Document Detail


Use of a subpulmonary ventricular chamber in the Fontan circulation.
MedLine Citation:
PMID:  6848884     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In order to study the usefulness of incorporating a subpulmonary ventricular chamber (SPVC) in the Fontan circulation, we compared the hemodynamics of 18 patients who underwent an atriopulmonary connection with those of 17 patients with an atrioventricular connection. Early postoperatively, regardless of whether an SPVC was incorporated or not, the mean pulmonary artery pressure was not higher than the mean right atrial pressure in any of our patients. The stroke work of the right heart was at best zero, and pressure tracings showed an a wave in the pulmonary artery (right atrium-dependent circulation). If an additional gradient was interposed between the right atrium and pulmonary artery, the effective stroke work of the right heart might be negative and the work curve have a negative slope. This can occur irrespective of the use of an SPVC. In the long term, if it grows sufficiently, an SPVC can sometimes provide a right ventricle-dependent pulmonary circulation with a more normal hemodynamic pattern (mean right atrial pressure less than mean pulmonary artery pressure). We concluded that an SPVC should be used in Fontan's circulation, provided that an obstruction-free atrioventricular connection can be established.
Authors:
C Bull; M R de Leval; J Stark; J F Taylor; F J Macartney
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  85     ISSN:  0022-5223     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  1983 Jan 
Date Detail:
Created Date:  1983-02-14     Completed Date:  1983-02-14     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  21-31     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Blood Flow Velocity
Child
Child, Preschool
Coronary Circulation
Electrocardiography
Evaluation Studies as Topic
Heart Atria / surgery*
Heart Defects, Congenital / surgery*
Heart Ventricles / surgery*
Hemodynamics
Humans
Methods
Pulmonary Artery / surgery*
Stroke Volume

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


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