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Predicting the pressure of the total cavopulmonary connection: clinical testing of a mathematical equation

Published online by Cambridge University Press:  23 July 2019

Arianna Di Molfetta ,
Roberta Iacobelli ,
Silvia Rotella ,
Maria G. Gagliardi ,
Antonio Amodeo ,
Roberto Formigari ,
Luciano Pasquini ,
Salvatore F. Iorio  and
Paolo Guccione
Arianna Di Molfetta*
Affiliation:
Department of Cardiac Surgey, Policlinico Agostino Gemelli, Rome, Italy
Roberta Iacobelli
Affiliation:
Department of Pediatric Cardiology and Cardiac Surgery, Pediatric Hospital Bambino Gesù, Rome, Italy
Silvia Rotella
Affiliation:
Faculty of Biomedical Engineer, Università Campus Bio-medico di Roma, Rome, Italy
Maria G. Gagliardi
Affiliation:
Department of Pediatric Cardiology and Cardiac Surgery, Pediatric Hospital Bambino Gesù, Rome, Italy
Antonio Amodeo
Affiliation:
Department of Pediatric Cardiology and Cardiac Surgery, Pediatric Hospital Bambino Gesù, Rome, Italy
Roberto Formigari
Affiliation:
Department of Pediatric Cardiology and Cardiac Surgery, Pediatric Hospital Bambino Gesù, Rome, Italy
Luciano Pasquini
Affiliation:
Department of Pediatric Cardiology and Cardiac Surgery, Pediatric Hospital Bambino Gesù, Rome, Italy
Salvatore F. Iorio
Affiliation:
Department of Pediatric Cardiology and Cardiac Surgery, Pediatric Hospital Bambino Gesù, Rome, Italy
Paolo Guccione
Affiliation:
Department of Pediatric Cardiology and Cardiac Surgery, Pediatric Hospital Bambino Gesù, Rome, Italy
*
Author for correspondence: Arianna Di Molfetta, MScBME, MD, PhD, Department of Cardiac Surgery, Policlinico Agostino Gemelli, Largo Agostino Gemelli, 8, Rome, Italy. Tel: 0039-3496775951; Fax: +39 0630155818; E-mail: arianna.dimolfetta@gmail.com
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Abstract

Introduction:

Some authors advocate the use of a dedicated formula to predict the Fontan pressure starting from pre-Fontan catheterisation data. This paper aims at testing the predictive value of the mentioned formula through a retrospective clinical study.

Methods and Results:

Pre-Fontan catheterisation data and Fontan pressure measured at the completion were retrospectively collected. Pre-Fontan data were used to calculate the predicted pressure in the Fontan system. The predicted values were compared to the Fontan pressure measured at the Fontan completion and with the needs for fenestration. One hundred twenty-four Fontan patients were retrospectively enrolled (At Fontan: median age 30.73 [24.70–37.20] months, median weight 12.00 [10.98–14.15] kg). Fontan conduit was fenestrated in 78 patients. A poor correlation (r2 = 0.05128) between the measured and predicted data for non-fenestrated patients was observed. In the case of Fontan-predicted pressure <17.59 mmHg, the formula identified a good short-term clinical outcome with a sensitivity of 92%.

Conclusion:

The proposed formula showed a poor capability in estimating the actual pressure into the Fontan system and in identifying patients needing fenestration. As the pressure into the Fontan system is determined by multiple factors, the tested formula could be an additional data in a multi-parametric approach.

Keywords

Fontansingle ventriclepressurecavopulmonary anastomosis
Type
Original Article
Information
Cardiology in the Young , Volume 29 , Issue 8 , August 2019 , pp. 1066 - 1071
Copyright
© Cambridge University Press 2019 

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Footnotes

All the authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.

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