In-Vitro Validation of Self-Powered Fontan Circulation for Treatment of Single Ventricle Anomaly

Around 8% of all newborns with a Congenital Heart Defect (CHD) have only a single functioning ventricle. The Fontan operation has served as palliation for this anomaly for decades, but the surgery entails multiple complications, and the survival rate is less than 50% by adulthood. A rapidly testable...

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Autores principales:	Arka Das, Ray Prather, Eduardo Divo, Michael Farias, Alain Kassab, William DeCampli
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	congenital heart defect single ventricle anomaly hypoplastic left heart syndrome Fontan circulation in-vitro modeling injection jet shunt Thermodynamics QC310.15-319 Descriptive and experimental mechanics QC120-168.85
Acceso en línea:	https://doaj.org/article/a094327086c441bfab20966b2afd01bb
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spelling	oai:doaj.org-article:a094327086c441bfab20966b2afd01bb2021-11-25T17:31:40ZIn-Vitro Validation of Self-Powered Fontan Circulation for Treatment of Single Ventricle Anomaly10.3390/fluids61104012311-5521https://doaj.org/article/a094327086c441bfab20966b2afd01bb2021-11-01T00:00:00Zhttps://www.mdpi.com/2311-5521/6/11/401https://doaj.org/toc/2311-5521Around 8% of all newborns with a Congenital Heart Defect (CHD) have only a single functioning ventricle. The Fontan operation has served as palliation for this anomaly for decades, but the surgery entails multiple complications, and the survival rate is less than 50% by adulthood. A rapidly testable novel alternative is proposed by creating a bifurcating graft, or Injection Jet Shunt (IJS), used to “entrain” the pulmonary flow and thus provide assistance while reducing the caval pressure. A dynamically scaled Mock Flow Loop (MFL) has been configured to validate this hypothesis. Three IJS nozzles of varying diameters 2, 3, and 4 mm with three aortic anastomosis angles and pulmonary vascular resistance (PVR) reduction have been tested to validate the hypothesis and optimize the caval pressure reduction. The MFL is based on a Lumped-Parameter Model (LPM) of a non-fenestrated Fontan circulation. The best outcome was achieved with the experimental testing of a 3 mm IJS by producing an average caval pressure reduction of more than 5 mmHg while maintaining the clinically acceptable pulmonary flow rate (<i>Q<sub>p</sub></i>) to systemic flow rate (<i>Q<sub>s</sub></i>) ratio of ~1.5. Furthermore, alteration of the PVR helped in achieving higher caval pressure reduction with the 3 mm IJS at the expense of an increase in <i>Q<sub>p</sub></i>/<i>Q<sub>s</sub></i> ratio.Arka DasRay PratherEduardo DivoMichael FariasAlain KassabWilliam DeCampliMDPI AGarticlecongenital heart defectsingle ventricle anomalyhypoplastic left heart syndromeFontan circulationin-vitro modelinginjection jet shuntThermodynamicsQC310.15-319Descriptive and experimental mechanicsQC120-168.85ENFluids, Vol 6, Iss 401, p 401 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	congenital heart defect single ventricle anomaly hypoplastic left heart syndrome Fontan circulation in-vitro modeling injection jet shunt Thermodynamics QC310.15-319 Descriptive and experimental mechanics QC120-168.85
spellingShingle	congenital heart defect single ventricle anomaly hypoplastic left heart syndrome Fontan circulation in-vitro modeling injection jet shunt Thermodynamics QC310.15-319 Descriptive and experimental mechanics QC120-168.85 Arka Das Ray Prather Eduardo Divo Michael Farias Alain Kassab William DeCampli In-Vitro Validation of Self-Powered Fontan Circulation for Treatment of Single Ventricle Anomaly
description	Around 8% of all newborns with a Congenital Heart Defect (CHD) have only a single functioning ventricle. The Fontan operation has served as palliation for this anomaly for decades, but the surgery entails multiple complications, and the survival rate is less than 50% by adulthood. A rapidly testable novel alternative is proposed by creating a bifurcating graft, or Injection Jet Shunt (IJS), used to “entrain” the pulmonary flow and thus provide assistance while reducing the caval pressure. A dynamically scaled Mock Flow Loop (MFL) has been configured to validate this hypothesis. Three IJS nozzles of varying diameters 2, 3, and 4 mm with three aortic anastomosis angles and pulmonary vascular resistance (PVR) reduction have been tested to validate the hypothesis and optimize the caval pressure reduction. The MFL is based on a Lumped-Parameter Model (LPM) of a non-fenestrated Fontan circulation. The best outcome was achieved with the experimental testing of a 3 mm IJS by producing an average caval pressure reduction of more than 5 mmHg while maintaining the clinically acceptable pulmonary flow rate (<i>Q<sub>p</sub></i>) to systemic flow rate (<i>Q<sub>s</sub></i>) ratio of ~1.5. Furthermore, alteration of the PVR helped in achieving higher caval pressure reduction with the 3 mm IJS at the expense of an increase in <i>Q<sub>p</sub></i>/<i>Q<sub>s</sub></i> ratio.
format	article
author	Arka Das Ray Prather Eduardo Divo Michael Farias Alain Kassab William DeCampli
author_facet	Arka Das Ray Prather Eduardo Divo Michael Farias Alain Kassab William DeCampli
author_sort	Arka Das
title	In-Vitro Validation of Self-Powered Fontan Circulation for Treatment of Single Ventricle Anomaly
title_short	In-Vitro Validation of Self-Powered Fontan Circulation for Treatment of Single Ventricle Anomaly
title_full	In-Vitro Validation of Self-Powered Fontan Circulation for Treatment of Single Ventricle Anomaly
title_fullStr	In-Vitro Validation of Self-Powered Fontan Circulation for Treatment of Single Ventricle Anomaly
title_full_unstemmed	In-Vitro Validation of Self-Powered Fontan Circulation for Treatment of Single Ventricle Anomaly
title_sort	in-vitro validation of self-powered fontan circulation for treatment of single ventricle anomaly
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/a094327086c441bfab20966b2afd01bb
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In-Vitro Validation of Self-Powered Fontan Circulation for Treatment of Single Ventricle Anomaly

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