ArticleEuropean journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery2022
Haemodynamic performance of 16-20-mm extracardiac Goretex conduits in adolescent Fontan patients at rest and during simulated exercise.
Article in European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.
- Biological tissue engineering for Fontan failure using decellularized extracellular matrix: a systematic review.Journal of translational medicine · 2026Pooled it
- Contemporary outcomes of the Fontan operation: An Australian and New Zealand Fontan Registry study.JTCVS open · 2026Article
- Cross-Sectional Area Changes in the Total Cavopulmonary Connection Pathway and Its Impact on Liver Fibrosis.Journal of clinical medicine · 2026Article
- Outcomes of a Physiology-driven Extracardiac Fontan Strategy Incorporating Computational Fluid Dynamics: A Multicentre Study.European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery · 2026Article
- Four-Dimensional Flow in Fontan Patients: Advanced Haemodynamic Assessment.Journal of clinical medicine · 2025Review
- Applications of Computational Fluid Dynamics in Congenital Heart Disease: A Review.Journal of cardiovascular development and disease · 2025Review
- Novel lateral tunnel Fontan operation in children promotes continued pathway growth into adulthood.JTCVS techniques · 2025Article
- Biomechanics and clinical implications of Fontan upsizing.Computers in biology and medicine · 2024Article
- Long-term outcomes of extracardiac Gore-Tex conduits in Fontan patients.International journal of cardiology. Congenital heart disease · 2024Article
- Upsizing the extracardiac Fontan conduit-the fourth staged procedure for the single-ventricle palliation?JTCVS techniques · 2024Article
- Noninvasive Advanced Cardiovascular Magnetic Resonance-Derived Fontan Hemodynamics Are Associated With Reduced Kidney Function But Not Albuminuria.Journal of the American Heart Association · 2024Article
- Percutaneous closure of veno-venous collaterals in adult patients with univentricular physiology after Fontan palliation: Single centre experience and systematic review.International journal of cardiology. Congenital heart disease · 2023Article
- Virtual surgery to predict optimized conduit size for adult Fontan patients with 16-mm conduits.Interdisciplinary cardiovascular and thoracic surgery · 2023Article
- Fontan conduit cross-sectional area and relationship to exercise performance.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic ResonanceArticle
Corrections and comments
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Authors and funding
14 authors at 3 institutions in 1 country.
Funding
Abstract
objectivesTo date, it is not known if 16-20-mm extracardiac conduits are outgrown during somatic growth from childhood to adolescence. This study aims to determine total cavopulmonary connection (TCPC) haemodynamics in adolescent Fontan patients at rest and during simulated exercise and to assess the relationship between conduit size and haemodynamics.
methodsPatient-specific, magnetic resonance imaging-based computational fluid dynamic models of the TCPC were performed in 51 extracardiac Fontan patients with 16-20-mm conduits. Power loss, pressure gradient and normalized resistance were quantified in rest and during simulated exercise. The cross-sectional area (CSA) (mean and minimum) of the vessels of the TCPC was determined and normalized for flow rate (mm2/l/min). Peak (predicted) oxygen uptake was assessed.
resultsThe median age was 16.2 years (Q1-Q3 14.0-18.2). The normalized mean conduit CSA was 35-73% smaller compared to the inferior and superior vena cava, hepatic veins and left/right pulmonary artery (all P < 0.001). The median TCPC pressure gradient was 0.7 mmHg (Q1-Q3 0.5-0.8) and 2.0 (Q1-Q3 1.4-2.6) during rest and simulated exercise, respectively. A moderate-strong inverse non-linear relationship was present between normalized mean conduit CSA and TCPC haemodynamics in rest and exercise. TCPC pressure gradients of ≥1.0 at rest and ≥3.0 mmHg during simulated exercise were observed in patients with a conduit CSA ≤ 45 mm2/l/min and favourable haemodynamics (<1 mmHg during both rest and exercise) in conduits ≥125 mm2/l/min. Normalized TCPC resistance correlated with (predicted) peak oxygen uptake.
conclusionsExtracardiac conduits of 16-20 mm have become relatively undersized in most adolescent Fontan patients leading to suboptimal haemodynamics.
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