BACKGROUND: There exists large geometric variability among total cavopulmonary connections (TCPC) because of the patient-specific anatomies and the chosen surgical procedure. In this study we present quantitative comparison of the geometric characteristics of the extracardiac and intraatrial Fontan anatomies, the two commonly used TCPC procedures. METHODS: A method of centerline approximation of the three-dimensional geometries (skeletonization) was used to quantify the TCPC geometric parameters such as vessel areas, curvature, and collinearity. The TCPC anatomies of 26 patients, 13 extracardiac and 13 intraatrial, were analyzed in this study. RESULTS: There was no significant difference in the vessel dimensions between extracardiac and intraatrial TCPCs, with the overall magnitudes agreeing well with that seen in normal children except for the inferior vena cava. Intraatrial baffles had significant fluctuations in cross-sectional area along the length of the baffle as opposed to extracardiacs (p < 0.05). Patients with hypoplastic left heart syndrome had significant narrowing of the left pulmonary artery (p < 0.05), suggesting a possible physical constriction from the reconstructed aorta. CONCLUSIONS: This study benchmarks the anatomic variability of patient-specific TCPCs. Intraatrial Fontan geometries have significant difference in the area variations across the vessel length compared with the extracardiac geometry. Also, patients with hypoplastic left heart are at a higher risk of left pulmonary artery narrowing.
BACKGROUND: There exists large geometric variability among total cavopulmonary connections (TCPC) because of the patient-specific anatomies and the chosen surgical procedure. In this study we present quantitative comparison of the geometric characteristics of the extracardiac and intraatrial Fontan anatomies, the two commonly used TCPC procedures. METHODS: A method of centerline approximation of the three-dimensional geometries (skeletonization) was used to quantify the TCPC geometric parameters such as vessel areas, curvature, and collinearity. The TCPC anatomies of 26 patients, 13 extracardiac and 13 intraatrial, were analyzed in this study. RESULTS: There was no significant difference in the vessel dimensions between extracardiac and intraatrial TCPCs, with the overall magnitudes agreeing well with that seen in normal children except for the inferior vena cava. Intraatrial baffles had significant fluctuations in cross-sectional area along the length of the baffle as opposed to extracardiacs (p < 0.05). Patients with hypoplastic left heart syndrome had significant narrowing of the left pulmonary artery (p < 0.05), suggesting a possible physical constriction from the reconstructed aorta. CONCLUSIONS: This study benchmarks the anatomic variability of patient-specific TCPCs. Intraatrial Fontan geometries have significant difference in the area variations across the vessel length compared with the extracardiac geometry. Also, patients with hypoplastic left heart are at a higher risk of left pulmonary artery narrowing.
Authors: Hamidreza Rajabzadeh-Oghaz; Bahar Firoozabadi; Mohammad Said Saidi; Mojdeh Monjezi; Mohammad Ali Navabi Shirazi; Elaheh Malakan Rad Journal: Med Biol Eng Comput Date: 2016-04-23 Impact factor: 2.602
Authors: Lakshmi P Dasi; Kartik S Sundareswaran; Colleen Sherwin; Diane de Zelicourt; Kirk Kanter; Mark A Fogel; Ajit P Yoganathan Journal: J Thorac Cardiovasc Surg Date: 2009-10-31 Impact factor: 5.209
Authors: Jeffrey A Feinstein; D Woodrow Benson; Anne M Dubin; Meryl S Cohen; Dawn M Maxey; William T Mahle; Elfriede Pahl; Juan Villafañe; Ami B Bhatt; Lynn F Peng; Beth Ann Johnson; Alison L Marsden; Curt J Daniels; Nancy A Rudd; Christopher A Caldarone; Kathleen A Mussatto; David L Morales; D Dunbar Ivy; J William Gaynor; James S Tweddell; Barbara J Deal; Anke K Furck; Geoffrey L Rosenthal; Richard G Ohye; Nancy S Ghanayem; John P Cheatham; Wayne Tworetzky; Gerard R Martin Journal: J Am Coll Cardiol Date: 2012-01-03 Impact factor: 24.094
Authors: Anitra Romfh; Francesca Romana Pluchinotta; Prashob Porayette; Anne Marie Valente; Stephen P Sanders Journal: J Clin Exp Cardiolog Date: 2012-06-15
Authors: Lakshmi P Dasi; Resmi Krishnankuttyrema; Hiroumi D Kitajima; Kerem Pekkan; Kartik S Sundareswaran; Mark Fogel; Shiva Sharma; Kevin Whitehead; Kirk Kanter; Ajit P Yoganathan Journal: J Thorac Cardiovasc Surg Date: 2009-03 Impact factor: 5.209