Evidence map›Paper›PMID 38753109›Full record

ArticleAnnals of biomedical engineering2024

Biomechanical Analysis of Age-Dependent Changes in Fontan Power Loss.

A Sahni, L Marshall, M A Cetatoiu, J Davee, N Schulz, E R Eickhoff, N St Clair, S Ghelani, A Prakash, P E Hammer and 4 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of biomedical engineering, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Biomechanics and clinical implications of Fontan upsizing.Computers in biology and medicine · 2024
    Article
  5. Direct assessment of total cavopulmonary connection power loss with interventional cardiac magnetic resonance in Fontan circulation.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

A SahniDepartment of Cardiac Surgery, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA.
L MarshallDepartment of Cardiac Surgery, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA.
M A CetatoiuDepartment of Cardiac Surgery, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA.
J DaveeDepartment of Cardiac Surgery, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA.
N SchulzDepartment of Cardiac Surgery, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA.
E R EickhoffDepartment of Cardiac Surgery, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA.
N St ClairDepartment of Cardiac Surgery, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA.
S GhelaniDepartment of Cardiology, Boston Children's Hospital, Boston, MA, USA.
A PrakashDepartment of Cardiology, Boston Children's Hospital, Boston, MA, USA.
P E HammerDepartment of Cardiac Surgery, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA.
D M HogansonDepartment of Cardiac Surgery, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA.
P J Del NidoDepartment of Cardiac Surgery, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA.
R H RathodDepartment of Cardiology, Boston Children's Hospital, Boston, MA, USA.
Vijay GovindarajanDepartment of Cardiac Surgery, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA. vijay.govindarajan@childrens.harvard.edu.

Funding

A Novel computational approach to optimize Fontan and improve surgical predictabilityR01HL161507 · NHLBI · BOSTON CHILDREN'S HOSPITAL · PI Vijay Govindarajan · 2022 to 2026
$3.0M
NHLBI NIH HHS R01 HL161507NHLBI NIH HHS R01HL161507
6 · The paper itself

Abstract

The hemodynamics in Fontan patients with single ventricles rely on favorable flow and energetics, especially in the absence of a subpulmonary ventricle. Age-related changes in energetics for extracardiac and lateral tunnel Fontan procedures are not well understood. Vorticity (VOR) and viscous dissipation rate (VDR) are two descriptors that can provide insights into flow dynamics and dissipative areas in Fontan pathways, potentially contributing to power loss. This study examined power loss and its correlation with spatio-temporal flow descriptors (vorticity and VDR). Data from 414 Fontan patients were used to establish a relationship between the superior vena cava (SVC) to inferior vena cava (IVC) flow ratio and age. Computational flow modeling was conducted for both extracardiac conduits (ECC, n = 16) and lateral tunnels (LT, n = 25) at different caval inflow ratios of 2, 1, and 0.5 that corresponded with ages 3, 8, and 15+. In both cohorts, vorticity and VDR correlated well with PL, but ECC cohort exhibited a slightly stronger correlation for PL-VOR (>0.83) and PL-VDR (>0.89) than that for LT cohort (>0.76 and > 0.77, respectively) at all ages. Our data also suggested that absolute and indexed PL increase (p < 0.02) non-linearly as caval inflow changes with age and are highly patient-specific. Comparison of indexed power loss between our ECC and LT cohort showed that while ECC had a slightly higher median PL for all 3 caval inflow ratio examined (3.3, 8.3, 15.3) as opposed to (2.7, 7.6, 14.8), these differences were statistically non-significant. Lastly, there was a consistent rise in pressure gradient across the TCPC with age-related increase in IVC flows for both ECC and LT Fontan patient cohort. Our study provided hemodynamic insights into Fontan energetics and how they are impacted by age-dependent change in caval inflow. This workflow may help assess the long-term sustainability of the Fontan circulation and inform the design of more efficient Fontan conduits.

Indexed as

Fontan ProcedureModels, CardiovascularAdolescentAdultAgingBiomechanical PhenomenaChildChild, PreschoolFemaleHemodynamicsHumansMaleVena Cava, InferiorVena Cava, SuperiorYoung AdultAge growthBulk and indexed power lossCaval flow ratiosExtracardiacLateral tunnelNon-linearityViscous dissipation rate; Fontan hemodynamicsVorticity

Identifiers

PMID38753109
PMCPMC11681105

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.