A Numerical Simulation Comparing a Cavopulmonary Assist Device and VA ECMO for Failing Fontan Support

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

A cavopulmonary assist device (CPAD) has been developed for failing Fontan support. This CPAD pumps blood from superior/inferior vena cavae (SVC/IVC) to pulmonary artery. In this study, we compared failing Fontan support with CPAD versus veno-arterial extracorporeal membrane oxygenation (VA ECMO) in silico. A numerical lumped-parameter circulatory system model was used to simulate Fontan circulation. Failing Fontan was simulated by increased pulmonary resistance. Central venous pressure (CVP), mean pulmonary arterial pressure (mPAP), left atrial pressure (LAP), and univentricular outflow (CO) were simulated and compared with published clinical data. The CPAD and VA ECMO were simulated using 1-5 L/min pump flows. In agreement with published clinical data, the simulated failing Fontan condition had increased CVP (19 mmHg) and mPAP (18 mmHg) with decreased LAP (7 mmHg) and cardiac output (3 L/min) compared with functional Fontan condition. The CPAD achieved total Fontan assistance with pump flows higher than original CO. Veno-arterial extracorporeal membrane oxygenation provided partial Fontan assistance with low pump flows. Blood went through pulmonary circulation with CPAD whereas VA ECMO bypassed pulmonary circulation and diminished univentricular blood flow (0.8 L/min). This in silico study demonstrated that CPAD preserved heart/lung function whereas VA ECMO had very low univentricular flow, potentially leading to thrombosis or univentricular atrophy.

Original languageEnglish
Pages (from-to)604-612
Number of pages9
JournalASAIO Journal
Volume63
Issue number5
DOIs
StatePublished - 2017

Bibliographical note

Funding Information:
This work was supported by Johnston-Wright Endowment, University of Kentucky Department of Surgery and National Natural Science Foundation of China (Grant No. 81471754).

Publisher Copyright:
© 2017 by the ASAIO.

Keywords

  • Fontan
  • cavopulmonary
  • double lumen cannula
  • lumped-parameter model
  • numerical simulation

ASJC Scopus subject areas

  • Biophysics
  • Bioengineering
  • Biomaterials
  • Biomedical Engineering

Fingerprint

Dive into the research topics of 'A Numerical Simulation Comparing a Cavopulmonary Assist Device and VA ECMO for Failing Fontan Support'. Together they form a unique fingerprint.

Cite this