HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Kevin G. Watterson Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Walker, P. G. Articles by Watterson, K. G. Search for Related Content PubMed PubMed Citation Articles by Walker, P. G. Articles by Watterson, K. G.

Eur J Cardiothorac Surg 2000;17:658-665
© 2000 Elsevier Science NL

Distribution of hepatic venous blood in the total cavo-pulmonary connection: an in vitro study

^a School of Mechanical Engineering, University of Leeds, Leeds LS2 9JT, UK
^b Yorkshire Heart Centre, Leeds, UK

Corresponding author. Tel.: +44-113-233-2161; fax: +44-113-242-4611
e-mail: p.g.walker{at}leeds.ac.uk

Objectives: The objective of this project was to quantify the effects of geometry on the distribution of hepatic blood to the lungs in patients with a total cavo-pulmonary connection. The basis for this work is the supposition that hepatic blood is necessary for proper lung function. Methods: Plastic models of these connections were made with varying degrees of offset between the inferior and superior vena cava and attached to an in vitro flow loop. Dye was injected into the inferior vena cava and its concentration quantified in each pulmonary artery. These data were converted to percentage concentration and distribution of hepatic blood to each lung. Results: With no offset between the vena cava, hepatic blood distribution and concentration to each lung was similar to normal. For an offset of one or more diameters, hepatic blood tended to flow preferentially towards the nearest pulmonary artery with the opposite pulmonary artery exhibiting a deficit (<10% of normal). Conclusions: Distribution of hepatic blood to each lung was found to be a function of vena cava offset and pulmonary artery flow split. Under normal conditions, 60% of blood towards the right pulmonary artery, the hepatic blood distribution to both lungs could be maintained above 50% of normal if the inferior vena cava was offset towards the left pulmonary artery. Offsetting the inferior vena cava towards the right pulmonary artery jeopardized the delivery of hepatic blood to one lung.

Key Words: Fontan • Total cavo-pulmonary connection • Atrio-venous malformation

This article has been cited by other articles:

				D. S. Nath, A. J. Carden, D. P. Nussbaum, A. J. Shin, R. G. Khemani, V. A. Starnes, and W. J. Wells Can the Kawashima procedure be performed in younger patients? Ann. Thorac. Surg., August 1, 2009; 88(2): 581 - 586. [Abstract] [Full Text] [PDF]

				L. P. Dasi, R. KrishnankuttyRema, H. D. Kitajima, K. Pekkan, K. S. Sundareswaran, M. Fogel, S. Sharma, K. Whitehead, K. Kanter, and A. P. Yoganathan Fontan hemodynamics: importance of pulmonary artery diameter. J. Thorac. Cardiovasc. Surg., March 1, 2009; 137(3): 560 - 564. [Abstract] [Full Text] [PDF]

				S.-J. Kim, E.-J. Bae, J.-Y. Lee, H.-G. Lim, C. Lee, and C.-H. Lee Inclusion of hepatic venous drainage in patients with pulmonary arteriovenous fistulas. Ann. Thorac. Surg., February 1, 2009; 87(2): 548 - 553. [Abstract] [Full Text] [PDF]

				D. B. McElhinney, J. Kreutzer, P. Lang, J. E. Mayer Jr, P. J. del Nido, and J. E. Lock Incorporation of the Hepatic Veins Into the Cavopulmonary Circulation in Patients With Heterotaxy and Pulmonary Arteriovenous Malformations After a Kawashima Procedure Ann. Thorac. Surg., November 1, 2005; 80(5): 1597 - 1603. [Abstract] [Full Text] [PDF]