The Journal of thoracic and cardiovascular surgery · 2026
Fontan pump: Advanced preclinical development.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Rodefeld Mark D, Figliola Richard, Conover Tim, Bennett Ed, Ivashchenko Artem, Neary Michael, Obeid Victor, Palazzolo Alan, Sarfare Shreyas, Giridharan Guruprasad A, Ghali George, Nakasoto Pablo, Yang Weiguang, Wampler Richard, Dasse Kurt
Аннотация
OBJECTIVE: Late Fontan failure and attrition is an increasingly prevalent problem for which there is no primary therapy. A Fontan circulation is a circulation that lacks a subpulmonary pump. We are developing a technology that can safely and reliably restore subpulmonary pump function in a Fontan circulation to reverse the Fontan paradox and maintain normal circulatory health.
METHODS: A rotary pump scaled for adolescent and adult use was developed for implantation to physiologically augment flow in the total cavopulmonary connection. Design objectives included 30/70% superior vena cava/inferior vena cava inflow draw over a broad range of performance, and no obstruction in the event of device failure. Hydrodynamic and hemodynamic performance were characterized in vitro in a Fontan mock circulatory loop using blood analog. Hemolysis was characterized in blood.
RESULTS: The pump augments total cavopulmonary connection flow (superior vena cava/inferior vena cava inflow; left pulmonary artery/right pulmonary artery outflow) at +6 to 10 mm Hg, ranging to +18 mm Hg at 3K RPM. Performance is consistent over a wide range of cardiac output. Power requirement is low (1 W) at +6 mm Hg pressure rise. Hemolysis is comparable with other commercially available pumps. Cavitation or suction was not observed. In the stalled condition (0 RPM), gradient is ≤1 mm Hg.
CONCLUSIONS: A Fontan pump can safely reverse the Fontan paradox. Features include a fail-safe contingency that is clinically manageable. The technology may prevent progression of Fontan failure in the setting of preserved systemic ventricular systolic function. As a surgical strategy of long-term biventricular health maintenance, it may improve quality and duration of life for patients with single ventricle heart disease.
METHODS: A rotary pump scaled for adolescent and adult use was developed for implantation to physiologically augment flow in the total cavopulmonary connection. Design objectives included 30/70% superior vena cava/inferior vena cava inflow draw over a broad range of performance, and no obstruction in the event of device failure. Hydrodynamic and hemodynamic performance were characterized in vitro in a Fontan mock circulatory loop using blood analog. Hemolysis was characterized in blood.
RESULTS: The pump augments total cavopulmonary connection flow (superior vena cava/inferior vena cava inflow; left pulmonary artery/right pulmonary artery outflow) at +6 to 10 mm Hg, ranging to +18 mm Hg at 3K RPM. Performance is consistent over a wide range of cardiac output. Power requirement is low (1 W) at +6 mm Hg pressure rise. Hemolysis is comparable with other commercially available pumps. Cavitation or suction was not observed. In the stalled condition (0 RPM), gradient is ≤1 mm Hg.
CONCLUSIONS: A Fontan pump can safely reverse the Fontan paradox. Features include a fail-safe contingency that is clinically manageable. The technology may prevent progression of Fontan failure in the setting of preserved systemic ventricular systolic function. As a surgical strategy of long-term biventricular health maintenance, it may improve quality and duration of life for patients with single ventricle heart disease.