Creation of the Fontan circulation in sheep: a survival model†

Interactive Cardiovascular and Thoracic Surgery
Joeri Van PuyveldeBart Meyns

Abstract

Patients with a single ventricle survive thanks to the Fontan palliation. Nevertheless, there is a growing number of Fontan patients with progressive heart failure. To validate therapeutic options in these patients, we developed a chronic Fontan large animal model. A Fontan circulation was surgically created in 15 sheep. The superior vena cava was anastomosed end-to-side to the pulmonary artery. The inferior vena cava was connected to the pulmonary artery by an ePTFE conduit, and the inferior vena cava-right atrium junction was ligated. Total cavopulmonary connection was successfully performed in all 15 animals. After creation of the Fontan circulation, central venous pressure increased from 4 [interquartile range (IQR) 3-6] mmHg to 16 (IQR 14-17) mmHg, mean arterial blood pressure decreased from 68 (IQR 54-75) mmHg to 52 (IQR 50-61) mmHg and cardiac output decreased from 5.1 (IQR 4.6-6.8) l/min to 1.7 (IQR 1.3-2.7) l/min. Five animals were electively sacrificed after a follow-up period of 21 weeks. These results demonstrate that it is feasible to create a chronic animal model with unsupported Fontan circulation. This animal model not only opens perspectives to investigate the pathophysiology of the failing Fontan circulation, ...Continue Reading

References

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Citations

Apr 1, 2021·Disease Models & Mechanisms·Abdul Jalil RufaihahCitra N Z Mattar
Jul 10, 2021·Seminars in Thoracic and Cardiovascular Surgery·Andrew B Goldstone, Katsuhide Maeda
Jul 1, 2019·The Journal of Thoracic and Cardiovascular Surgery·Christopher R Broda, Iki Adachi
Sep 9, 2019·The Journal of Thoracic and Cardiovascular Surgery·Christopher R Broda, Iki Adachi
Apr 23, 2021·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Joshua P CysykGerson Rosenberg

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