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the patterns of flow in the total extracardiac cavopulmonary connection

Published online by Cambridge University Press:  23 September 2005

antonio amodeo
Affiliation:
department of paediatric cardiology and cardiac surgery of the bambino gesù hospital, istituto superiore di sanità, rome, italy
mauro grigioni
Affiliation:
laboratory of biomedical engineering, istituto superiore di sanità, rome, italy
giuseppe d'avenio
Affiliation:
laboratory of biomedical engineering, istituto superiore di sanità, rome, italy
carla daniele
Affiliation:
laboratory of biomedical engineering, istituto superiore di sanità, rome, italy
roberto m. di donato
Affiliation:
department of paediatric cardiology and cardiac surgery of the bambino gesù hospital, istituto superiore di sanità, rome, italy

Abstract

more than 30 years ago, fontan and baudet proposed bypass of a dysfunctional right ventricle by connecting the pulmonary arteries directly to the right atrium, the so-called atriopulmonary anastomosis. since then, much experience has been accrued in the field of the functionally univentricular circulation. the proposed connections have been subjected to several modifications, aiming towards minimizing the losses of energy in the cavopulmonary system, and thereby improving the clinical outcomes. a remarkable improvement was achieved with the introduction of the concept of the total cavopulmonary connection, specifically the combination of a bi-directional glenn anastomosis with a tubular intracardiac extension from the inferior caval venous to the pulmonary arteries. this design was shown to avoid the dissipation of energy associated with the swirling patterns seen in the traditional atrio-pulmonary anastomosis.

Type
original article
Copyright
2004 cambridge university press

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