title: Acute histological changes of the lung after experimental Fontan circulation in a swine model.
abstract: BACKGROUND
  Histological changes of the lungs were studied after the establishment of a modified total cavopulmonary connection (TCPC) without the use of cardiopulmonary bypass (CPB) or other means of temporary bypass on a swine model.
  
  
  METHODS
  8 open chest-anesthetized pigs Landrace x Large White pigs (mean weight 43kg, mean age 4.5 months) underwent TCPC by the use of an appropriate size Y-shaped conduit connecting the superior and inferior caval veins (end-to-end anastomosis) to the pulmonary trunk (end-to-side anastomosis). After sternotomy, a wedge resection of the lung parenchyma was performed at baseline. Hemodynamic stability was sustained after TCPC establishment and 2 hours later another wedge resection of the lung was performed (from the same anatomic area). Histological studies were conducted by hematoxylin and eosin staining.
  
  
  RESULTS
  All samples (n=8) at baseline were consistent with normal lung parenchyma. After the establishment of TCPC, all samples (n=8) revealed moderate mononuclear infiltration adjacent to pulmonary alveoli and bronchioles, findings compatible with bronchiolitis.
  
  
  CONCLUSIONS
  In a normal swine model, 2 hours after the establishment of Fontan circulation without the use of CPB, pathologic examination of the lungs revealed bronchiolitis. Further research is needed to clarify these findings and the potential implications to the Fontan circulation, either immediate or long-term.
authors.affiliation: Department of Thoracic Surgery, Sismanoglio General Hospital of Athens, Athens, Greece. meletis_kanakis@yahoo.gr
authors.forename: Meletios A
authors.initials: MA
authors.lastname: Kanakis
authors.forename: Michalis
authors.initials: M
authors.lastname: Katsimpoulas
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Kavantzas
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Kostomitsopoulos
authors.forename: Constantinos
authors.initials: C
authors.lastname: Dimitriou
authors.forename: Achilleas
authors.initials: A
authors.lastname: Lioulias
authors.forename: Alkiviadis
authors.initials: A
authors.lastname: Kostakis
authors.forename: Fotios
authors.initials: F
authors.lastname: Mitropoulos
mesh_terms: D000818:Animals; D001988:Bronchiolitis / Q000209:etiology* / Q000473:pathology*; D004562:Electrocardiography; D018729:Fontan Procedure / Q000009:adverse effects*; D006652:Histological Techniques; D008297:Male; D013552:Swine