| Cavopulmonary assist for the univentricular Fontan circulation: von Kármán viscous impeller pump. | |
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MedLine Citation:
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PMID: 20561640 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: In a univentricular Fontan circulation, modest augmentation of existing cavopulmonary pressure head (2-5 mm Hg) would reduce systemic venous pressure, increase ventricular filling, and thus substantially improve circulatory status. An ideal means of providing mechanical cavopulmonary support does not exist. We hypothesized that a viscous impeller pump, based on the von Kármán viscous pump principle, is optimal for this role. METHODS: A 3-dimensional computational model of the total cavopulmonary connection was created. The impeller was represented as a smooth 2-sided conical actuator disk with rotation in the vena caval axis. Flow was modeled under 3 conditions: (1) passive flow with no disc; (2) passive flow with a nonrotating disk, and (3) induced flow with disc rotation (0-5K rpm). Flow patterns and hydraulic performance were examined for each case. Hydraulic performance for a vaned impeller was assessed by measuring pressure increase and induced flow over 0 to 7K rpm in a laboratory mock loop. RESULTS: A nonrotating actuator disc stabilized cavopulmonary flow, reducing power loss by 88%. Disk rotation (from baseline dynamic flow of 4.4 L/min) resulted in a pressure increase of 0.03 mm Hg. A further increase in pressure of 5 to 20 mm Hg and 0 to 5 L/min flow was obtained with a vaned impeller at 0 to 7K rpm in a laboratory mock loop. CONCLUSIONS: A single viscous impeller pump stabilizes and augments cavopulmonary flow in 4 directions, in the desired pressure range, without venous pathway obstruction. A viscous impeller pump applies to the existing staged protocol as a temporary bridge-to-recovery or -transplant in established univentricular Fontan circulations and may enable compressed palliation of single ventricle without the need for intermediary surgical staging or use of a systemic-to-pulmonary arterial shunt. |
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Authors:
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Mark D Rodefeld; Brandon Coats; Travis Fisher; Guruprasad A Giridharan; Jun Chen; John W Brown; Steven H Frankel |
Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't Date: 2010-06-18 |
Journal Detail:
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Title: The Journal of thoracic and cardiovascular surgery Volume: 140 ISSN: 1097-685X ISO Abbreviation: J. Thorac. Cardiovasc. Surg. Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-08-20 Completed Date: 2010-09-20 Revised Date: 2011-09-13 |
Medline Journal Info:
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Nlm Unique ID: 0376343 Medline TA: J Thorac Cardiovasc Surg Country: United States |
Other Details:
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Languages: eng Pagination: 529-36 Citation Subset: AIM; IM |
Copyright Information:
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2010 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved. |
Affiliation:
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Section of Cardiothoracic Surgery, Department of Surgery, Indiana University School of Medicine and James Whitcomb Riley Hospital for Children, Indianapolis, Ind 46202, USA. rodefeld@iupui.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Blood Pressure Computer Simulation Fontan Procedure / adverse effects, instrumentation* Heart Bypass, Right / adverse effects, instrumentation* Heart Defects, Congenital / physiopathology, surgery* Heart-Assist Devices* Hemodynamics* Hemorheology Humans Models, Cardiovascular Prosthesis Design Regional Blood Flow Stress, Mechanical |
| Grant Support | |
ID/Acronym/Agency:
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HL080089/HL/NHLBI NIH HHS; R01 HL098353-01A1/HL/NHLBI NIH HHS; R21 HL080089-02/HL/NHLBI NIH HHS |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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