PMID: 9647092Jul 1, 1998Paper

Superior hydrodynamics of a modified cavopulmonary connection for the Norwood operation

The Annals of Thoracic Surgery
H H SieversG Pfister

Abstract

In the Fontan circulation, energy consumption at the cavopulmonary connection is crucial. Our hypothesis was that a modification of the standard Norwood variant of cavopulmonary connection with an extended anastomosis would improve hydrodynamics. The in vitro hydrodynamics of two different Perspex glass models resembling the Norwood variant of cavopulmonary connection (model I) and the modification (model II) were analyzed in a mock circulation at nonpulsatile flows of 2 to 5 L/min to simulate rest and exercise. The pulmonary flow split was varied to imitate varying lung resistances. Inferior-to-superior caval flow ratio and size of models were increased to simulate growth. The pulmonary flow was preferentially directed to the left lung in model I and was better balanced in model II. Power losses increased exponentially with total flow in both models and were markedly higher in model I. These differences were attenuated in the larger models. Anastomotic turbulences were larger in model I. Power losses in both models were relatively insensitive to changes in pulmonary flow split. The proposed modification of the Norwood variant of cavopulmonary connection seems to be hydrodynamically advantageous and warrants further evaluation.

References

Nov 1, 1992·Circulation·W G Guntheroth
Jan 1, 1990·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·J W KirklinE H Blackstone
Oct 9, 1986·The New England Journal of Medicine·L L BaileyE L Petry
May 1, 1971·Thorax·F Fontan, E Baudet
Jan 6, 1983·The New England Journal of Medicine·W I NorwoodD D Hansen
Nov 1, 1995·Journal of Biomechanical Engineering·Y H KimA P Yoganathan

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Citations

Jul 10, 2003·Critical Care Clinics·Steven M SchwartzDavid P Nelson
Sep 4, 2007·Pediatric Cardiology·E L BoveG Dubini
May 21, 2004·Journal of Cardiac Surgery·Jefferson M LyonsJeffrey M Pearl
Jul 8, 2008·Journal of Biomechanical Engineering·Hiroumi D KitajimaAjit P Yoganathan

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