title: Experimentally modified Fontan circulation in an adolescent pig model without the use of cardiopulmonary bypass.
abstract: BACKGROUND
  The feasibility and the hemodynamic outcome of Fontan circulation, without the use of cardiopulmonary bypass, were studied on a beating heart of an adolescent pig model, using a modified total cavopulmonary connection.
  
  
  METHODS
  Eight open-chest anesthetized pigs underwent a successful total cavopulmonary connection with the use of an appropriate Y-shaped Dacron-type conduit. Through a median sternotomy, the distal part of the superior vena cava was anastomosed end-to-end to one side of the conduit. The other side of the graft was anastomosed end-to-side to the main pulmonary artery. The conduit was tailored to an appropriate length and anastomosed end-to-end to the inferior vena cava. The hemodynamic status of the animals was recorded before and after the establishment of the total cavopulmonary connection.
  
  
  RESULTS
  Forty-five minutes after completion of total cavopulmonary connection, and for a total of 1 hour, hemodynamic measurements showed a decrease in mean arterial and mean pulmonary artery pressures, heart rate and cardiac output. The inferior vena caval pressure and total pulmonary vascular resistance were increased.
  
  
  CONCLUSIONS
  A total cavopulmonary connection, performed on a beating heart, without extracorporeal circulation or other means of temporary bypass, although it is technically demanding, is feasible.<br />
authors.affiliation: Department of Thoracic Surgery, Sismanoglio General Hospital, Athens, Greece. meletis_kanakis@yahoo.gr
authors.forename: Meletios A
authors.initials: MA
authors.lastname: Kanakis
authors.forename: Fotios A
authors.initials: FA
authors.lastname: Mitropoulos
authors.forename: Michalis
authors.initials: M
authors.lastname: Katsimpoulas
authors.forename: Constantinos
authors.initials: C
authors.lastname: Dimitriou
authors.forename: Michalis
authors.initials: M
authors.lastname: Peroulis
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Kostomitsopoulos
authors.forename: Achilleas
authors.initials: A
authors.lastname: Lioulias
authors.forename: Alkiviadis
authors.initials: A
authors.lastname: Kostakis
mesh_terms: D000818:Animals; D001794:Blood Pressure; D002302:Cardiac Output; D002315:Cardiopulmonary Bypass; D018729:Fontan Procedure / Q000379:methods*; D018610:Heart Bypass, Right / Q000379:methods*; D006339:Heart Rate; D008297:Male; D034421:Sus scrofa