Version 1
: Received: 8 April 2024 / Approved: 9 April 2024 / Online: 9 April 2024 (11:24:03 CEST)
How to cite:
AbdelMassih, A.; Allami, Z.; AlTatari, M.; AbuGhosh, R.; AlFakhori, A.; AlMistarihi, O.; Alkhouli, L. Fontan Assist Devices, a Systematic Review of Twenty Years of Experimental and In Vivo Trials. Preprints2024, 2024040656. https://doi.org/10.20944/preprints202404.0656.v1
AbdelMassih, A.; Allami, Z.; AlTatari, M.; AbuGhosh, R.; AlFakhori, A.; AlMistarihi, O.; Alkhouli, L. Fontan Assist Devices, a Systematic Review of Twenty Years of Experimental and In Vivo Trials. Preprints 2024, 2024040656. https://doi.org/10.20944/preprints202404.0656.v1
AbdelMassih, A.; Allami, Z.; AlTatari, M.; AbuGhosh, R.; AlFakhori, A.; AlMistarihi, O.; Alkhouli, L. Fontan Assist Devices, a Systematic Review of Twenty Years of Experimental and In Vivo Trials. Preprints2024, 2024040656. https://doi.org/10.20944/preprints202404.0656.v1
APA Style
AbdelMassih, A., Allami, Z., AlTatari, M., AbuGhosh, R., AlFakhori, A., AlMistarihi, O., & Alkhouli, L. (2024). Fontan Assist Devices, a Systematic Review of Twenty Years of Experimental and In Vivo Trials. Preprints. https://doi.org/10.20944/preprints202404.0656.v1
Chicago/Turabian Style
AbdelMassih, A., Omar AlMistarihi and Laila Alkhouli. 2024 "Fontan Assist Devices, a Systematic Review of Twenty Years of Experimental and In Vivo Trials" Preprints. https://doi.org/10.20944/preprints202404.0656.v1
Abstract
Background:Fontan completion is the last stage of univentricular repair, which drains the inferior vena cava against gravity to a higher-pressure pulmonary arterial circulation. The passivity and anti-gravity nature of this circulation render a failing Fontan, not an uncommon encounter, twenty years ago, Rodefeld and colleagues, decided to explore the feasibility of vascular pumps to support the passive nature of Fontan circulation, and since then, trials are still ongoing, and we aimed through this review to wrap up the results of these trials. Methods:A literature review has been conducted, to identify any in vivo or in vitro trial of a Fontan assist device. Several outcome parameters determined whether the trial will be included or not in this review, including, the flow rate of a pump if applicable, the number of compressions per minute if a compression device has been used, the resultant flow rate, the inferior and superior vena cava pressures, associated with each setting of the respective device, and any evidence of hemolysis or clotting within the circuit. Results:A total of ten trials have been included, with 23 different settings. Three designs have been identified, out of which two fall within the pump design, namely the connecting chamber and the intravascular pump designs; only one trial explored the possible use of a compression device. The commonest design encountered in in-vivo trials was the intravascular pump (67%). No reports of significant hemolysis or thrombosis were found. An increasing flow rate beyond 5L/min was associated with a negative outcome in the connecting chamber design, increasing upstream pressure in the SVC, while intravascular pumps did not display this limitation. Conclusion:Univentricular heart patients are a relatively small population, with very extensive needs, despite twenty years of trials, no study has yet concluded the optimal design or settings for a Fontan assist device. In this review, we identified that the intravascular pump remains the most practical design, due to its easy mode of insertion, and that it is not faced with the limitation or risk of increasing upstream resistance. There is still a long way to conclude its use as other designs such as compression devices have not yet been fully studied.
Medicine and Pharmacology, Cardiac and Cardiovascular Systems
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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