Conversion to Total Cavopulmonary Connection Improves Functional Status Even in Older Patients with Failing Fontan Circulation

2015 ◽  
Vol 63 (05) ◽  
pp. 380-387 ◽  
Author(s):  
Julie Cleuziou ◽  
Jelena Kasnar-Samprec ◽  
Melchior Burri ◽  
Vanessa Hepp ◽  
Manfred Vogt ◽  
...  
Keyword(s):  
Functional Status ◽  
Older Patients ◽  
Fontan Circulation ◽  
Total Cavopulmonary Connection ◽  
Cavopulmonary Connection ◽  
Failing Fontan

Reappraisal of lung manifestations in the setting of Fontan circulation

2021 ◽  
pp. 021849232110567
Author(s):  
Meletios Kanakis ◽  
Thomas Martens ◽  
Martin Kostolny ◽  
Konstantinos Petsios ◽  
Nicholas Giannopoulos ◽  
...  
Keyword(s):  
Blood Flow ◽  
Literature Review ◽  
Clinical Experience ◽  
Fontan Circulation ◽  
Total Cavopulmonary Connection ◽  
Central Venous ◽  
Term Survival ◽  
Long Term Survival ◽  
Cavopulmonary Connection

Fontan circulation is a well-established palliation in patients with functional single ventricles. Absence of a sub-pulmonary pumping chamber creates a unique physiology in which blood flow is mainly guided by negative intrathoracic and elevated central venous pressures. Various pulmonary anatomic or pathophysiologic changes can jeopardize optimal Fontan circulation. Long-term survival of patients who have undergone the contemporary total cavopulmonary connection is satisfactory. Thorough literature review in conjunction with accumulated clinical experience can lead clinicians to extract conclusions regarding Fontan and lung interactions indicating the purpose of this review.

Valveless pump models that laid a false but fortuitous trail on the way towards the total cavopulmonary connection

2005 ◽  
Vol 15 (S3) ◽  
pp. 74-79 ◽  
Author(s):  
Philip J. Kilner
Keyword(s):  
Right Atrium ◽  
Fontan Operation ◽  
Venous Pressure ◽  
Fontan Circulation ◽  
Right Atrial ◽  
Total Cavopulmonary Connection ◽  
Valveless Pump ◽  
Cavopulmonary Connection ◽  
The Way

When Fontan and Baudet devised what has become known as the Fontan operation, they understandably assumed that inflow and outflow valves should be included to achieve a pump-like action of the subpulmonary right atrial cavity. Over the following years, however, it became apparent that valves did not function satisfactorily in this situation. Worse, the implanted valves had a tendency to become obstructive, which often lead to critical elevation of the already raised systemic venous pressure. Surgeons gradually realised that the outcomes of surgery designed to create the Fontan circulation were likely to be better without inclusion of valves in the subpulmonary right atrium, and they stopped putting them in.

a study of the fontan circulation and ventricular energetics based on a model

2004 ◽  
Vol 14 (S3) ◽  
pp. 11-19 ◽  
Author(s):  
andrea ripoli ◽  
sergio berti ◽  
mattia glauber ◽  
vittorio vanini ◽  
vincenzo stefano luisi ◽  
...  
Keyword(s):  
Single Ventricle ◽  
Volume Overload ◽  
Systemic Circulation ◽  
Fontan Circulation ◽  
Total Cavopulmonary Connection ◽  
Right Heart ◽  
Cavopulmonary Anastomosis ◽  
Bidirectional Cavopulmonary Anastomosis ◽  
The Right ◽  
Cavopulmonary Connection

patients with congenitally malformed hearts characterised by a functionally single ventricle are currently treated using several procedures that bypass the right heart, such as the fontan and hemi-fontan operations, the bidirectional cavopulmonary anastomosis, and the total cavopulmonary connection. all these options are based on the procedures introduced for palliative correction of tricuspid atresia by fontan and baudet in 1971. introduced with the purpose of reducing the pre-operative volume overload, the surgical task mainly consists of separating the pulmonary from the systemic circulation. irrespective of the specific operation performed, we can call the resulting circulation the fontan circulation.

Experimental Study of Powered Fontan Hemodynamics in an Idealized Total Cavopulmonary Connection Model

2011 ◽  
Author(s):  
Jeffrey R. Kennington ◽  
Mark D. Rodefeld ◽  
Steven H. Frankel ◽  
Jun Chen ◽  
Anna-Elodie M. Kerlo ◽  
...  
Keyword(s):  
Birth Defects ◽  
Single Ventricle ◽  
Fontan Circulation ◽  
Total Cavopulmonary Connection ◽  
Cfd Simulations ◽  
Percutaneous Catheter ◽  
Number Of Patients ◽  
Fontan Failure ◽  
Computational Fluid Dynamics Cfd ◽  
Cavopulmonary Connection

Cardiac single ventricle birth defects are a leading cause of death among birth defects for children under one years of age. Fontan palliation is the current clinical treatment for patients with these birth defects and result in a single working ventricle to power the entire system by forming a total cavopulmonary connection (TCPC). A significant number of patients with univentricle Fontan circulation develop Fontan failure caused by the inability of the single ventricle to power the Fontan circulation. The use of mechanical cavopulmonary assist device has been proposed as a treatment for these patients. Particularly, the application of a percutaneous, catheter driven, viscous impeller pump (VIP) has been identified to provide promising cavopulmonary support [1]. Computational Fluid Dynamics (CFD) simulations have demonstrated that this VIP pump can satisfactorily augment cavopulmonary blood flow at pressures sufficient to overcome increased downstream resistance. Experimental characterization of flow induced by the VIP in the TCPC, including detailed flow structures and hemodynamic performances, needs to be conducted for minimizing risk of hemolysis and thrombosis while maximizing the pump performance, and for validating the results from high-fidelity CFD simulations.

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