Skip to main content
SpringerLink
Log in

Eeffects of arteriovenous shunt on ventricular function in dog

  • Original Article
  • Published:
The Japanese Journal of Thoracic and Cardiovascular Surgery Aims and scope Submit manuscript

Abstract

Background: The bidirectional cavopulmonary shunt has been increasingly accepted as an interim step to the Fontan operation. However, the effect(s) of chronic volume overload on ventricular function are not yet well understood.Methods: Twelve mongrel dogs, with (chronic volume overload group), or without (control group) a femoral arteriovenous shunt created 8 weeks before the assessment, were subjected to a right heart bypass from the right atrium to the proximal pulmonary trunk. Nonpulsatile perfusion via the bypass was achieved using a centrifugal pump and cross-clamping of the pulmonary trunk. Left ventricular function was evaluated using the end-systolic elastance and the Doppler flow pattern on echocardiograms (epicardiac and transesophageal, simultaneously) during acute volume loading.Results: The left ventricular weight and the left ventricular weight/end-diastolic volume ratio showed no change from control values. The sum of the isovolumetric contraction time and the isovolumetric relaxation time divided by the ejection time remained constant during acute volume loading in the chronic volume overload group, while an increase was demonstrated in the control group. The chronic volume overload group showed a lower Ees (30.8 ± 16.4 mmHg/cm2 vs. 107.6 ± 70.3 mmHg/cm2, p=0.03) than the control group.Conclusions: The global ventricular performance changed with chronic adaptation to the arteriovenous shunt, and became resistant to acute volume loading. Left ventricular contractility under nonpulsatile pulmonary perfusion was impaired by chronic volume overload, which is deleterious to the Fontan operation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Mayer JE, Bridges ND, Lock JE, Hanley FL, Jonas RA, Castaneda AR. Factors associated with marked reduction in mortality for Fontan operation in patients with single ventricle. J Thorac Cardiovasc Surg 1992; 103: 444–52.

    PubMed  Google Scholar 

  2. Kirklin JK, Blackstone EH, Kirklin JW, Pacifico AD, Bargeron LM. The Fontan operation: ventricular hypertrophy, age, and date of operation as risk factors. J Thorac Cardiovasc Surg 1986; 92: 1049–64.

    PubMed  CAS  Google Scholar 

  3. Fontan F, Kirklin JW, Fernandez G, Costa F, Naftel DC, Tritto F, et al. Outcome after a “perfect” Fontan operation. Circulation 1990; 81: 1520–36.

    Article  PubMed  CAS  Google Scholar 

  4. Schiller NS, Shah PM, Crawford M, DeMaria A, Devereux R, Feigenbaum H, et al. Recommendations for quantitation of the left ventricle by two-dimensional echocardiography. J Am Soc Echocardiogr 1989; 2: 358–67.

    PubMed  CAS  Google Scholar 

  5. McCulagh WH, Covell JW, Ross J. Left ventricular dilatation and diastolic compliance changes during chronic volume overloading. Circulation 1972; 45: 943–51.

    Google Scholar 

  6. Gewilling M, Daenen W, Aubert A, Van der Hauwaert L. Abolishment of chronic volume overload: Implication for diastolic function of the systemic ventricle immediately after Fontan repair. Circulation 1992; 86(Suppl II): II–93-9.

    Google Scholar 

  7. Mace L, Dervanian P, Weiss M, Daniel J, Losay J, Neveux J. Hemodynamics of different degrees of right heart bypass: experimental assessment. Ann Thorac Surg 1995; 60: 1230–7.

    Article  PubMed  CAS  Google Scholar 

  8. Sagawa K. The end-systolic pressure-volume relation of the ventricle: definition, modifications and clinical use. Circulation 1981; 63: 1223–7.

    Article  PubMed  CAS  Google Scholar 

  9. Gorcsan J, Denault LG, Mandarino WA, Pinsky MR. Left ventricular pressure-volume relations with transesophageal echocardiographic automated border detection: comparison with conductance-catheter technique. Am Heart J 1996; 131: 544–52.

    Article  PubMed  Google Scholar 

  10. Tei C, Lieng H-L, Hodge DO, Bailey KR, Oh J-K, Rodeheffer RJ, et al. New index of combined systolic and diastolic myocardial performance: a simple and reproducible measure of cardiac function — a study in normal and dilated cardiomyopathy. J Cardiol 1995; 26: 357–66.

    PubMed  CAS  Google Scholar 

  11. Wolk MJ, Keefe JF, Bing OHL, Finkelstein LJ, Levine HJ. Estimation of V maxiautonic systoles from the rate of relative increase of isovolumic pressure: (dp/dt) kP. J Clin Invest 1971; 50: 1276–85.

    Article  PubMed  CAS  Google Scholar 

  12. Grossman W, McLaurin LP, Rollet EL. Alteration in left ventricular relaxation and diastolic compliance in congestive cardiomyopathy. Cardiovasc Res 1979; 13: 514–22.

    Article  PubMed  CAS  Google Scholar 

  13. Fogel MA, Gupta KB, Weinberg PM, Hoffman EA. Regional wall motion and strain analysis across stages of Fontan reconstruction by magnetic resonance tagging. Am J Physiol 1995; 269: H1132–52.

    PubMed  CAS  Google Scholar 

  14. Fogel MA, Weinberg PM, Chin AJ, Fellows KE, Hoffman EA. Late ventricular geometry and performance changes of functional single ventricle throughout staged Fontan reconstruction assessed by magnetic resonance imaging. J Am Coll Cardiol 1996; 28: 212–21.

    Article  PubMed  CAS  Google Scholar 

  15. Gewillig M, Lundstroem U, Deanfield J, Bull C, Franklin R, Graham T, et al. Impact of the Fontan operation on left ventricular size and contractility in tricuspid atresia. Circulation 1990; 81: 118–27.

    Article  PubMed  CAS  Google Scholar 

  16. Papadimitriou J, Hopkins B, Taylor R: Regression of left ventricular dilatation and hypertrophy after removal of volume overload. Circ Res 1974; 35: 127–35.

    PubMed  CAS  Google Scholar 

  17. Bridges ND, Jonas RA, Mayer JE, Flanagan MF, Keane JF, Castaneda AR. Bidirectional cavopulmonary anastomosis as interim palliation for high-risk Fontan candidates: early results. Circulation 1993; 88: 149–50.

    Google Scholar 

  18. Norwood WI, Jacobs ML. Fontan’s procedure in two stages. Am J Surg 1993 166: 548–51.

    Article  PubMed  CAS  Google Scholar 

  19. Florentino JV, Mengo G, Gallo JP, Skerl CB, Ranzzini ME, Vazquez JC. Bidirectional cavopulmonary shunt in patients with multiple risk factors. Ann Thorac Surg 1995; 60: S558–62.

    Article  Google Scholar 

  20. Lamberti JJ, Spicer RL, Waldman JD, Grehl TM, Thomson D, George L, et al. The bidirectional cavopulmonary shunt. J Thorac Cardiovasc Surg 1990; 100: 22–30.

    PubMed  CAS  Google Scholar 

  21. Lavigne JE, Messina LM, Golding MR, Kerr JC, Hobson RW, Swan KG: Fistula size and hemodynamic events within and about canine femoral arteriovenous fistulas. J Thorac Cardiovasc Surg 1977; 74:551–6.

    PubMed  CAS  Google Scholar 

  22. Gerdes AM, Clark LC, Capasso JM. Regression of cardiac hypertrophy after closing an aortocaval fistula in rats. Am J Physiol 1995; H2345–51.

Download references

Author information

Authors and Affiliations

  1. Division of Cardiovascular Surgery, Keio University Hospital, 35 Shinanomachi, Shinjuku-ku, 160-0016, Tokyo, Japan

    Tadashi Omoto, Ryo Aeba, Toshiyuki Katogi, Tsutomu Ito & Shiaki Kawada

Authors
  1. Tadashi Omoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ryo Aeba
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Toshiyuki Katogi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Tsutomu Ito
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Shiaki Kawada
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Omoto, T., Aeba, R., Katogi, T. et al. Eeffects of arteriovenous shunt on ventricular function in dog. Jpn J Thorac Caridovasc Surg 47, 116–120 (1999). https://doi.org/10.1007/BF03217954

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03217954

Index words

Search

Navigation