Document Detail


Simulation of the Fontan circulation during rest and exercise.
MedLine Citation:
PMID:  23367460     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The Fontan palliation was introduced as surgical repair method for tricuspid atresia, creating a univentricular serial circulation. However, it is used as treatment for other life threatening complex congenital heart diseases as well. The variation of underlying pathologies treated with this palliation makes optimization difficult. To assist the optimization process, we adjusted a lumped parameter computational model of the biventricular circulation (CircAdapt) and evaluated the univentricular circulation. The model simulates beat-to-beat dynamics of the two cardiac chambers, the valves, and the systemic and pulmonary circulations. The univentricular circulation in rest and exercise was simulated. Exercise resulted in increased stroke volume, heart rate, pulse pressure, and stressed blood volume. Central venous pressure rose as a result of the constant pulmonary resistance, reducing systemic pressure drop. Reduced systemic pressure drop implies either reduction of systemic flow or further decrease of systemic resistance. Based on our simulation results, we conclude that exercise capacity in Fontan patients is limited due to increase of central venous pressure and the impossibility to reduce systemic resistance further, restricting systemic flow.
Authors:
Yvette Koeken; Theo Arts; Tammo Delhaas
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Conference proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Conference     Volume:  2012     ISSN:  1557-170X     ISO Abbreviation:  Conf Proc IEEE Eng Med Biol Soc     Publication Date:  2012  
Date Detail:
Created Date:  2013-01-31     Completed Date:  2013-09-17     Revised Date:  2014-08-21    
Medline Journal Info:
Nlm Unique ID:  101243413     Medline TA:  Conf Proc IEEE Eng Med Biol Soc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  6673-6     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Algorithms
Blood Pressure
Cardiac Output
Central Venous Pressure
Computer Simulation
Exercise*
Fontan Procedure / methods*
Heart Defects, Congenital / physiopathology*
Heart Rate
Heart Ventricles
Humans
Models, Cardiovascular
Rest*
Software
Stroke Volume

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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