Partial cavopulmonary assist from the inferior vena cava to the pulmonary artery improves hemodynamics in failing Fontan circulation: a theoretical analysis

Shuji Shimizu, Toru Kawada, Dai Une, Masafumi Fukumitsu, Michael James Turner, Atsunori Kamiya, Toshiaki Shishido, Masaru Sugimachi

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Cavopulmonary assist (CPA) for failing Fontan patients remains a challenging issue in the clinical setting. To evaluate the effectiveness of a partial CPA from the inferior vena cava (IVC) to the pulmonary artery (PA), we performed a theoretical analysis using a computational model of the Fontan circulation. Cardiac chambers and vascular systems were described as the time-varying elastance model and the modified three-element Windkessel model, respectively. A rotational pump described as a non-linear function was inserted between the IVC and the PA. When pulmonary vascular resistance index varied from 2.1 to 5.9 Wood units m2, the partial CPA maintained cardiac index as efficiently as total CPA and markedly reduced the IVC pressure compared with total CPA. However, the partial CPA increased the superior vena cava pressure substantially. The modification from total to partial CPA is potentially an effective alternative in failing Fontan patients suffering from high IVC pressure.

Original languageEnglish
Pages (from-to)249-255
Number of pages7
JournalJournal of Physiological Sciences
Volume66
Issue number3
DOIs
Publication statusPublished - May 1 2016
Externally publishedYes

Fingerprint

Inferior Vena Cava
Pulmonary Artery
Hemodynamics
Pressure
Superior Vena Cava
Vascular Resistance
Blood Vessels

Keywords

  • Assist device
  • Cavopulmonary assist
  • Computational model
  • Fontan circulation
  • Inferior vena cava
  • Pulmonary vascular resistance

ASJC Scopus subject areas

  • Physiology

Cite this

Partial cavopulmonary assist from the inferior vena cava to the pulmonary artery improves hemodynamics in failing Fontan circulation : a theoretical analysis. / Shimizu, Shuji; Kawada, Toru; Une, Dai; Fukumitsu, Masafumi; Turner, Michael James; Kamiya, Atsunori; Shishido, Toshiaki; Sugimachi, Masaru.

In: Journal of Physiological Sciences, Vol. 66, No. 3, 01.05.2016, p. 249-255.

Research output: Contribution to journalArticle

Shimizu, Shuji ; Kawada, Toru ; Une, Dai ; Fukumitsu, Masafumi ; Turner, Michael James ; Kamiya, Atsunori ; Shishido, Toshiaki ; Sugimachi, Masaru. / Partial cavopulmonary assist from the inferior vena cava to the pulmonary artery improves hemodynamics in failing Fontan circulation : a theoretical analysis. In: Journal of Physiological Sciences. 2016 ; Vol. 66, No. 3. pp. 249-255.
@article{ab1201f737be4e9ca1b75d9ed479441b,
title = "Partial cavopulmonary assist from the inferior vena cava to the pulmonary artery improves hemodynamics in failing Fontan circulation: a theoretical analysis",
abstract = "Cavopulmonary assist (CPA) for failing Fontan patients remains a challenging issue in the clinical setting. To evaluate the effectiveness of a partial CPA from the inferior vena cava (IVC) to the pulmonary artery (PA), we performed a theoretical analysis using a computational model of the Fontan circulation. Cardiac chambers and vascular systems were described as the time-varying elastance model and the modified three-element Windkessel model, respectively. A rotational pump described as a non-linear function was inserted between the IVC and the PA. When pulmonary vascular resistance index varied from 2.1 to 5.9 Wood units m2, the partial CPA maintained cardiac index as efficiently as total CPA and markedly reduced the IVC pressure compared with total CPA. However, the partial CPA increased the superior vena cava pressure substantially. The modification from total to partial CPA is potentially an effective alternative in failing Fontan patients suffering from high IVC pressure.",
keywords = "Assist device, Cavopulmonary assist, Computational model, Fontan circulation, Inferior vena cava, Pulmonary vascular resistance",
author = "Shuji Shimizu and Toru Kawada and Dai Une and Masafumi Fukumitsu and Turner, {Michael James} and Atsunori Kamiya and Toshiaki Shishido and Masaru Sugimachi",
year = "2016",
month = "5",
day = "1",
doi = "10.1007/s12576-015-0422-3",
language = "English",
volume = "66",
pages = "249--255",
journal = "Journal of Physiological Sciences",
issn = "1880-6546",
publisher = "Springer Japan",
number = "3",

}

TY - JOUR

T1 - Partial cavopulmonary assist from the inferior vena cava to the pulmonary artery improves hemodynamics in failing Fontan circulation

T2 - a theoretical analysis

AU - Shimizu, Shuji

AU - Kawada, Toru

AU - Une, Dai

AU - Fukumitsu, Masafumi

AU - Turner, Michael James

AU - Kamiya, Atsunori

AU - Shishido, Toshiaki

AU - Sugimachi, Masaru

PY - 2016/5/1

Y1 - 2016/5/1

N2 - Cavopulmonary assist (CPA) for failing Fontan patients remains a challenging issue in the clinical setting. To evaluate the effectiveness of a partial CPA from the inferior vena cava (IVC) to the pulmonary artery (PA), we performed a theoretical analysis using a computational model of the Fontan circulation. Cardiac chambers and vascular systems were described as the time-varying elastance model and the modified three-element Windkessel model, respectively. A rotational pump described as a non-linear function was inserted between the IVC and the PA. When pulmonary vascular resistance index varied from 2.1 to 5.9 Wood units m2, the partial CPA maintained cardiac index as efficiently as total CPA and markedly reduced the IVC pressure compared with total CPA. However, the partial CPA increased the superior vena cava pressure substantially. The modification from total to partial CPA is potentially an effective alternative in failing Fontan patients suffering from high IVC pressure.

AB - Cavopulmonary assist (CPA) for failing Fontan patients remains a challenging issue in the clinical setting. To evaluate the effectiveness of a partial CPA from the inferior vena cava (IVC) to the pulmonary artery (PA), we performed a theoretical analysis using a computational model of the Fontan circulation. Cardiac chambers and vascular systems were described as the time-varying elastance model and the modified three-element Windkessel model, respectively. A rotational pump described as a non-linear function was inserted between the IVC and the PA. When pulmonary vascular resistance index varied from 2.1 to 5.9 Wood units m2, the partial CPA maintained cardiac index as efficiently as total CPA and markedly reduced the IVC pressure compared with total CPA. However, the partial CPA increased the superior vena cava pressure substantially. The modification from total to partial CPA is potentially an effective alternative in failing Fontan patients suffering from high IVC pressure.

KW - Assist device

KW - Cavopulmonary assist

KW - Computational model

KW - Fontan circulation

KW - Inferior vena cava

KW - Pulmonary vascular resistance

UR - http://www.scopus.com/inward/record.url?scp=84946811125&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84946811125&partnerID=8YFLogxK

U2 - 10.1007/s12576-015-0422-3

DO - 10.1007/s12576-015-0422-3

M3 - Article

C2 - 26546008

AN - SCOPUS:84946811125

VL - 66

SP - 249

EP - 255

JO - Journal of Physiological Sciences

JF - Journal of Physiological Sciences

SN - 1880-6546

IS - 3

ER -