Dependence of energy losses on total cavopulmonary connection (TCPC) geometry: a comparison between straight and flared TCPC

摘要

In children with single ventricle congential heart disease, only one ventricle is pumping blood to the systemic circulation and lungs. Since there must be a complete separation between oxygenated and deoxygenated blood, surgical repair, known as the Fontan operation, is the only survival option for these patients. In the absence of the right ventricle, the left ventricle is responsible for pumping blood to the lungs. This imposes an additional power task to the ventricle. Energy conservation is a major objective in the new surgery-corrected circulatory system to protect the single ventricle from failure. Therefore, the original Fontan atriopulmonary connection was replaced by the cavopulmonary connection. Currently, the most promising modification used is the Total Cavopulmonary Connection (TCPC) which involves surgical connection of the superir and inferior vena cava (SVC and IvC, respectively) directly to the left and right pulmonary arteries (LPA and RPA, respectively), bypassing the entire right side of the heart. A major factor of importance in such a connection is its geometrical characteristics that may energetically affect its performance.