemodynamic parameters (such as energy loss). Recent studies have shown that these assumptions may result in significant inaccuracies in modeling TCPC hemodynamics [2, 3].

Hemodynamic Impact of Stenting in the Total Cavopulmonary Connection With Lateral Tunnel Stenosis

2012 ◽  
Author(s):  
Elaine Tang ◽  
Doff B. McElhinney ◽  
Ajit P. Yoganathan
Keyword(s):  
Heart Defects ◽  
Superior Vena ◽  
Pulmonary Arteries ◽  
Vena Cava ◽  
Total Cavopulmonary Connection ◽  
Lateral Tunnel ◽  
The Us ◽  
Intravascular Stent ◽  
The Right ◽  
Cavopulmonary Connection

2 per 1000 children in the US are born with functionally single ventricle (SV) heart defects. To restore the separate systemic and pulmonary circulations, a Total Cavopulmonary Connection (TCPC) is carried out through a series of surgical steps, which result in the direct connection of the superior vena cava (SVC) and inferior vena cava (IVC) to the pulmonary arteries without an intervening pulmonary ventricle. One way to complete the TCPC is by placing a synthetic patch in the right atrium, forming an intracardiac lateral tunnel (LT) as the final step. As patients grow, some LT pathways become stenosed. The stenosis can impose extra resistance to flow in addition to the TCPC in the SV circulation. One method of treating LT stenosis is by placement of an intravascular stent.

In Vitro Investigation of the Effect of Flow Pulsatility on Power Loss in the Total Cavopulmonary Connection

2011 ◽  
Author(s):  
Elaine Tang ◽  
Reza H. Khiabani ◽  
Christopher M. Haggerty ◽  
Ajit P. Yoganathan
Keyword(s):  
Heart Defects ◽  
Pulmonary Arteries ◽  
Patient Specific ◽  
Total Cavopulmonary Connection ◽  
Unique Challenge ◽  
Venae Cavae ◽  
In Vitro Investigation ◽  
The Right ◽  
Cavopulmonary Connection

Total Cavopulmonary Connection (TCPC) is the most common surgical palliation for single ventricle heart defects. In such connections, venae cavae are connected to the pulmonary arteries, bypassing the right ventricle. The patient-specific anatomical complexity makes characterization and optimization of the fluid mechanics a unique challenge.

A Case of Intravenous Leiomyomatosis Extending into the Right Atrium, Right Ventricle and Pulmonary Arteries

2005 ◽  
Vol 13 (1) ◽  
pp. 28
Author(s):  
Hye Sun Seo ◽  
Chul Min Ahn ◽  
Sungha Park ◽  
Eui Young Choi ◽  
Jong Won Ha ◽  
...  
Keyword(s):  
Right Ventricle ◽  
Right Atrium ◽  
Pulmonary Arteries ◽  
Intravenous Leiomyomatosis ◽  
The Right

scholarly journals P686 Right atrial, right ventricular and pulmonary cement embolism: a rare complication of percutaneous vertebroplasty

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
S Akhunova ◽  
R Khayrullin ◽  
N Stekolshchikova ◽  
M Samigullin ◽  
V Padiryakov
Keyword(s):  
Pulmonary Artery ◽  
Right Ventricle ◽  
Right Atrium ◽  
Percutaneous Vertebroplasty ◽  
Rare Complication ◽  
Clinical Manifestations ◽  
Stable Condition ◽  
Right Atrial ◽  
Cement Embolism ◽  
The Right

Abstract A 68-year-old man was admitted to the hospital with complaints of pain in the lumbar spine. He had L5 disc herniation, Spinal stenosis of the L5 root canal - S1 on the right in the past medical history. Percutaneous vertebroplasty at the level of L3 and Th8 vertebral bodies was performed six months ago due to painful vertebral hemangioma. The man is suffering from arterial hypertension, receives antihypertensive therapy. During routine transthoracic echocardiography, a hyperechoic structure with a size of 9.5 x 0.9 cm was found in the right atrium and right ventricle. Chest computed tomography with contrast enhancement revealed signs of bone cement in the right atrium and right ventricle, in the right upper lobe artery, in the branches of the upper lobe artery, in the paravertebral venous plexuses. Considering the duration of the disease, the stable condition, the absence of clinical manifestations and disorders of intracardiac hemodynamics, it was decided to refrain from surgical treatment. Antiplatelet therapy and dynamic observation were recommended. Conclusion Percutaneous vertebroplasty is a modern minimally invasive surgical procedure for the treatment of degenerative-dystrophic diseases of the spine. However, the cement can penetrate into the paravertebral veins and migrate to the right chambers of the heart and the pulmonary artery. This clinical case demonstrates asymptomatic cement embolism of the right chambers of the heart and pulmonary artery after percutaneous vertebroplasty, detected incidentally during routine echocardiography. Abstract P686 Figure.

Angiosarcoma of the right atrium and right ventricle

2017 ◽  
Vol 32 (12) ◽  
pp. 807-808 ◽  
Author(s):  
Jinaga Nageswar Rao ◽  
Deepak Gowda G ◽  
Rajan Anand ◽  
Neelam B. Desai
Keyword(s):  
Right Ventricle ◽  
Right Atrium ◽  
The Right
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