Avalonelite double lumen cannula for total cavopulmonary assist in failing Fontan sheep model with valved extracardiac conduit

Cheng Zhou, Dongfang Wang, Francesca Condemi, Guangfeng Zhao, Stephen Topaz, Cherry Ballard-Croft, Joseph B. Zwischenberger

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

The AvalonElite double lumen cannula (DLC) provides total cavopulmonary assist (CPA) in failing Fontan sheep, but recirculation limits reliability. To improve CPA performance, a two-valve extracardiac conduit (ECC) was used to bracket infusion blood toward pulmonary artery (PA). A total cavopulmonary connection with failing Fontan circulation adult sheep model was created with valved ECC (n = 6). The valved ECC was connected to superior/inferior venae cavae (SVC/IVC) and right PA. The AvalonElite DLC was inserted from right jugular vein with infusion opening between the ECC valves. The DLC drainage lumen withdrew blood from SVC/IVC, and the infusion lumen returned blood to ECC. A failing Fontan sheep model with valved ECC was successfully created. Central venous pressure increased from 9 ± 1 to 17 ± 1 mm Hg, systolic arterial pressure decreased from 103 ± 9 to 51 ± 13 mm Hg, and cardiac output decreased from 3.6 ± 0.3 to 1.4 ± 0.2 L/min. Serum lactate significantly increased, indicating poor tissue perfusion. At 4 L/min pumping flow, the AvalonElite DLC returned hemodynamics/lactate to baseline levels throughout 6 hour CPA. Necropsy revealed intact/well-functioning ECC valves and well-positioned DLC with no visible thrombosis. The AvalonElite DLC provides reliable CPA performance in failing Fontan sheep with valved ECC.

Original languageEnglish
Pages (from-to)361-366
Number of pages6
JournalASAIO Journal
Volume65
Issue number4
DOIs
StatePublished - 2019

Bibliographical note

Funding Information:
This study was supported by the Johnston-Wright Endowment at the University of Kentucky Department of Surgery.

Publisher Copyright:
Copyright © 2018 by the ASAIO

Keywords

  • AvalonElite
  • Cavopulmonary assist
  • Fontan
  • Sheep
  • Total cavopulmonary connection

ASJC Scopus subject areas

  • Biophysics
  • Bioengineering
  • Biomaterials
  • Biomedical Engineering

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