Effects of Exercise and Respiration on Blood Flow in Total Cavopulmonary Connection

Hjortdal, Vibeke E.; Emmertsen, K; Stenbøg, Elisabeth; Fründ, Ernst-Torben Wilhelm; Schmidt, Morten; Kromann, O.; Sørensen, Keld E.; Pedersen, Erik Morre

doi:10.1161/01.cir.0000087406.27922.6b

Cited by 176 publications

(195 citation statements)

References 21 publications

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“…Respiratory motion can also be avoided by breath-hold 2D flow techniques. However, flow patterns, particularly in the venous system, are coupled to respiration and were shown to vary largely between in-and expiration (24). Interestingly, the nongated, single-average 4D acquisition used in our study obtained nearly identical measurements compared to conventional 2D or gated 4D acquisition.…”

Section: Discussionmentioning

confidence: 60%

Flow‐sensitive four‐dimensional cine magnetic resonance imaging for offline blood flow quantification in multiple vessels: A validation study

Nordmeyer

Riesenkampff

Crelier

et al. 2010

Magnetic Resonance Imaging

101

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Purpose:To further validate the quantitative use of flowsensitive four-dimensional velocity encoded cine magnetic resonance imaging (4D VEC MRI) for simultaneously acquired venous and arterial blood flow in healthy volunteers and for abnormal flow in patients with congenital heart disease.Materials and Methods: Stroke volumes (SV) obtained in arterial and venous thoracic vessels were compared between standard two-dimensional (2D), 4D VEC MRI with and without respiratory navigator gating (gated/nongated) in volunteers (n ¼ 7). In addition, SV and regurgitation fractions (RF) measured in aorta or pulmonary trunk of patients with malformed and/or insufficient valves (n ¼ 10) were compared between 2D and nongated 4D VEC MRI methods. Results:In volunteers and patients, Bland-Altman tests showed excellent agreement between 2D, gated, and nongated 4D VEC MRI obtained quantitative blood flow measurements. The bias between 2D and gated 4D VEC MRI was <0.5 mL for SV; between 2D and nongated 4D VEC MRI the bias was <0.7 mL for SV and <1% for RF.Conclusion: Blood flow can be quantified accurately in arterial, venous, and pathological flow conditions using 4D VEC MRI. Nongated 4D VEC MRI has the potential to be suited for clinical use in patients with congenital heart disease who require flow acquisitions in multiple vessels.

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Section: Discussionmentioning

confidence: 60%

Flow‐sensitive four‐dimensional cine magnetic resonance imaging for offline blood flow quantification in multiple vessels: A validation study

Nordmeyer

Riesenkampff

Crelier

et al. 2010

Magnetic Resonance Imaging

101

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show abstract

“…Note that the SVC flowrate is synchronized with the heart cycle, while the IVC flowrate is synchronized with the respiratory cycle. Cardiac catheterization pressure tracings, echocardiography, and MR studies have all demonstrated that respiration significantly effects Fontan flow rates and pressures [15,30]. As seen with the echocardiographic tracings, quantitative real-time phase contrast MR measurements by Hjortdal et al [15] show that flow rates in the IVC vary significantly with respiration at rest (as much as 80%), with smaller cardiac pulsatility superimposed.…”

Section: Simulation Resultsmentioning

confidence: 93%

Computational fluid–structure interaction: methods and application to a total cavopulmonary connection

et al. 2009

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The Fontan procedure is a surgery that is performed on single-ventricle heart patients, and, due to the wide range of anatomies and variations among patients, lends itself nicely to study by advanced numerical methods. We focus on a patient-specific Fontan configuration, and perform a fully coupled fluid-structure interaction (FSI) analysis of hemodynamics and vessel wall motion. To enable physiologically realistic simulations, a simple approach to constructing a variable-thickness blood vessel wall description is proposed. Rest and exercise conditions are simulated and rigid versus flexible vessel wall simulation results are compared. We conclude that flexible wall modeling plays an important role in predicting quantities of hemodynamic interest in the Fontan connection. To the best of our knowledge, this paper presents the first three-dimensional patientspecific fully coupled FSI analysis of a total cavopulmonary connection that also includes large portions of the pulmonary circulation.

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“…Imaging modalities used in adult congenital heart patients (26,27) exclude obstruction and look at pulmonary venous return. (28,29) In the HLHS post Norwood, it is the modality of choice for examining the Damus connection and the reconstructed aortic arch.…”

mentioning

confidence: 99%

Management of the Fontan circulation in the adult patient

Clift

2017

SAHJ

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Effects of Exercise and Respiration on Blood Flow in Total Cavopulmonary Connection

Cited by 176 publications

References 21 publications

Flow‐sensitive four‐dimensional cine magnetic resonance imaging for offline blood flow quantification in multiple vessels: A validation study

Flow‐sensitive four‐dimensional cine magnetic resonance imaging for offline blood flow quantification in multiple vessels: A validation study

Computational fluid–structure interaction: methods and application to a total cavopulmonary connection

Management of the Fontan circulation in the adult patient

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