Optimal Fenestration of the Fontan Circulation
In: Frontiers in Physiology, Jg. 13 (2022-06-01)
Online
academicJournal
Zugriff:
In this paper, we develop a pulsatile compartmental model of the Fontan circulation and use it to explore the effects of a fenestration added to this physiology. A fenestration is a shunt between the systemic and pulmonary veins that is added either at the time of Fontan conversion or at a later time for the treatment of complications. This shunt increases cardiac output and decreases systemic venous pressure. However, these hemodynamic benefits are achieved at the expense of a decrease in the arterial oxygen saturation. The model developed in this paper incorporates fenestration size as a parameter and describes both blood flow and oxygen transport. It is calibrated to clinical data from Fontan patients, and we use it to study the impact of a fenestration on several hemodynamic variables, including systemic oxygen availability, effective oxygen availability, and systemic venous pressure. In certain scenarios corresponding to high-risk Fontan physiology, we demonstrate the existence of a range of fenestration sizes in which the systemic oxygen availability remains relatively constant while the systemic venous pressure decreases.
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Optimal Fenestration of the Fontan Circulation
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Autor/in / Beteiligte Person: | Ahmad, Zan ; Jin, Lynn H. ; Penny, Daniel J. ; Rusin, Craig G. ; Peskin, Charles S. ; Puelz, Charles |
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Zeitschrift: | Frontiers in Physiology, Jg. 13 (2022-06-01) |
Veröffentlichung: | Frontiers Media S.A., 2022 |
Medientyp: | academicJournal |
ISSN: | 1664-042X (print) |
DOI: | 10.3389/fphys.2022.867995 |
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