title: The Fontan circulation: who controls cardiac output?
abstract: In a Fontan circuit the mechanisms involved in control of cardiac output at rest and during exercise differ significantly from normal. The classical model presumes an unlimited preload which is not available in the Fontan circuit. This review critically analyses the role of contractility, heart rate, and afterload and highlights the importance of pulmonary vascular resistance (PVR) in determining adequate preload and, therefore, cardiac output in these patients. A conceptual model of the determinants of cardiac output in Fontan patients is presented.
authors.affiliation: Paediatric and Congenital Cardiology, University Hospitals Leuven, Belgium. marc.gewillig@uzleuven.be
authors.forename: Marc
authors.initials: M
authors.lastname: Gewillig
authors.forename: Stephen C
authors.initials: SC
authors.lastname: Brown
authors.forename: Benedicte
authors.initials: B
authors.lastname: Eyskens
authors.forename: Ruth
authors.initials: R
authors.lastname: Heying
authors.forename: Javier
authors.initials: J
authors.lastname: Ganame
authors.forename: Werner
authors.initials: W
authors.lastname: Budts
authors.forename: Andre
authors.initials: A
authors.lastname: La Gerche
authors.forename: Matthias
authors.initials: M
authors.lastname: Gorenflo
mesh_terms: D002302:Cardiac Output; D015444:Exercise; D018729:Fontan Procedure / Q000009:adverse effects; D006330:Heart Defects, Congenital / Q000503:physiopathology / Q000601:surgery*; D006339:Heart Rate; D006801:Humans; D008955:Models, Cardiovascular; D009200:Myocardial Contraction; D011652:Pulmonary Circulation; D016896:Treatment Outcome; D014655:Vascular Resistance