Preliminary clinical experience with a bifurcated Y-graft Fontan procedure--a feasibility study.
Preliminary clinical experience with a bifurcated Y-graft Fontan procedure--a feasibility study.
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DOI：
10.1016/j.jtcvs.2012.05.015
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发表时间：
2012-08
影响因子：
6
通讯作者：
Yoganathan, Ajit P.
中科院分区：
文献类型：
--
作者：
Kanter, Kirk R.;Haggerty, Christopher M.;Restrepo, Maria;de Zelicourt, Diane A.;Rossignac, Jarek;Parks, W. James;Yoganathan, Ajit P.
Optimizing flow and diminishing power loss in the Fontan circuit can improve hemodynamic efficiency potentially improving long-term outcomes. Computerized modeling has predicted improved energetics with a Y-graft Fontan. From August to December, 2010, six consecutive children had a completion Fontan (n=3) or a Fontan revision (n=3) using a bifurcated polytetrafluoroethylene Y-graft (18×9×9 mm in 2, 20×10×10 mm in 4) connecting the inferior vena cava (IVC) to the right and left pulmonary arteries (PAs) with separate graft limbs. Patents were imaged by magnetic resonance imaging (MRI; n-5) or computerized tomography (n=1). Computational fluid dynamics (CFD) assessed Fontan hemodynamics, power loss, and IVC flow splits to the branch PAs. Clinical parameters were compared with 12 patients immediately preceding this series who had a lateral Fontan procedure. Despite longer crossclamp and bypass times (not statistically significant), the Y-graft Fontan patients had postoperative courses similar to the conventional Fontan patients. Other than two early readmissions for pleural effusions managed with diuretics, on 6–12 months follow-up (mean 8 months), all six patients have done well. Postoperative flow modeling demonstrated balanced distribution of IVC flow to both PAs with minimal flow disturbance. Improvements in hemodynamics and efficiency were noted when the Y-graft branches were anastomosed distally and aligned tangentially with the branch PAs. This preliminary surgical experience demonstrates clinical feasibility of the bifurcated Y-graft Fontan. CFD shows acceptable hemodynamics with low calculated power losses and balanced distribution of IVC flow to the PAs as long as the branch grafts are anastomosed distally.
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DOI：
10.1016/j.cma.2010.03.012
发表时间：
2010-01-01
影响因子：
7.2
作者：
Yang, Weiguang;Feinstein, Jeffrey A.;Marsden, Alison L.
通讯作者：
Marsden, Alison L.
影响因子：
4.6
作者：
Ensley, AE;Lynch, P;Yoganathan, AP
通讯作者：
Yoganathan, AP
DOI：
10.1152/ajpheart.00628.2008
发表时间：
2008-12-01
影响因子：
4.8
作者：
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通讯作者：
Yoganathan, Ajit P.
个性化的基于计算机的手术计划，以解决单个心室患者的肺动脉畸形畸形，其下腔静脉和偶像延续。
影响因子：
6
作者：
de Zelicourt, Diane A.;Haggerty, Christopher M.;Sundareswaran, Kartik S.;Whited, Brian S.;Rossignac, Jarek R.;Kanter, Kirk R.;Gaynor, J. William;Spray, Thomas L.;Sotiropoulos, Fotis;Fogel, Mark A.;Yoganathan, Ajit P.
通讯作者：
Yoganathan, Ajit P.
影响因子：
1.5
作者：
Goksel, O. S.;Tireli, E.;Dayioglu, E.
通讯作者：
Dayioglu, E.