PMID- 37902686
OWN - NLM
STAT- MEDLINE
DCOM- 20231031
LR  - 20231104
IS  - 1538-943X (Electronic)
IS  - 1058-2916 (Linking)
VI  - 69
IP  - 11
DP  - 2023 Nov 1
TI  - Anatomical Compliance of Cavopulmonary Assist Device Designs: A Virtual Fitting 
      Study in Fontan Patients.
PG  - 1016-1024
LID - 10.1097/MAT.0000000000002013 [doi]
AB  - Several device designs for cavopulmonary mechanical circulatory support (MCS) are 
      under investigation, however, challenged by the Fontan population's heterogeneity 
      in size, cardiovascular and thoracic anatomy. This study aimed to preclinically 
      assess the anatomical compliance of proposed device designs in silico. 
      Representative double- and single-outlet cavopulmonary assist device (CPAD) 
      designs were virtually implanted into CT imaging data of 10 patients previously 
      palliated with total cavopulmonary connection (TCPC) for functionally 
      univentricular hearts. Anatomical device compatibility was characterized 
      concerning pump proximity to cardiovascular, respiratory and thoracic structures, 
      as well as pump in- and outflow graft configuration. In 10 Fontan patients with a 
      median age of 10.4 years (interquartile range [IQR] 5.0-15.3 years) and a median 
      body surface area of 1.09 m2 (IQR 0.76-1.28 m2), implantation of a double-outlet 
      CPAD was feasible in 1 patient (10%). In all other, adverse device intersection 
      with the trachea and (neo-)aorta, or posterior pulmonary artery outflow graft 
      kinking were observed. A single-outlet design permitted enhanced device 
      mobilization adapting to individual anatomical conditions, resulting in device 
      fit in nine of 10 patients (90%). Despite vast anatomical variations among single 
      ventricle patients, a single-outlet device design may provide intracorporeal 
      cavopulmonary MCS to a broad spectrum of failing Fontan patients.
CI  - Copyright (c) ASAIO 2023.
FAU - Karner, Barbara
AU  - Karner B
AUID- ORCID: 0000-0001-6277-7702
AD  - From the Department of Cardiac Surgery, Medical University of Vienna, Vienna, 
      Austria.
AD  - Division of Cardiac Surgery, Department of Surgery, Medical University Graz, 
      Graz, Austria.
FAU - Escher, Andreas
AU  - Escher A
AUID- ORCID: 0000-0003-0325-5597
AD  - From the Department of Cardiac Surgery, Medical University of Vienna, Vienna, 
      Austria.
FAU - Schorn, Therese
AU  - Schorn T
AD  - From the Department of Cardiac Surgery, Medical University of Vienna, Vienna, 
      Austria.
FAU - Narayanaswamy, Krishnaraj
AU  - Narayanaswamy K
AD  - From the Department of Cardiac Surgery, Medical University of Vienna, Vienna, 
      Austria.
FAU - Sachweh, Jorg
AU  - Sachweh J
AUID- ORCID: 0000-0001-5279-324
AD  - Department of Congenital and Pediatric Heart Surgery, Children's Heart Clinic, 
      University Heart & Vascular Center, University Medical Center Hamburg-Eppendorf, 
      Hamburg, Germany.
FAU - Laufer, Gunther
AU  - Laufer G
AUID- ORCID: 0000-0001-7257-110
AD  - From the Department of Cardiac Surgery, Medical University of Vienna, Vienna, 
      Austria.
FAU - Hubler, Michael
AU  - Hubler M
AUID- ORCID: 0000-0001-7672-8629
AD  - Department of Congenital and Pediatric Heart Surgery, Children's Heart Clinic, 
      University Heart & Vascular Center, University Medical Center Hamburg-Eppendorf, 
      Hamburg, Germany.
FAU - Zimpfer, Daniel
AU  - Zimpfer D
AUID- ORCID: 0000-0002-2185-4895
AD  - From the Department of Cardiac Surgery, Medical University of Vienna, Vienna, 
      Austria.
AD  - Division of Cardiac Surgery, Department of Surgery, Medical University Graz, 
      Graz, Austria.
FAU - Granegger, Marcus
AU  - Granegger M
AUID- ORCID: 0000-0002-1425-1236
AD  - From the Department of Cardiac Surgery, Medical University of Vienna, Vienna, 
      Austria.
AD  - Biofluid Mechanics Laboratory, Charite-Universitatsmedizin Berlin, Berlin, 
      Germany.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20231026
PL  - United States
TA  - ASAIO J
JT  - ASAIO journal (American Society for Artificial Internal Organs : 1992)
JID - 9204109
SB  - IM
MH  - Humans
MH  - Child, Preschool
MH  - Child
MH  - Adolescent
MH  - *Pulmonary Artery
MH  - *Aorta
MH  - Body Surface Area
MH  - Patient Compliance
MH  - Patients
COIS- Disclosure: M.G. received personal fees and research grants from BerlinHeart GmbH 
      and research grants from 4Fontan AG. D.Z. received personal fees from Abbott, 
      Medtronic, Abiomed, Edwards, Daiichi Sankyo and research grants from Abbott, 
      Medtronic, Berlin Heart, Edwards, Corcym. The other authors have no conflicts of 
      interest to report.
EDAT- 2023/10/30 12:42
MHDA- 2023/10/31 06:42
CRDT- 2023/10/30 11:14
PHST- 2023/10/31 06:42 [medline]
PHST- 2023/10/30 12:42 [pubmed]
PHST- 2023/10/30 11:14 [entrez]
AID - 00002480-202311000-00009 [pii]
AID - 10.1097/MAT.0000000000002013 [doi]
PST - ppublish
SO  - ASAIO J. 2023 Nov 1;69(11):1016-1024. doi: 10.1097/MAT.0000000000002013. Epub 
      2023 Oct 26.