{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T09:46:41Z","timestamp":1789206401312,"version":"build-2803163510"},"reference-count":40,"publisher":"Cambridge University Press (CUP)","issue":"3","license":[{"start":{"date-parts":[[2011,10,19]],"date-time":"2011-10-19T00:00:00Z","timestamp":1318982400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cardiol Young"],"published-print":{"date-parts":[[2012,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S1047951111001491_abs1\" sec-type=\"general\"><jats:title>Objective<\/jats:title><jats:p>To investigate the effect of pulsatility of venous flow waveform in the inferior and superior caval vessels on the performance of functional and \u201cfailing\u201d Fontan patients based on two primary performance measures \u2013 the conduit power loss and the distribution of inferior caval flow (hepatic factors) to the lungs.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951111001491_abs2\" sec-type=\"methods\"><jats:title>Methods<\/jats:title><jats:p>Doppler angiography flows were acquired from two typical extra-cardiac conduit \u201cfailing\u201d Fontan patients, aged 13 and 25 years, with ventricle dysfunction. Using computational fluid dynamics, haemodynamic efficiencies of \u201cfailing\u201d, functional, and<jats:italic>in vitro<\/jats:italic>-generated mechanically assisted venous flow waveforms were evaluated inside an idealised total cavopulmonary connection with a caval offset. To investigate the effect of venous pulsatility alone, cardiac output was normalised to 3 litres per minute in all cases. To quantify the pulsatile behaviour of venous flows, two new performance indices were suggested.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951111001491_abs3\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>Variations in the pulsatile content of venous waveforms altered the conduit efficiency notably. High-frequency and low-amplitude oscillations lowered the pulsatile component of the power losses in \u201cfailing\u201d Fontan flow waveforms. Owing to the offset geometry, hepatic flow distribution depended strongly on the ratio of time-dependent caval flows and the pulsatility content rather than mixing at the junction. \u201cFailing\u201d Fontan flow waveforms exhibited less balanced hepatic flow distribution to lungs.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951111001491_abs4\" sec-type=\"conclusion\"><jats:title>Conclusions<\/jats:title><jats:p>The haemodynamic efficiency of single-ventricle circulation depends strongly on the pulsatility of venous flow waveforms. The proposed performance indices can be calculated easily in the clinical setting in efforts to better quantify the energy efficiency of Fontan venous waveforms in pulsatile settings.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s1047951111001491","type":"journal-article","created":{"date-parts":[[2011,10,19]],"date-time":"2011-10-19T11:16:29Z","timestamp":1319022989000},"page":"251-262","source":"Crossref","is-referenced-by-count":8,"title":["Pulsatile venous waveform quality affects the conduit performance in functional and \u201cfailing\u201d Fontan circulations"],"prefix":"10.1017","volume":"22","author":[{"given":"Onur","family":"Dur","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ergin","family":"Kocyildirim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ozlem","family":"Soran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter D.","family":"Wearden","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor O.","family":"Morell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Curt G.","family":"DeGroff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerem","family":"Pekkan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2011,10,19]]},"reference":[{"key":"S1047951111001491_ref28","doi-asserted-by":"publisher","DOI":"10.1007\/s00392-007-0470-z"},{"key":"S1047951111001491_ref21","first-page":"1673","article-title":"Fontan hemodynamics: what is the problem?","volume":"139","author":"Dasi","year":"2010","journal-title":"JTCVS"},{"key":"S1047951111001491_ref20","doi-asserted-by":"publisher","DOI":"10.1115\/1.4000954"},{"key":"S1047951111001491_ref37","first-page":"H540","article-title":"Flow restriction of one carotid artery in juvenile rats inhibits growth of arterial diameter","volume":"248","author":"Guyton","year":"1985","journal-title":"Am J Physiol"},{"key":"S1047951111001491_ref19","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000087406.27922.6B"},{"key":"S1047951111001491_ref16","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2008.04.011"},{"key":"S1047951111001491_ref8","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.854331"},{"key":"S1047951111001491_ref34","doi-asserted-by":"publisher","DOI":"10.1115\/1.1632523"},{"key":"S1047951111001491_ref12","doi-asserted-by":"publisher","DOI":"10.1115\/1.1487880"},{"key":"S1047951111001491_ref10","doi-asserted-by":"publisher","DOI":"10.1007\/s10439-007-9356-0"},{"key":"S1047951111001491_ref2","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-007-9007-0"},{"key":"S1047951111001491_ref13","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(03)00698-6"},{"key":"S1047951111001491_ref24","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.738559"},{"key":"S1047951111001491_ref6","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.680827"},{"key":"S1047951111001491_ref14","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-007-9104-0"},{"key":"S1047951111001491_ref18","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2009.03.019"},{"key":"S1047951111001491_ref4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2008.04.036"},{"key":"S1047951111001491_ref1","doi-asserted-by":"crossref","first-page":"682","DOI":"10.1016\/S0022-5223(19)35174-8","article-title":"Total cavopulmonary connection: a logical alternative to atriopulmonary connection for complex Fontan operations. Experimental studies and early clinical experience","volume":"96","author":"de Leval","year":"1988","journal-title":"J Thorac Cardiovasc Surg"},{"key":"S1047951111001491_ref17","doi-asserted-by":"publisher","DOI":"10.1111\/j.1747-0803.2010.00383.x"},{"key":"S1047951111001491_ref9","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2010.04.015"},{"key":"S1047951111001491_ref22","doi-asserted-by":"publisher","DOI":"10.1016\/S1010-7940(01)00857-0"},{"key":"S1047951111001491_ref11","doi-asserted-by":"publisher","DOI":"10.1007\/s10439-005-1731-0"},{"key":"S1047951111001491_ref26","doi-asserted-by":"publisher","DOI":"10.1007\/s10439-006-9224-3"},{"key":"S1047951111001491_ref30","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2008.06.026"},{"key":"S1047951111001491_ref33","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2008.06.043"},{"key":"S1047951111001491_ref5","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.00628.2008"},{"key":"S1047951111001491_ref3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.01.074"},{"key":"S1047951111001491_ref25","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2006.11.043"},{"key":"S1047951111001491_ref31","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1594.2009.00951.x"},{"key":"S1047951111001491_ref32","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2010.06.009"},{"key":"S1047951111001491_ref35","volume-title":"Investigation of the Unsteady Venous Hemodynamics in Fontan Patients to Enable New Therapeutic Options for Improving the Long Term Outcome","author":"Dur","year":"2011"},{"key":"S1047951111001491_ref36","doi-asserted-by":"crossref","unstructured":"36. Dur O , Kocyildirim E , Degroff CG , Wearden P , Morell V , Pekkan K . Effect of caval waveform on energy dissipation of failing Fontan patients. Paper presented at: Proceedings of the ASME Summer Bioengineering Conference, Lake Tahoe, 2009.","DOI":"10.1115\/SBC2009-206540"},{"key":"S1047951111001491_ref38","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2009.07.033"},{"key":"S1047951111001491_ref39","doi-asserted-by":"publisher","DOI":"10.1161\/01.RES.46.4.470"},{"key":"S1047951111001491_ref40","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.103.8.e39"},{"key":"S1047951111001491_ref23","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951109990382"},{"key":"S1047951111001491_ref29","unstructured":"29. Pekkan K , Sasmazel A , Sundareswaran K , Respiratory augmentation of blood flow in the early post-op Fontan circulation \u2013 feasibility of intra-pulmonic balloon pumping and external counterpulsation of systemic venous return. 16th World Congress of the World Society of Cardio-Thoracic Surgeons, Ottawa, Canada, 2006."},{"key":"S1047951111001491_ref15","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.104.530931"},{"key":"S1047951111001491_ref7","doi-asserted-by":"publisher","DOI":"10.1097\/01.mat.0000176169.73987.0d"},{"key":"S1047951111001491_ref27","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.102.suppl_3.III-148"}],"container-title":["Cardiology in the Young"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1047951111001491","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,6,26]],"date-time":"2020-06-26T06:18:39Z","timestamp":1593152319000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1047951111001491\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,10,19]]},"references-count":40,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2012,6]]}},"alternative-id":["S1047951111001491"],"URL":"https:\/\/doi.org\/10.1017\/s1047951111001491","relation":{},"ISSN":["1047-9511","1467-1107"],"issn-type":[{"value":"1047-9511","type":"print"},{"value":"1467-1107","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,10,19]]}}}