The Journal of Thoracic and Cardiovascular Surgery
Volume 137, Issue 3 , Pages 560-564 , March 2009

Fontan hemodynamics: Importance of pulmonary artery diameter

  • Lakshmi P. Dasi, PhD

      Affiliations

    • Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, Ga
    • Contributed equally.
    • ,
  • Resmi KrishnankuttyRema, MS

      Affiliations

    • Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, Ga
    • Contributed equally.
    • ,
  • Hiroumi D. Kitajima, PhD

      Affiliations

    • Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, Ga
    • ,
  • Kerem Pekkan, PhD

      Affiliations

    • Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, Ga
    • Currently working in the Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, Pa.
    • ,
  • Kartik S. Sundareswaran, MS

      Affiliations

    • Children's Healthcare of Atlanta, Atlanta, Ga
    • ,
  • Mark Fogel, MD

      Affiliations

    • Children's Hospital of Philadelphia, Philadelphia, Pa
    • ,
  • Shiva Sharma, MD

      Affiliations

    • Pediatric Cardiology Services, Lawrenceville, Ga
    • ,
  • Kevin Whitehead, MD, PhD

      Affiliations

    • Children's Hospital of Philadelphia, Philadelphia, Pa
    • ,
  • Kirk Kanter, MD

      Affiliations

    • Children's Healthcare of Atlanta, Atlanta, Ga
    • Emory University School of Medicine, Atlanta, Ga
    • ,
  • Ajit P. Yoganathan, PhD

      Affiliations

    • Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, Ga
    • Corresponding Author InformationAddress for reprints: Ajit P. Yoganathan, PhD, Wallace H. Coulter School of Biomedical Engineering, Georgia Institute of Technology, Room 2119 U.A. Whitaker Building, 313 First Dr. Atlanta, GA 30332-0535.

Received 30 November 2007 ,Revised 29 February 2008 ,Accepted 4 April 2008.

References 

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  2. Kumar SP, Rubinstein CS, Simsic JM, Taylor AB, Saul JP, Bradley SM. Lateral tunnel versus extracardiac conduit Fontan procedure: a concurrent comparison. Ann Thorac Surg. 2003;76:1389–1397
  3. Stamm C, Friehs I, Mayer JE, Zurakowski D, Triedman JK, Moran AM, et al. Long-term results of the lateral tunnel Fontan operation. J Thorac Cardiovasc Surg. 2001;121:28–41
  4. Azakie A, McCrindle BW, Van Arsdell G, Benson LN, Coles J, Hamilton R, et al. Extracardiac conduit versus lateral tunnel cavopulmonary connections at a single institution: impact on outcomes. J Thorac Cardiovasc Surg. 2001;122:1219–1228
  5. Senzaki H, Masutani S, Kobayashi J, Kobayashi T, Sasaki N, Asano H, et al. Ventricular afterload and ventricular work in Fontan circulation—comparison with normal two-ventricle circulation and single-ventricle circulation with Blalock–Taussig shunts. Circulation. 2002;105:2885–2892
  6. de Zelicourt DA, Pekkan K, Wills L, Kanter K, Forbess J, Sharma S, et al. In vitro flow analysis of a patient-specific intraatrial total cavopulmonary connection. Ann Thorac Surg. 2005;79:2094–2102
  7. Ensley AE, Lynch P, Chatzimavroudis GP, Lucas C, Sharma S, Yoganathan AP. Toward designing the optimal total cavopulmonary connection: an in vitro study. Ann Thorac Surg. 1999;68:1384–1390
  8. Pekkan K, de Zelicourt D, Kitajima H, Forbess JM, Kanter KR, Parks JW, et al. Functional left pulmonary artery stenosis in total cavopulmonary connection (TCPC): assessing improvements in lung perfusion and cardiac workload with computer-aided angioplasty. Circulation. 2004;110:737
  9. Whitehead KK, Pekkan K, Kitajima HD, Paridon SM, Yoganathan AP, Fogel MA. Nonlinear power loss during exercise in single-ventricle patients after the Fontan: insights from computational fluid dynamics. Circulation. 2007;116:165–171
  10. Hosein RBM, Clarke AJB, McGuirk SP, Griselli M, Stumper O, De Giovanni JV, et al. Factors influencing early and late outcome following the Fontan procedure in the current era. The “Two Commandments”?. Eur J Cardiothorac Surg. 2007;31:344–353
  11. Walker PG, Howe TT, Davies RL, Fisher J, Watterson KG. Distribution of hepatic venous blood in the total cavo-pulmonary connection: an in vitro study. Eur J Cardiothoracic Surg. 2000;17:658–665
  12. Walker PG, Oweis GF, Watterson KG. Distribution of hepatic venous blood in the total cavo pulmonary connection: an in vitro study into the effects of connection geometry. J Biomech Eng. 2001;123:558–564
  13. Ryu K, Healy TM, Ensley AE, Sharma S, Lucas C, Yoganathan AP. Importance of accurate geometry in the study of the total cavopulmonary connection: computational simulations and in vitro experiments. Ann Biomed Eng. 2001;29:844–853
  14. KrishnankuttyRema R, Dasi LP, Pekkan K, Sundareswaran KS, Fogel M, Sharma S, et al. Quantitative analysis of extracardiac versus intraatrial Fontan anatomic geometries. Ann Thorac Surg. 2008;85:810–817
  15. Katajima HD. In vitro fluid dynamics of stereolithographic single ventricle congenetal heart defects from in vivo magnatic resonance imaging. [PhD dissertation] Atlanta: School of Biomedical Engineering, Georgia Institute of Technology; 2007;
  16. Frakes DH, Conrad CP, Healy TM, Monaco JW, Fogel M, Sharma S, et al. Application of an adaptive control grid interpolation technique to morphological vascular reconstruction. IEEE Trans Biomed Eng. 2003;50:197–206
  17. Frakes DH, Smith MJT, Parks J, Sharma S, Fogel M, Yoganathan AP. New techniques for the reconstruction of complex vascular anatomies from MRI images. J Cardiovasc Magn Reson. 2005;7:425–432
  18. de Zelicourt D, Pekkan K, Kitajima H, Frakes D, Yoganathan AP. Single-step stereolithography of complex anatomical models for optical flow measurements. J Biomech Eng. 2005;127:204–207
  19. Milnor WR, Bergel DH, Bargaine JD. Hydraulic power associated with pulmonary blood flow and its relation to heart rate. Circ Res. 1966;19:467–480
  20. Costa NP, Maia R, Proenca MF, Pinho FT. Edge effects on the flow characteristics in a 90 degree junction. J Fluids Eng. 2006;128:1204–1217
  21. Bassett MD, Winterbone DE, Pearson RJ. Calculation of steady flow pressure loss coefficients for pipe junctions. Proceedings of the Institution of Mechanical Engineers Part C. J Mech Engin Sci. 2001;215:861–881

 Funded by the National Heart, Lung, and Blood Institute (HL67622).

PII: S0022-5223(08)01946-6

doi: 10.1016/j.jtcvs.2008.04.036

The Journal of Thoracic and Cardiovascular Surgery
Volume 137, Issue 3 , Pages 560-564 , March 2009

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