Transient Hemodynamic Changes upon Changing a BCPA into a TCPC in Staged Fontan Operation: A Computational Model Study
The clinical benefits of the Fontan operation in treating single-ventricle defects have been well documented. However, perioperative mortality or morbidity remains a critical problem. The purpose of the present study was to identify the cardiovascular factors that dominate the transient hemodynamic...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2013-01-01
|
| Series: | The Scientific World Journal |
| Online Access: | http://dx.doi.org/10.1155/2013/486815 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832558786772992000 |
|---|---|
| author | Fuyou Liang Hideaki Senzaki Zhaofang Yin Yuqi Fan Koichi Sughimoto Hao Liu |
| author_facet | Fuyou Liang Hideaki Senzaki Zhaofang Yin Yuqi Fan Koichi Sughimoto Hao Liu |
| author_sort | Fuyou Liang |
| collection | DOAJ |
| description | The clinical benefits of the Fontan operation in treating single-ventricle defects have been well documented. However, perioperative mortality or morbidity remains a critical problem. The purpose of the present study was to identify the cardiovascular factors that dominate the transient hemodynamic changes upon the change of a bidirectional cavopulmonary (Glenn) anastomosis (BCPA) into a total cavopulmonary connection (TCPC). For this purpose, two computational models were constructed to represent, respectively, a single-ventricle circulation with a BCPA and that with a TCPC. A series of model-based simulations were carried out to quantify the perioperative hemodynamic changes under various cardiovascular conditions. Obtained results indicated that the presence of a low pulmonary vascular resistance and/or a low lower-body vascular resistance is beneficial to the increase in transpulmonary flow upon the BCPA to TCPC change. Moreover, it was found that ventricular diastolic dysfunction and mitral valve regurgitation, despite being well-known risk factors for poor postoperative outcomes, do not cause a considerable perioperative reduction in transpulmonary flow. The findings may help physicians to assess the perioperative risk of the TCPC surgery based on preoperative measurement of cardiovascular function. |
| format | Article |
| id | doaj-art-343907494be844c58dfc4d55c42f794a |
| institution | Kabale University |
| issn | 1537-744X |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | The Scientific World Journal |
| spelling | doaj-art-343907494be844c58dfc4d55c42f794a2025-02-03T01:31:31ZengWileyThe Scientific World Journal1537-744X2013-01-01201310.1155/2013/486815486815Transient Hemodynamic Changes upon Changing a BCPA into a TCPC in Staged Fontan Operation: A Computational Model StudyFuyou Liang0Hideaki Senzaki1Zhaofang Yin2Yuqi Fan3Koichi Sughimoto4Hao Liu5SJTU-CU International Cooperative Research Center, School of Naval Architecture, Ocean and Civil Engineering, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai 200240, ChinaDepartment of Pediatrics and Pediatric Cardiology, Saitama Medical Center, Saitama Medical University, Staff Office Building 101, 1981 Kamoda, Kawagoe, Saitama 3508550, JapanDepartment of Cardiology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai 200011, ChinaDepartment of Cardiology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai 200011, ChinaDepartment of Cardiac Surgery, Royal Children’s Hospital, 50 Flemington Road, Parkville Victoria, Melbourne, VIC 3052, AustraliaSJTU-CU International Cooperative Research Center, School of Naval Architecture, Ocean and Civil Engineering, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai 200240, ChinaThe clinical benefits of the Fontan operation in treating single-ventricle defects have been well documented. However, perioperative mortality or morbidity remains a critical problem. The purpose of the present study was to identify the cardiovascular factors that dominate the transient hemodynamic changes upon the change of a bidirectional cavopulmonary (Glenn) anastomosis (BCPA) into a total cavopulmonary connection (TCPC). For this purpose, two computational models were constructed to represent, respectively, a single-ventricle circulation with a BCPA and that with a TCPC. A series of model-based simulations were carried out to quantify the perioperative hemodynamic changes under various cardiovascular conditions. Obtained results indicated that the presence of a low pulmonary vascular resistance and/or a low lower-body vascular resistance is beneficial to the increase in transpulmonary flow upon the BCPA to TCPC change. Moreover, it was found that ventricular diastolic dysfunction and mitral valve regurgitation, despite being well-known risk factors for poor postoperative outcomes, do not cause a considerable perioperative reduction in transpulmonary flow. The findings may help physicians to assess the perioperative risk of the TCPC surgery based on preoperative measurement of cardiovascular function.http://dx.doi.org/10.1155/2013/486815 |
| spellingShingle | Fuyou Liang Hideaki Senzaki Zhaofang Yin Yuqi Fan Koichi Sughimoto Hao Liu Transient Hemodynamic Changes upon Changing a BCPA into a TCPC in Staged Fontan Operation: A Computational Model Study The Scientific World Journal |
| title | Transient Hemodynamic Changes upon Changing a BCPA into a TCPC in Staged Fontan Operation: A Computational Model Study |
| title_full | Transient Hemodynamic Changes upon Changing a BCPA into a TCPC in Staged Fontan Operation: A Computational Model Study |
| title_fullStr | Transient Hemodynamic Changes upon Changing a BCPA into a TCPC in Staged Fontan Operation: A Computational Model Study |
| title_full_unstemmed | Transient Hemodynamic Changes upon Changing a BCPA into a TCPC in Staged Fontan Operation: A Computational Model Study |
| title_short | Transient Hemodynamic Changes upon Changing a BCPA into a TCPC in Staged Fontan Operation: A Computational Model Study |
| title_sort | transient hemodynamic changes upon changing a bcpa into a tcpc in staged fontan operation a computational model study |
| url | http://dx.doi.org/10.1155/2013/486815 |
| work_keys_str_mv | AT fuyouliang transienthemodynamicchangesuponchangingabcpaintoatcpcinstagedfontanoperationacomputationalmodelstudy AT hideakisenzaki transienthemodynamicchangesuponchangingabcpaintoatcpcinstagedfontanoperationacomputationalmodelstudy AT zhaofangyin transienthemodynamicchangesuponchangingabcpaintoatcpcinstagedfontanoperationacomputationalmodelstudy AT yuqifan transienthemodynamicchangesuponchangingabcpaintoatcpcinstagedfontanoperationacomputationalmodelstudy AT koichisughimoto transienthemodynamicchangesuponchangingabcpaintoatcpcinstagedfontanoperationacomputationalmodelstudy AT haoliu transienthemodynamicchangesuponchangingabcpaintoatcpcinstagedfontanoperationacomputationalmodelstudy |