Quantification of ventricular volume load in the context of a bidirectional cavopulmonary shunt: a theoretical treatise

The Annals of Thoracic Surgery
Tjark EbelsRolf M F Berger

Abstract

Functional univentricular hearts are currently palliated by a staged procedure of which the bidirectional cavopulmonary shunt is usually the second stage. In addition to this stage, a calibrated amount of additional pulmonary blood flow may be preserved to promote pulmonary artery growth and increase the length of the interval preceding the total cavopulmonary connection. However, additional pulmonary blood flow can be deleterious for ventricular functioning and development as it increases functional ventricular volume load. Using the Fick principle we devised a theoretic framework to estimate the ventricular volume loading caused by additional pulmonary and collateral aortopulmonary flow. To use this framework, blood samples need to be taken intraoperatively from the aorta, pulmonary veins, and inferior caval vein to determine oxygen saturations. The oxygen saturation samples have to be taken sequentially with and without additional pulmonary blood flow. The objective of this paper is to provide a theoretic framework to estimate the ventricular volume loading caused by collateral aortopulmonary flow and additional pulmonary blood flow in the context of a bidirectional cavopulmonary shunt in the staged palliation of univentricu...Continue Reading

References

Nov 1, 1992·Catheterization and Cardiovascular Diagnosis·C SteinbergD A Notterman
Oct 8, 2004·The Thoracic and Cardiovascular Surgeon·P A BerdatA Serraf
Jun 7, 2008·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Christian SchreiberRüdiger Lange
Dec 1, 2009·Interactive Cardiovascular and Thoracic Surgery·Marc GewilligMatthias Gorenflo

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Citations

May 29, 2012·The Annals of Thoracic Surgery·Glen Van Arsdell, Rajiv Chaturvedi
Apr 24, 2012·The Annals of Thoracic Surgery·Ymkje J van SlootenTjark Ebels

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