Caval Blood Flow During Supine Exercise in Normal and Fontan Patients

Hjortdal, Vibeke E.; Christensen, Thomas; Larsen, Steffen Falgreen; Emmertsen, K; Pedersen, Erik Morre

doi:10.1016/j.athoracsur.2007.08.062

Cited by 38 publications

(41 citation statements)

References 21 publications

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“…IVCincrease was necessary because dobutamine increases blood flow equally between the upper and lower half of the body. However, during supine exercise on a bicycle ergometer, this increase is mainly in the lower half of the body 9. Some studies have shown this effect by using a supine bicycle ergometer during MRI flow measurements 9 10.…”

Section: Methodsmentioning

confidence: 99%

“…However, during supine exercise on a bicycle ergometer, this increase is mainly in the lower half of the body 9. Some studies have shown this effect by using a supine bicycle ergometer during MRI flow measurements 9 10. IVCincrease condition was based on results reported by Hjortdal et al ,9 where caval blood flow was measured by MRI in Fontan patients during supine exercise on a MRI-compatible ergometer.…”

Section: Methodsmentioning

confidence: 99%

“…Some studies have shown this effect by using a supine bicycle ergometer during MRI flow measurements 9 10. IVCincrease condition was based on results reported by Hjortdal et al ,9 where caval blood flow was measured by MRI in Fontan patients during supine exercise on a MRI-compatible ergometer. In their study, the exercise at a load of 1.0 W/kg caused a twofold flow increase in the IVC, while SVC flow remained constant 9.…”

Section: Methodsmentioning

confidence: 99%

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Computational fluid dynamics in Fontan patients to evaluate power loss during simulated exercise

Bossers

Cibiş

Gijsen

et al. 2014

Heart

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Computational fluid dynamics in Fontan patients to evaluate power loss during simulated exercise

Bossers

Cibiş

Gijsen

et al. 2014

Heart

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“…As shown previously, catheterizations tend to underestimate the magnitude of physiological deficits in similar patients. [16][17][18] Exercise tolerance is abnormal in Fontan patients because of a combination of factors, 19,20 one of which may be energy loss in the LT. [21][22][23][24][25] Accordingly, any benefits derived from LT stenting are likely related to reduction in the resistance of and consequent energy loss across the LT.…”

Section: Lt Hemodynamicsmentioning

confidence: 99%

Outcomes of Stent Implantation for Obstruction of Intracardiac Lateral Tunnel Fontan Pathways

Mets

Bergersen²,

Mayer³

et al. 2013

Circ: Cardiovascular Interventions

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“…Previous studies focusing on functionally healthy patients after total caval pulmonary connection suggested the venae cavae flows and pressures to be biphasic complex waveforms (6)(7)(8)(9). Recent attempts to quantify the pulsatility in Fontan patients revealed significant differences among different patient cohorts and suggested pulsatility as a promising parameter to predict late Fontan failure (10).…”

Section: Introductionmentioning

confidence: 99%

Pulsatile venous waveform quality in Fontan circulation-clinical implications, venous assists options and the future

Koçyıldırım

Dur²,

Soran³

et al. 2012

Anadolu Kardiyol Derg

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Objective: Functionally univentricular heart (FUH) anomalies are the leading cause of death from all structural birth defects. Total cavopulmonary connection (TCPC) is the last stage of the palliative surgical reconstruction with significant late hemodynamic complications requiring high-risk heart transplantation. Alternative therapeutic options for these critically ill patients are crucial. In Phase I, we investigated the effect of pulsatility of venous flow (VF) waveform on the performance of functional and "failing" Fontan (FF) patients based on conduit power loss. In phase 2, the effect of enhanced external counter pulsation on Fontan circulation flow rates is monitored. Methods: In phase 1, Doppler VFs were acquired from FF patients with ventricle dysfunction. Using computational fluid dynamics (CFD), hemodynamic efficiencies of the FF, functional and in-vitro generated mechanically assisted VF waveforms were evaluated. In phase 2, Fontan circulation on sheep model was created and enhanced external counter pulsation (EECP) applied. Results: Variations in the pulsatile content of the VF waveforms altered conduit efficiency notably. High frequency and low amplitude oscillations lowered the pulsatile component of power losses in FF VF waveforms. The systemic venous flow, pulmonary artery and aorta flows increased by utilizing EECP. Conclusion: Our data highlighted the significance of VF pulsatility on energy efficiency inside SV circulation and the feasibility of VF waveform optimization. EECP assist in Fontan circulation can result in venous flow augmentation. (Anadolu Kardiyol Derg 2012; 12: 420-6) Key words: Fontan, Fontan circulation, failing Fontan circulation, enhanced external counterpulsation, animal experiment, content of the VF waveforms ÖZET Amaç: Fonksiyonel tek ventrikül anomalileri tüm yapısal konjenital kalp anomalileri arasında beşinci en sık defekt olup, önde gelen bir ölüm sebebidir. Total kavopulmoner konneksiyon ameliyatı palyatif cerrahi rekonstrüksiyon ameliyatlarının en son basamağı olup, çoğunlukla kalp transplantasyonu gerektiren hemodinamik komplikasyonları mevcuttur. İleri derecedeki hasta bu kişilerde alternatif tedavi seçenekleri gereklidir. Çalışmamızın faz I evresinde, fonsiyonel ve bozulmuş Fontan dolaşımı olan hastalardaki kondüit enerji kaybı baz alınarak pulsatil venöz dalga niteliğini çalıştık. İkinci fazda ise, güçlendirilmiş eksternal kontrpulsasyonun Fontan dolaşımı akımları üzerindeki etkisini araştırdık. Yöntemler: Faz I'de, ventriküler fonksiyon bozukluğu olan bozulmuş Fontan dolaşımı olan hastalarda Doppler venöz akımları analiz edildi. Bilgisayarlı akışkan dinamikleri yöntemiyle bozulmuş Fontan dolaşımının hemodinamik özellikleri ve venöz dalga niteliği değerlendirildi. Faz II' de Fontan dolaşımı gerçekleştirilen koyun modelinde güçlendirilmiş eksternal kontrpulsasyon uygulandı. Bulgular: Venöz akım dalga niteliği pulsatilite ilişkisi tespit edildi. Bozulmuş Fontan dolaşımı olan hastalardaki yüksek frekans ve düşük amplitüdlü osilasyonların, venöz dalga nitel...

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Caval Blood Flow During Supine Exercise in Normal and Fontan Patients

Cited by 38 publications

References 21 publications

Computational fluid dynamics in Fontan patients to evaluate power loss during simulated exercise

Computational fluid dynamics in Fontan patients to evaluate power loss during simulated exercise

Outcomes of Stent Implantation for Obstruction of Intracardiac Lateral Tunnel Fontan Pathways

Pulsatile venous waveform quality in Fontan circulation-clinical implications, venous assists options and the future

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