Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

Acute hemodynamic changes after Fontan operation: an experimental study

K Haneda1, T Konnai, N Sato

  • 1Department of Thoracic and Cardiovascular Surgery, Tohoku University School of Medicine, Sendai, Japan.

The Tohoku Journal of Experimental Medicine
|February 1, 1993
PubMed
Summary
This summary is machine-generated.

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

Separation and Characterization of Mammalian X- and Y-bearing Sperm.

Development, growth & differentiation·2023
Same author

LOCALIZATION OF DYNEIN IN SEA URCHIN EGGS DURING CLEAVAGE.

Development, growth & differentiation·2023
Same author

Identification of the starting point for spermatogenesis resumption in the post-diapause development of the sweet potato hornworm, Agrius convolvuli L.

Journal of insect physiology·2011
Same author

Ultrastructure and function of long and short sperm in Cicadidae (Hemiptera).

Journal of insect physiology·2003
Same author

Increased turnover of T lymphocytes in HIV-1 infection and its reduction by antiretroviral therapy.

The Journal of experimental medicine·2001
Same author

[Successful second transplant from one-locus HLA-mismatched unrelated donor for graft rejection following initial transplant from another unrelated donor in a patient with chronic myelogenous leukemia].

[Rinsho ketsueki] The Japanese journal of clinical hematology·2001
Same journal

Demographic and Geographical Distribution of Dentists in Japan: Analysis of National Data in 1996, 2006, and 2016.

The Tohoku journal of experimental medicine·2026
Same journal

Association of Myeloid Derived Suppressor Cells and Immunosuppressive Elements with Disease and Prognosis in Pancreatic Adenocarcinoma.

The Tohoku journal of experimental medicine·2026
Same journal

Reduced EphB2 Expression Due to Hypermethylation in DLBCL-NOS Is Associated with Prognosis.

The Tohoku journal of experimental medicine·2026
Same journal

Dynamic Expression of Podoplanin Correlates with Synovitis Severity in a Lipopolysaccharide-Induced Rabbit Arthritis Model.

The Tohoku journal of experimental medicine·2026
Same journal

Fifteen Years On: A Retrospective Institutional Case Study of Soma General Hospital Following the 2011 Fukushima Daiichi Nuclear Accident.

The Tohoku journal of experimental medicine·2026
Same journal

Optimizing Outcomes in ICU Pulmonary Infections: The Role of Comprehensive Nursing Intervention.

The Tohoku journal of experimental medicine·2026
See all related articles

This study examines how blood flow and pressure change immediately after a Fontan procedure, a surgery used to treat certain heart defects. By creating this circulation in a canine model, researchers observed significant drops in blood pressure and cardiac output, alongside a rise in pulmonary vascular resistance. These findings highlight the importance of monitoring lung vessel resistance during this specific surgical intervention.

Area of Science:

  • Cardiovascular physiology research within Fontan circulation studies
  • Surgical outcomes research in veterinary medicine

Background:

Prior research has shown that the Fontan procedure fundamentally alters blood flow patterns in patients with complex congenital heart defects. That uncertainty drove investigators to explore how these modifications impact immediate systemic stability. No prior work had resolved the precise hemodynamic shifts occurring right after the surgical connection is finalized. This gap motivated a controlled investigation using an animal model to isolate these variables. Clinical observations often suggest that systemic performance declines following such bypass procedures. However, the exact physiological mechanisms remain poorly understood in the immediate postoperative window. Scientists require accurate data to predict how the body adjusts to this modified circulatory state. This study addresses these questions by measuring pressure and flow changes in a controlled experimental setting.

Purpose Of The Study:

The aim of this study is to evaluate the acute hemodynamic changes occurring after the establishment of the Fontan circulation. Researchers sought to quantify how this surgical bypass impacts systemic and pulmonary performance. The motivation stems from the need to understand the immediate physiological adjustments required by the cardiovascular system. Many patients undergoing this procedure exhibit complex heart conditions that complicate postoperative recovery. By using an animal model, the team aimed to isolate the effects of the bypass from other clinical variables. This investigation addresses the uncertainty surrounding how the heart and lungs adapt to redirected blood flow. The authors intended to provide baseline data for predicting surgical outcomes in high-risk populations. This study clarifies the immediate hemodynamic consequences of the Fontan operation.

Keywords:
congenital heart defectscardiac surgerypulmonary vascular resistancesystemic perfusion

Frequently Asked Questions

The researchers observed a marked decline in systemic arterial pressure and cardiac output, alongside a significant rise in pulmonary vascular resistance. These hemodynamic shifts occurred immediately following the surgical establishment of the bypass connection in the canine subjects.

The team utilized a 10 mm Gore-Tex graft to connect the right atrium to the pulmonary artery. This synthetic conduit facilitates the redirection of blood flow required for the modified circulation model.

Occlusion of the tricuspid valve is necessary to ensure that systemic venous return is directed entirely toward the pulmonary arteries. This step prevents backflow and forces blood through the newly created graft connection.

The investigators employed adult mongrel dogs, each weighing approximately 11.3 kg, to serve as the experimental subjects. This animal model allows for the direct measurement of pressure and flow variables in a controlled environment.

Related Experiment Videos

Main Methods:

Review Approach: The investigators performed an experimental surgery on seven adult mongrel dogs to simulate the Fontan procedure. They utilized a purse-string suture to occlude the tricuspid valve under inflow occlusion. A 10 mm Gore-Tex graft was then inserted to link the right atrium with the pulmonary artery. This surgical design allowed for the direct observation of systemic and pulmonary pressure dynamics. The team monitored aortic pressure and cardiac output throughout the transition period. They also calculated pulmonary vascular resistance to assess changes in lung blood flow. Heart rate and systemic vascular resistance were tracked to identify potential compensatory mechanisms. This systematic approach provided a clear view of the immediate physiological consequences of the bypass.

Main Results:

Key Findings From the Literature: The study demonstrated that aortic pressure dropped from 94.9 mmHg to 41.9 mmHg following the establishment of the bypass. Cardiac output simultaneously declined from 0.907 liter/min to 0.259 liter/min in the subjects. These results indicate a substantial reduction in systemic perfusion immediately after the surgery. The researchers also recorded an increase in pulmonary vascular resistance from 11.6 units to 21.8 units. No significant alterations were detected in heart rate or systemic vascular resistance during the transition. These data confirm that the pulmonary vasculature experiences the most dramatic change in resistance. The findings suggest that the new circulation places a significant burden on the pulmonary system. This evidence quantifies the acute hemodynamic instability inherent in the Fontan model.

Conclusions:

The authors propose that the primary hemodynamic shifts following this surgery involve substantial reductions in systemic arterial pressure and cardiac output. Their synthesis suggests that these alterations occur alongside a notable rise in pulmonary vascular resistance. These findings imply that clinicians must remain vigilant regarding resistance levels within the lungs. The researchers suggest that patients with pre-existing pulmonary hypertension face higher risks during this procedure. Their work indicates that resistance might reach dangerous thresholds in certain clinical scenarios. This analysis highlights the necessity of evaluating vascular health before proceeding with the operation. The authors conclude that hemodynamic stability depends heavily on the pulmonary vascular response to the new circulation. These implications provide a framework for better managing surgical expectations in complex cardiac cases.

Pulmonary vascular resistance increased from 11.6 units to 21.8 units after the procedure. This measurement indicates a substantial rise in the opposition to blood flow through the lung vessels following the surgery.

The authors propose that surgeons should consider the potential for pulmonary vascular resistance to reach a critical level. This warning is particularly relevant when performing the operation on patients who already exhibit signs of pulmonary hypertension.