Influence of arteriotomy shape on power losses across in vitro cavopulmonary connections.

Background: In the Fontan circulation power supply for maintaining adequate lung perfusion via a total cavopulmonary connection is limited. This study, aiming at the detection of energy consuming variables, compares the influence of two different pulmonary arteriotomy shapes on power losses across cavopulmonary connections.

Methods: Two types of surgical junctions of cavopulmonary connections were studied in a mock circulation. Firstly a slot-shaped incision and secondly an oval-shaped excision within the pulmonary artery was performed. The cross sections of native caval veins were sutured end-to-side with the edges of the incised and excised pulmonary arteries, respectively. Pressures and flows were measured at total flow rates varying from 1200 ml/min to 6000 ml/min and power losses calculated.

Results: Power losses were, in dependence of total flow, 10.66-32.64% lower across the oval-shaped junctions if compared to the corresponding slot-shaped junctions (p<0.05).

Conclusions: Surgical junctions including an oval excision within the pulmonary artery may reduce power losses across cavopulmonary connections if compared to simple slot-shaped incisions. These findings may have some influence on surgical techniques to improve hemodynamics of cavopulmonary connections.