Acquired fontan paradox in isolated right ventricular cardiomyopathy

Saran, Mahim; Sivasubramonian, Sivasankaran; Abhilash, Sreevilasam Pushpangadhan; Tharakan, Jaganmohan A.

doi:10.4103/0974-2069.189117

Cited by 5 publications

(3 citation statements)

References 9 publications

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“…Such a result is somehow expected since in absence of any contractile ventricular activity the model reproduces the passive conduit behaviour in which the blood flows from RA into PuA. Thus, the nonfunctional RV leads to condition similar to the spontaneous evolution of the Fontan circulation, as highlighted in Saran et al 45 . However, in the simulated case, RA function is maintained and therefore RA effectively 'takes over' as the main right-sided pump.…”

Section: Discussionsupporting

confidence: 54%

Understanding and Recognition of the Right Ventricular Function and Dysfunction: A Numerical Study

Comunale

Peruzzo

Castaldi

et al. 2020

Preprint

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The role played by the right ventricular (RV) dysfunction has long been underestimated in clinical practice. Recent findings are progressively confirming that when the RV efficiency deteriorates both the right and the left circulation is (significantly) affected, but studies dedicated to a detailed description of RV hemodynamic role still lack. In response to such a gap in knowledge, this work proposes a numerical model that for the first time evaluates the effect of isolated RV dysfunction on the whole circulation. Lumped parameter modelling was applied to represent the physio-pathological hemodynamics. Different grades of impairment were simulated for three dysfunctions i.e., systolic, diastolic, and combined systolic and diastolic. Hemodynamic alterations (i.e., of blood pressure, flow, global hemodynamic parameters), arising from the dysfunctions, are calculated and analysed. Results well accord with clinical observations, showing that RV dysfunction significantly affects both the pulmonary and systemic hemodynamics. Successful validation against in vivo data proved the clinical potentiality of the model i.e., the capability of identifying the degree of RV impairment for given hemodynamic conditions. This study aims at contributing to the improvement of RV dysfunction recognition and treatment, and to the development of tools for the clinical management of pathologies involving the right heart.

show abstract

Section: Discussionsupporting

confidence: 54%

Understanding and Recognition of the Right Ventricular Function and Dysfunction: A Numerical Study

Comunale

Peruzzo

Castaldi

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…We also observed that, importantly, when the contractile activity is absent ( p = 100%), the model captures the nearly constant P rv and Q pv . Such a result, somehow expected, shows that in absence of any contractile activity the right ventricle behaves like a passive conduit i.e., a condition similar to the spontaneous evolution of the Fontan circulation appears 46 , but with the RA still contracting.…”

Section: Discussionsupporting

confidence: 53%

Understanding and recognition of the right ventricular function and dysfunction via a numerical study

Comunale

Peruzzo

Castaldi

et al. 2021

Sci Rep

View full text Add to dashboard Cite

The role played by the right ventricular (RV) dysfunction has long been underestimated in clinical practice. Recent findings are progressively confirming that when the RV efficiency deteriorates both the right and the left circulation is (significantly) affected, but studies dedicated to a detailed description of RV hemodynamic role still lack. In response to such a gap in knowledge, this work proposes a numerical model that for the first time evaluates the effect of isolated RV dysfunction on the whole circulation. Lumped parameter modelling was applied to represent the physio-pathological hemodynamics. Different grades of impairment were simulated for three dysfunctions i.e., systolic, diastolic, and combined systolic and diastolic. Hemodynamic alterations (i.e., of blood pressure, flow, global hemodynamic parameters), arising from the dysfunctions, are calculated and analysed. Results well accord with clinical observations, showing that RV dysfunction significantly affects both the pulmonary and systemic hemodynamics. Successful verification against in vivo data proved the clinical potentiality of the model i.e., the capability of identifying the degree of RV impairment for given hemodynamic conditions. This study aims at contributing to the improvement of RV dysfunction recognition and treatment, and to the development of tools for the clinical management of pathologies involving the right heart.

show abstract

“…It is good to know that both nature and surgeons are revising the limitations of creating a Fontan circuit so that current limitation of age and pulmonary vascular resistance is revised to higher numbers. [ 3 4 ]…”

mentioning

confidence: 99%