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The Journal of Cardiovascular Surgery 2002 December;43(6):787-91

Copyright © 2009 EDIZIONI MINERVA MEDICA

lingua: Inglese

Influence of arteriotomy shape on powerlosses across in vitro cavopulmonary connections

Gerdes A., Benthin U., Sievers H. H.

Department of Cardiac Surgery Medical University of Lübeck, Lübeck, Germany


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Back­ground. In the ­Fontan cir­cu­la­tion ­power ­supply for main­taining ade­quate ­lung per­fu­sion via a ­total cav­o­pul­mo­nary con­nec­tion is lim­ited. ­This ­study, ­aiming at the detec­tion of ­energy con­suming var­i­ables, com­pares the influ­ence of two dif­ferent pul­mo­nary arter­i­otomy ­shapes on pow­er­losses ­across cav­o­pul­mo­nary con­nec­tions.
­Methods. Two ­types of sur­gical junc­tions of cav­o­pul­mo­nary con­nec­tions ­were ­studied in a ­mock cir­cu­la­tion. ­Firstly a ­slot-­shaped inci­sion and sec­ondly an ­oval-­shaped exci­sion ­within the pul­mo­nary ­artery was per­formed. The ­cross sec­tions of ­native ­caval ­veins ­were ­sutured end-to-­side ­with the ­edges of the ­incised and ­excised pul­mo­nary ­arteries, respec­tively. Pres­sures and ­flows ­were meas­ured at ­total ­flow ­rates var­ying ­from 1200 ml/min to 6000 ml/min and pow­er­losses cal­cu­lated.
­Results. Pow­er­losses ­were, in depen­dence of ­total ­flow, 10.66-32.64% ­lower ­across the ­oval-­shaped junc­tions if com­pared to the cor­re­sponding ­slot-­shaped junc­tions (p<0.05).
Con­clu­sions. Sur­gical junc­tions ­including an ­oval exci­sion ­within the pul­mo­nary ­artery may ­reduce pow­er­losses ­across cav­o­pul­mo­nary con­nec­tions if com­pared to ­simple ­slot-­shaped inci­sions. ­These find­ings may ­have ­some influ­ence on sur­gical tech­niques to ­improve hemo­dy­namics of cav­o­pul­mo­nary con­nec­tions.

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