Document Detail


Wang-Zwische Double-Lumen Cannula Leads to Total Cavopulmonary Support in a Failing Fontan Sheep Model.
MedLine Citation:
PMID:  21531379     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: We are developing a total cavopulmonary support system for failing Fontan physiology using the percutaneous Wang-Zwische double-lumen cannula (DLC). METHODS: We developed a sheep model of failing Fontan physiology through a right thoracotomy in 5 sheep. An extracardiac conduit was anastomosed to the inferior vena cava and superior vena cava, and a graft was applied to connect the conduit and the right pulmonary artery (PA) to create total vena cava-to-PA diversion, excluding the right heart. The DLC (commercialized as AvalonElite, Avalon Laboratories LLC, Rancho Dominguez, CA) was coupled with a CentriMag pump (Levitronix Waltham, MA) to form a cavopulmonary support system. The DLC was inserted through the right jugular vein and the superior vena cava into the extracardiac conduit with the infusion lumen opening aligned with the right PA bridge. Blood was withdrawn from the superior vena cava and the inferior vena cava through the drainage lumen and pumped into the right PA through the infusion lumen, with flow adjusted to 4.0 ± 0.5 L/min. RESULTS: A successful Fontan model was created without cardiopulmonary bypass. After total venous blood diversion from the vena cava to the right PA artery, failing Fontan physiology developed, evidenced by elevated central venous pressure and dropping mean PA pressure and systolic arterial pressure. The DLC was successfully inserted, and hemodynamics were normalized in all 5 sheep for the duration of the 2-hour study. CONCLUSIONS: We created a model of failing Fontan circulation in sheep without cardiopulmonary bypass. The DLC system achieved total cavopulmonary support for 2 hours in our failing Fontan sheep model.
Authors:
Dongfang Wang; Mark Plunkett; James Lynch; Xiaoqin Zhou; Cherry Ballard-Croft; Joseph B Zwischenberger
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-4-29
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  -     ISSN:  1552-6259     ISO Abbreviation:  -     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-5-2     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Surgery, University of Kentucky College of Medicine, Lexington, Kentucky.
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