To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure email@example.com
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
The recent developments in imaging techniques have created new opportunities to give an accurate description of the three-dimensional morphology of vessels. Such three-dimensional reconstruction of anatomical structures from medical images has achieved importance in several applications, such as the reconstruction of human bones, spine portions, and vascular districts.
surgical repairs of many severe congenital cardiac malformations, such as the procedures used to redirect the flow of blood in the setting of absent or suboptimal perfusions, are performed either using direct vascular anastomosis, or by the insertion of interpositioned prosthetic shunts. examples of these applications can be found when considering those cardiac malformations characterized by the common physiological feature of having a single pumping ventricle, usually due to the incomplete and rudimentary form of the complementary ventricle. in this situation, since the circulation depends on the functionally single ventricle, pulmonary perfusion can be derived from the systemic circulation through a synthetic tube (gore-tex®, falstaff, az, usa), usually connected between the brachiocephalic or subclavian arteries and the right or left pulmonary arteries. this arrangement is called the modified blalock-taussig shunt (fig. 1, left). the effect is to produce parallel circulations (fig. 1, right). survival at this stage is closely dependent on the balance between systemic and pulmonary flows, and thus on the fluid-dynamics through the interposition shunt, which is often the sole source of pulmonary perfusion.
a hydraulic circulatory duplicator is a hydraulic circuit, closed or open that physically reproduces one human district, along with the effects of any connected apparatus, on local fluid dynamics. such hydraulic circulatory duplicators are usually made up of rigid or deformable pipes, pressure loss generators, such as valves or sponge elements, compliant elements such as a pneumatic room, elastic elements, pumping elements, which may be centrifugal, axial, or roller, and tanks. all the elements are connected by joints. the systems are completed by transducers of pressure or flow, and systems for visualising flow or measuring other parameters of interest.
the bidirectional cavo-pulmonary anastomosis is a well-established palliative procedure for patients with a functionally univentricular circulation. it is usually considered one step in preparation for fontan procedure, but it may be performed as a long-term palliation for patients deemed to be at high-risk. in this subset of patients, a valuable surgical option could be to add, or maintain, an additional source of flow of blood to the lungs, either derived from a patent but banded trunk or one protected by native pulmonary stenosis, or a systemic-to-pulmonary arterial shunt. the risk and benefits of providing an additional source of pulmonary flow after construction of a bidirectional cavopulmonary anastomosis are strongly debated. in terms of benefit, the arterial saturation of oxygen is increased due to the greater ratio of pulmonary-to-systemic flow, arteriovenous fistulas are prevented and, as a consequence of the arterial pulsatile flow, the pulmonary arteries are stimulated to grow. the most significant drawbacks are volume overload of the functionally single ventricle, and higher pressures compared to an isolated bidirectional cavopulmonary anastomosis.
Email your librarian or administrator to recommend adding this to your organisation's collection.