| The lower limit of the pulmonary artery index for the extracardiac Fontan circulation. | |
| | |
MedLine Citation:
|
PMID: 21277599 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVE: In the era of the staged Fontan operation, small pulmonary artery index (<250 mm(2)/m(2)) has not affected the early or midterm results. The lower limit of pulmonary artery index, however, has not yet been determined. We created numeric models of the Fontan circulation to investigate the lower limit of the pulmonary artery size. METHODS: The extracardiac Fontan geometries with pulmonary artery index, ranging from 50 to 200 mm(2)/m(2) with every 10-mm(2)/m(2) increase, were created from the postoperative angiographic data of 17 patients. The superior and inferior vena caval flow rates at rest and on 2 exercise levels (0.5 and 1.0 W/kg) were given by magnetic resonance imaging flow studies. Respiration-driven transient flow analysis was performed with a finite element solver. Energy loss and mean inferior vena caval pressure were obtained from the results. RESULTS: Energy loss and mean inferior vena caval pressure were prominently increased in small pulmonary artery index models, especially during exercise. The pulmonary artery indices sufficient for mean inferior vena caval pressure less than 17 mm Hg were 80 mm(2)/m(2) at rest, 100 mm(2)/m(2) during 0.5-W/kg exercise, and 110 mm(2)/m(2) during 1.0-W/kg exercise. With the increase of pulmonary arterial resistance, mean inferior vena caval pressure increased, but the flow pattern did not change. CONCLUSIONS: A small pulmonary artery causes a high pressure gradient and a high energy loss. The lower limit of pulmonary artery index, considering the exercise tolerance, was 110 mm(2)/m(2). |
| | |
Authors:
|
Keiichi Itatani; Kagami Miyaji; Yayoi Nakahata; Kuniyoshi Ohara; Shinichi Takamoto; Masahiro Ishii |
Related Documents
:
|
14980849 - A mediastinal false aneurysm with aortocutaneous fistula. 14603429 - Long-term outcomes of brachiobasilic transposition fistula for haemodialysis. 20859729 - Suprasternal approach for impending tracheo-innominate artery fistula. 15282499 - Infective endocarditis of the aortic valve complicated by massive pericardial effusion ... 11920349 - Salvage of poorly developed arteriovenous fistulae with percutaneous ligation of access... 11158419 - Video-assisted basilic vein transposition for haemodialysis vascular access: preliminar... 16555039 - Imaging of aortopulmonary collateral arteries with high-resolution multidetector ct. 7785409 - Anomaly of the ulnar artery arising from the brachial artery. 7299829 - The internal carotid artery does not directly supply the brain in the monodontidae (ord... |
Publication Detail:
|
Type: Journal Article Date: 2011-02-01 |
Journal Detail:
|
Title: The Journal of thoracic and cardiovascular surgery Volume: 142 ISSN: 1097-685X ISO Abbreviation: J. Thorac. Cardiovasc. Surg. Publication Date: 2011 Jul |
Date Detail:
|
Created Date: 2011-06-20 Completed Date: 2011-08-19 Revised Date: 2012-04-23 |
Medline Journal Info:
|
Nlm Unique ID: 0376343 Medline TA: J Thorac Cardiovasc Surg Country: United States |
Other Details:
|
Languages: eng Pagination: 127-35 Citation Subset: AIM; IM |
Copyright Information:
|
Copyright © 2011 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved. |
Affiliation:
|
Department of Cardiovascular Surgery, Kitasato University School of Medicine, Sagamihara, Japan. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Blood Flow Velocity Blood Pressure Computer Simulation* Exercise Tolerance Finite Element Analysis Fontan Procedure* / adverse effects Hemodynamics* Humans Magnetic Resonance Imaging Models, Cardiovascular* Numerical Analysis, Computer-Assisted Patient Selection* Pulmonary Artery / physiopathology, radiography, surgery* Pulmonary Circulation* Regional Blood Flow Respiratory Mechanics Vascular Resistance Vena Cava, Inferior / physiopathology Vena Cava, Superior / physiopathology Venous Pressure |
| Comments/Corrections | |
Comment In:
|
J Thorac Cardiovasc Surg. 2012 Apr;143(4):989-90; author reply 990
[PMID:
22424523
]
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Natural orifice transluminal endoscopic surgery: A transtracheal approach for the thoracic cavity in...
Next Document: Late improvement in graft patency after coronary artery bypass grafting: Serial assessment with mult...