In vitro investigation of axial mechanical support devices implanted in the novel convergent cavopulmonary connection Fontan

Vincent Cleveland, Jacqueline Contento, Paige Mass, Priyanka Hardikar, Qiyuan Wu, Xiaolong Liu, Seda Aslan, Yue Hin Loke, Axel Krieger, Scott Lunos, Laura Olivieri, Pranava Sinha

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


OBJECTIVES: The 2 opposing inflows and 2 outflows in a total cavopulmonary connection make mechanical circulatory support (MCS) extremely challenging. We have previously reported a novel convergent cavopulmonary connection (CCPC) Fontan design that improves baseline characteristics and provides a single inflow and outflow, thus simplifying MCS. This study aims to assess the feasibility of MCS of this novel configuration using axial flow pumps in an in vitro benchtop model. METHODS: Three-dimensional segmentations of 12 single-ventricle patients (body surface area 0.5-1.75 m2) were generated from cardiovascular magnetic resonance images. The CCPC models were designed by connecting the inferior vena cava and superior vena cava to a shared conduit ascending to the pulmonary arteries, optimized in silico. The 12 total cavopulmonary connection and their corresponding CCPC models underwent in vitro benchtop characterization. Two MCS devices were used, the Impella RP® and the PediPump. RESULTS: MCS successfully and symmetrically reduced the pressure in both vena cavae by >20 mmHg. The devices improved the hepatic flow distribution balance of all CCPC models (Impella RP®P = 0.045, PediPump P = 0.055). CONCLUSIONS: The CCPC Fontan design provides a feasible MCS solution for a failing Fontan by balancing hepatic flow distribution and symmetrically decompressing the central venous pressure. Cardiac index may also improve with MCS. Additional studies are needed to evaluate this concept for managing Fontan failure.

Original languageEnglish (US)
Article numberezad413
JournalEuropean Journal of Cardio-thoracic Surgery
Issue number1
StatePublished - Jan 1 2024

Bibliographical note

Publisher Copyright:
© 2024 The Author(s). Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.


  • Cardiac index
  • Convergent cavopulmonary connection
  • Flow loop
  • Fontan redesign
  • Hepatic flow distribution
  • Mechanical circulatory support

PubMed: MeSH publication types

  • Journal Article


Dive into the research topics of 'In vitro investigation of axial mechanical support devices implanted in the novel convergent cavopulmonary connection Fontan'. Together they form a unique fingerprint.

Cite this