Abstract:
BACKGROUND:The physiological importance of the lateral tunnel stenosis in the Fontan pathway for children with single ventricle physiology can be difficult to determine. The impact of the stenosis and stent implantation on total cavopulmonary connection resistance has not been characterized, and there are no clear guidelines for intervention. Methods and results A computational framework for haemodynamic assessment of stent implantation in patients with lateral tunnel stenosis was developed. Cardiac magnetic resonances images were reconstructed to obtain total cavopulmonary connection anatomies before stent implantation. Stents with 2-mm diameter increments were virtually implanted in each patient to understand the impact of stent diameter. Numerical simulations were performed in all geometries with patient-specific flow rates. Exercise conditions were simulated by doubling and tripling the lateral tunnel flow rate. The resulting total cavopulmonary connection vascular resistances were computed. A total of six patients (age: 14.4 ± 3.1 years) with lateral tunnel stenosis were included for preliminary analysis. The mean baseline resistance was 1.54 ± 1.08 WU · m(2) and dependent on the stenosis diameter. It was further exacerbated during exercise. It was observed that utilising a stent with a larger diameter lowered the resistance, but the resistance reduction diminished at larger diameters. CONCLUSIONS:Using a computational framework to assess the severity of lateral tunnel stenosis and the haemodynamic impact of stent implantation, it was observed that stenosis in the lateral tunnel pathway was associated with higher total cavopulmonary connection resistance than unobstructed pathways, which was exacerbated during exercise. Stent implantation could reduce the resistance, but the improvement was specific to the minimum diameter.
journal_name
Cardiol Youngjournal_title
Cardiology in the youngauthors
Tang E,McElhinney DB,Restrepo M,Valente AM,Yoganathan APdoi
10.1017/S1047951114002765subject
Has Abstractpub_date
2016-01-01 00:00:00pages
116-26issue
1eissn
1047-9511issn
1467-1107pii
S1047951114002765journal_volume
26pub_type
杂志文章abstract::We report here the case of a 27-year-old woman with Noonan syndrome presenting with ventricular fibrillation. After successful defibrillation, echocardiography revealed hypertrophic cardiomyopathy associated with left ventricular outflow tract obstruction. Normal echocardiographic cardiac structure and function were r...
journal_title:Cardiology in the young
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doi:10.1017/S1047951110001708
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journal_title:Cardiology in the young
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journal_title:Cardiology in the young
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2018-07-01 00:00:00
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doi:10.1017/S1047951107000352
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journal_title:Cardiology in the young
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journal_title:Cardiology in the young
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journal_title:Cardiology in the young
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journal_title:Cardiology in the young
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doi:10.1017/S1047951114002339
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journal_title:Cardiology in the young
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journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951110001502
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journal_title:Cardiology in the young
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doi:10.1017/S1047951112000224
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pub_type: 杂志文章,随机对照试验
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pub_type: 杂志文章,评审
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pub_type: 杂志文章
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journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951110000089
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pub_type: 杂志文章,多中心研究
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