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Anatomic substrates for, and function of, the functionally univentricular circulation before and after surgical procedures

Published online by Cambridge University Press:  26 October 2005

Gabriele Dubini
Laboratory of Biological Structure Mechanics, Department of Structural Engineering, Politecnico di Milano, Milan, Italy
Paolo M. Arciprete
Department of Paediatric Cardiac Surgery, Giovanni XXIII Hospital, Bari, Italy
Vincenzo Stefano Luisi
Paediatric Cardiac Surgery, G. Pasquinucci Hospital, Massa, Italy


Whatever the specific anatomy, the Fontan circulation, be it created directly or subsequent to a bi-directional cavopulmonary anastomosis, transforms completely the pattern of circulation of the blood. In essence, it converts a network of circulations in parallel into one in series. The haemodynamic consequences are numerous. The most important and direct among them is, perhaps, the increase in afterload, as well as the reduction in preload, for the systemic ventricle. From the clinical point of view, the most immediate and relevant implication is the amelioration of cyanosis, this being the consequence of removing the common mixing of systemic and pulmonary venous blood within the heart.

Second International Workshop
© 2005 Cambridge University Press

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