Off-Pump “Clamp and Sew” Extracardiac Fontan With Inverted Bifurcated Graft for Dextrocardia With Heterotaxy Syndrome

Avoiding cardiopulmonary bypass during palliation of single ventricle has the advantages of minimizing transfusions, pulmonary vascular resistance, and avoiding the inflammatory response from cardiopulmonary bypass. It is however not always straightforward, and the technique may be faced with challenges.

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Relation of Systemic Venous Return, Pulmonary Vascular Resistance, and Diastolic Dysfunction to Exercise Capacity in Patients With Single Ventricle Receiving Fontan Palliation

The American Journal of Cardiology ◽

10.1016/j.amjcard.2009.12.020 ◽

2010 ◽

Vol 105 (8) ◽

pp. 1169-1175 ◽

Cited By ~ 53

Author(s):

Bryan H. Goldstein ◽

Chad E. Connor ◽

Lindsay Gooding ◽

Albert P. Rocchini

Keyword(s):

Diastolic Dysfunction ◽

Pulmonary Vascular Resistance ◽

Exercise Capacity ◽

Vascular Resistance ◽

Single Ventricle ◽

Venous Return ◽

Systemic Venous Return ◽

Fontan Palliation

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Off-pump extracardiac Fontan completion: Surgical technique and pitfalls

10.1510/mmcts.2021.004 ◽

2021 ◽

Keyword(s):

Surgical Technique ◽

Laminar Flow ◽

Single Ventricle ◽

Fontan Procedure ◽

Atrial Arrhythmias ◽

Off Pump ◽

Extracardiac Fontan

Completion of the extracardiac Fontan procedure is the final palliative stage for treating a functional single ventricle. It has been associated with a smaller incidence of atrial arrhythmias and more laminar flow in the Fontan pathway. We present our technique for the off-pump extracardiac Fontan procedure.

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THE EFFECT OF RESPIRATORY ACIDEMIA ON PULMONARY VASCULAR RESISTANCE FOLLOWING CARDIOPULMONARY BYPASS

Anesthesia & Analgesia ◽

10.1213/00000539-199002001-00118 ◽

1990 ◽

Vol 70 (Supplement) ◽

pp. S118 ◽

Cited By ~ 1

Author(s):

D Fullerton ◽

L E Kirson ◽

J Brown ◽

M Grosso ◽

G Whitman

Keyword(s):

Cardiopulmonary Bypass ◽

Pulmonary Vascular Resistance ◽

Vascular Resistance

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209 MRI cardiac catheter assessment of total and differential pulmonary vascular resistance in the context of single ventricle physiology

Journal of Cardiovascular Magnetic Resonance ◽

10.1186/1532-429x-10-s1-a70 ◽

2008 ◽

Vol 10 (S1) ◽

Cited By ~ 1

Author(s):

Aaron J Bell ◽

Gerald Greil ◽

Philipp Beerbaum ◽

Tobias Shaeffter ◽

Reza Razavi

Keyword(s):

Pulmonary Vascular Resistance ◽

Vascular Resistance ◽

Single Ventricle ◽

Single Ventricle Physiology ◽

Cardiac Catheter

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Off-pump coronary artery bypass surgery versus standard linear or pulsatile cardiopulmonary bypass: endothelial activation and inflammatory response

European Journal of Cardio-Thoracic Surgery ◽

10.1016/j.ejcts.2009.11.010 ◽

2010 ◽

Vol 37 (4) ◽

pp. 897-904 ◽

Cited By ~ 46

Author(s):

Francesco Onorati ◽

Antonino S. Rubino ◽

Sergio Nucera ◽

Daniela Foti ◽

Vincenzo Sica ◽

...

Keyword(s):

Cardiopulmonary Bypass ◽

Coronary Artery ◽

Inflammatory Response ◽

Coronary Artery Bypass Surgery ◽

Bypass Surgery ◽

Artery Bypass ◽

Endothelial Activation ◽

Off Pump ◽

Standard Linear ◽

Pump Coronary Artery Bypass

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Lung Injury after Cardiopulmonary Bypass

Perfusion ◽

10.1191/0267659106pf872oa ◽

2006 ◽

Vol 21 (4) ◽

pp. 225-228 ◽

Cited By ~ 78

Author(s):

Stephen C Clark

Keyword(s):

Cardiopulmonary Bypass ◽

Lung Function ◽

Lung Injury ◽

Inflammatory Response ◽

Pulmonary Injury ◽

Respiratory Impairment ◽

Off Pump ◽

Clinical Benefits ◽

Clinical Advantage ◽

Leukocyte Filtration

Pulmonary injury during cardiopulmonary bypass is common as patient factors (smoking, pain, pneumonia) and the effects of cardiopulmonary bypass combine to compromise lung function after cardiac surgery. Lung injury follows the propagation of an inflammatory response involving cytokines, complement, neutrophils, monocytes, activated endothelial cells and platelets. Neutrophils sequester in the lung in response to chemo-tactic agents and release injurious oxygen free radicals and specific enzymes resulting in widespread pulmonary injury. To alleviate this lung injury a number of possible interventions exist. Off pump surgery may reduce the degree of systemic inflammation but respiratory impairment still occurs and the clinical advantage is uncertain. The use of leukocyte filtration can attenuate the acute inflammatory response with encouraging though variable results. Aprotinin, Pentoxyfilline, Nitric oxide, Aspirin and other agents have shown benefits in lung function after cardiopulmonary bypass induced lung injury. Given the magnitude and diversity of the inflammatory response to cardiopulmonary bypass many possible interventions exist to attenuate lung injury resulting from extracorporeal circulation. Immediate clinical benefits are likely to result from successful amelioration of the processes involved.

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