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Ideal chest compression site for cardiopulmonary resuscitation in fontan circulation patients with dextrocardia

Jin Hee Kim1, Jae Yun Jung2, Sangyun Lee3

  • 1Department of Emergency Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.

BMC Cardiovascular Disorders
|January 3, 2024
PubMed

Insights

For patients with corrected single ventricle and dextrocardia, right-sided chest compression during cardiopulmonary resuscitation (CPR) is more effective. This approach optimizes compression of the single ventricle compared to conventional methods.

Area of Science:

  • Cardiology
  • Pediatric Cardiology
  • Cardiac Surgery

Background:

  • Patients with a single ventricle and dextrocardia corrected by Fontan surgery present unique anatomical challenges.
  • Cardiopulmonary resuscitation (CPR) effectiveness can be influenced by anatomical variations.

Purpose of the Study:

  • To determine the optimal chest compression site for CPR in patients with a single ventricle and dextrocardia post-Fontan surgery.
  • To improve resuscitation outcomes in this specific patient population.

Main Methods:

  • Retrospective analysis of chest computed tomography (CT) images from patients who underwent Fontan surgery.
  • Identification of the largest part of the compressed single ventricle as the ideal compression site.
  • Measurement of sternal deviation and calculation of compressed structure area fractions.

Main Results:

  • Analysis included 58 patients (67.2% male).
  • The ideal compression site showed a mean right deviation similar to sternum width (32.85 ± 15.61 mm).
  • Right-sided compression at the ideal site increased single ventricle area fraction by 7% compared to conventional methods (0.22 ± 0.11 vs. 0.15 ± 0.10, P < 0.05).

Conclusions:

  • Right-sided chest compression may be superior to conventional locations for CPR in patients with Fontan circulation and dextrocardia.
  • Targeting the largest part of the single ventricle optimizes compression efficacy.
Abstract

Keywords:
Cardiopulmonary resuscitationDextrocardiaFontan procedure

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