{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T07:37:48Z","timestamp":1788593868297,"version":"build-2803163510"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2022,11,7]],"date-time":"2022-11-07T00:00:00Z","timestamp":1667779200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002996","name":"Dutch Heart Foundation","doi-asserted-by":"crossref","award":["2018-T083"],"award-info":[{"award-number":["2018-T083"]}],"id":[{"id":"10.13039\/501100002996","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100002996","name":"Dutch Heart Foundation","doi-asserted-by":"crossref","award":["CVON-2017-08-RADAR"],"award-info":[{"award-number":["CVON-2017-08-RADAR"]}],"id":[{"id":"10.13039\/501100002996","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,12,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p\/>\n                  <jats:sec>\n                    <jats:title>OBJECTIVES<\/jats:title>\n                    <jats:p>To date, it is not known if 16\u201320-mm extracardiac conduits are outgrown during somatic growth from childhood to adolescence. This study aims to determine total cavopulmonary connection (TCPC) haemodynamics in adolescent Fontan patients at rest and during simulated exercise and to assess the relationship between conduit size and haemodynamics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Patient-specific, magnetic resonance imaging-based computational fluid dynamic models of the TCPC were performed in 51 extracardiac Fontan patients with 16\u201320-mm conduits. Power loss, pressure gradient and normalized resistance were quantified in rest and during simulated exercise. The cross-sectional area (CSA) (mean and minimum) of the vessels of the TCPC was determined and normalized for flow rate (mm2\/l\/min). Peak (predicted) oxygen uptake was assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>The median age was 16.2\u2009years (Q1\u2013Q3 14.0\u201318.2). The normalized mean conduit CSA was 35\u201373% smaller compared to the inferior and superior vena cava, hepatic veins and left\/right pulmonary artery (all P\u2009&amp;lt;\u20090.001). The median TCPC pressure gradient was 0.7\u2009mmHg (Q1\u2013Q3 0.5\u20130.8) and 2.0 (Q1\u2013Q3 1.4\u20132.6) during rest and simulated exercise, respectively. A moderate\u2013strong inverse non-linear relationship was present between normalized mean conduit CSA and TCPC haemodynamics in rest and exercise. TCPC pressure gradients of \u22651.0 at rest and \u22653.0\u2009mmHg during simulated exercise were observed in patients with a conduit CSA \u2264 45 mm2\/l\/min and favourable haemodynamics (&amp;lt;1 mmHg during both rest and exercise) in conduits \u2265125 mm2\/l\/min. Normalized TCPC resistance correlated with (predicted) peak oxygen uptake.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Extracardiac conduits of 16\u201320 mm have become relatively undersized in most adolescent Fontan patients leading to suboptimal haemodynamics.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejcts\/ezac522","type":"journal-article","created":{"date-parts":[[2022,11,6]],"date-time":"2022-11-06T16:18:11Z","timestamp":1667751491000},"source":"Crossref","is-referenced-by-count":22,"title":["Haemodynamic performance of 16\u201320-mm extracardiac Goretex conduits in adolescent Fontan patients at rest and during simulated exercise"],"prefix":"10.1093","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1804-3220","authenticated-orcid":false,"given":"Friso M","family":"Rijnberg","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic Surgery, Leiden University Medical Center , Leiden, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca C","family":"van \u2018t Hul","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Biomechanical Engineering, Erasmus MC , Rotterdam, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark G","family":"Hazekamp","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Leiden University Medical Center , Leiden, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pieter J","family":"van den Boogaard","sequence":"additional","affiliation":[{"name":"Department of Radiology, Leiden University Medical Center , Leiden, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joe F","family":"Juffermans","sequence":"additional","affiliation":[{"name":"Department of Radiology, Leiden University Medical Center , Leiden, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hildo J","family":"Lamb","sequence":"additional","affiliation":[{"name":"Department of Radiology, Leiden University Medical Center , Leiden, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Covadonga","family":"Terol Espinosa de Los Monteros","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology, Leiden University Medical Center , Leiden, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucia J M","family":"Kroft","sequence":"additional","affiliation":[{"name":"Department of Radiology, Leiden University Medical Center , Leiden, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sasa","family":"Kenjeres","sequence":"additional","affiliation":[{"name":"Department of Chemical Engineering, Faculty of Applied Sciences, Delft University of Technology and J.M. Burgers centrum Research School for Fluid Mechanics , Delft, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2154-4923","authenticated-orcid":false,"given":"Saskia","family":"le Cessie","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology, Leiden University Medical Center , Leiden, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monique R M","family":"Jongbloed","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Anatomy & Embryology, Leiden University Medical Center , Leiden, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1946-1715","authenticated-orcid":false,"given":"Jos J M","family":"Westenberg","sequence":"additional","affiliation":[{"name":"Department of Radiology, Leiden University Medical Center , Leiden, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arno A W","family":"Roest","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology, Leiden University Medical Center , Leiden, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jolanda J","family":"Wentzel","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Biomechanical Engineering, Erasmus MC , Rotterdam, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,11,7]]},"reference":[{"key":"2023012806423758000_ezac522-B1","doi-asserted-by":"crossref","first-page":"CIR0000000000000696","DOI":"10.1161\/CIR.0000000000000696","article-title":"Evaluation and management of the child and adult with Fontan circulation: a scientific statement from the American Heart 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