Evidence map›Paper›PMID 40323666›Full record

ArticleAmerican journal of physiology. Heart and circulatory physiology2025

Evolving hemodynamics in Fontan circulation: age-driven insights in patients with interrupted inferior vena cava and hepatoazygos shunt.

Vikas Kannojiya, Akshita Sahni, Emily Eickhoff, Neha Zacharia, Nicole St Clair, Noah Schulz, Peter E Hammer, Pedro J Del Nido, Rahul H Rathod, David M Hoganson and 1 more

Abstract read
In one paragraph

Article in American journal of physiology. Heart and circulatory physiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. 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

11 authors.

Vikas KannojiyaDepartment of Cardiovascular Surgery, Boston Children's Hospital, Boston, Massachusetts, United States.
Akshita SahniDepartment of Cardiovascular Surgery, Boston Children's Hospital, Boston, Massachusetts, United States.ORCID 0000-0002-4444-5904
Emily EickhoffDepartment of Cardiovascular Surgery, Boston Children's Hospital, Boston, Massachusetts, United States.
Neha ZachariaDepartment of Cardiovascular Surgery, Boston Children's Hospital, Boston, Massachusetts, United States.
Nicole St ClairDepartment of Cardiovascular Surgery, Boston Children's Hospital, Boston, Massachusetts, United States.ORCID 0000-0001-8048-9309
Noah SchulzDepartment of Cardiovascular Surgery, Boston Children's Hospital, Boston, Massachusetts, United States.
Peter E HammerDepartment of Cardiovascular Surgery, Boston Children's Hospital, Boston, Massachusetts, United States.
Pedro J Del NidoDepartment of Cardiovascular Surgery, Boston Children's Hospital, Boston, Massachusetts, United States.
Rahul H RathodDepartment of Cardiology, Boston Children's Hospital, Boston, Massachusetts, United States.ORCID 0000-0002-7149-5421
David M HogansonDepartment of Cardiovascular Surgery, Boston Children's Hospital, Boston, Massachusetts, United States.
Vijay GovindarajanDepartment of Cardiovascular Surgery, Boston Children's Hospital, Boston, Massachusetts, United States.ORCID 0000-0003-3900-8205

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
HHS | NIH | National Heart, Lung, and Blood Institute (NHLBI) R01HL161507NHLBI NIH HHS R01 HL161507
6 · The paper itself

Abstract

Patients with interrupted inferior vena cava (I-IVC) and azygos continuation who undergo Fontan completion via hepatoazygos shunting exhibit unique hemodynamic challenges. This study evaluates age-related shifts in systemic venous return dominance, hepatic flow distribution (HFD), power loss (PL), and flow disturbances using patient-specific computational fluid dynamics (CFD). Data analysis from 95 patients with I-IVC showed a nonlinear shift in upper-to-lower body systemic flow dominance with ratios of 2, 1, and 0.5 (correlating to ages ∼3, ∼10, and ∼20, respectively). CFD simulations for 17 selected patients revealed a trend of increasing HFD toward the right pulmonary artery, with median splits of 45%-49%, 48%-52%, and 40%-60% for the respective flow ratios. Power loss increased significantly with lower-body flow dominance. Median values for absolute PL were 4.75 mW (ratio 2), 16.5 mW (ratio 1), and 33.7 mW (ratio 0.5). Indexed PL showed a similar trend, rising from 0.04 mW/m

Indexed as

Azygos VeinFontan ProcedureHeart Defects, CongenitalHemodynamicsLiver CirculationVena Cava, InferiorAdolescentAdultAge FactorsChildChild, PreschoolFemaleHumansInfantMaleModels, Cardiovascularhemodynamicshepatic flowHepatoazygos shuntinterrupted inferior vena cavapower loss

Identifiers

PMID40323666
PMCPMC12165781

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Registered trials

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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.