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Asian Cardiovasc Thorac Ann 2006;14:183-188
© 2006 Asia Publishing EXchange Ltd

ORIGINAL CONTRIBUTIONS

Experimental Study of Effect of Fontan Circuit on Pulmonary Microcirculation

Zongtao Yin, MD, Zengwei Wang, MD, Hongyu Zhu, MD, Renfu Zhang, MD, Huishan Wang, MD, Xinmin Li, MD

Department of Cardiovascular Surgery, Shenyang Northern Hospital, Shenyang, China

For reprint information contact: Zongtao Yin, MD Tel: 86 133 0988 1423 Fax: 86 24 2391 2376 Email: yzt1210{at}hotmail.com, Department of Cardiovascular Surgery, Shenyang Northern Hospital, 83 Wenhua Road, Shenhe District, Shenyang 110016, China.

Pulsatile pulmonary blood flow plays an important role in regulating shear-stress-mediated release of endothelium-derived nitric oxide and endothelin-1, and it reduces pulmonary vascular resistance by passive capillary recruitment. The aim of this study was to demonstrate changes in pulmonary capillary structure and endothelial function induced by the chronic nonpulsatile flow of the Fontan circulation. A canine model with nonpulsatile flow in the right lung was established, and sacrificed 3 months later. Compared to the left lung, wall thickness of the pulmonary arterioles was thinner, endothelin-1 expression was weaker, endothelial nitric oxide synthase activity was stronger, and there was a good correlation between the histomorphometric and immunohistochemical findings. These data indicate that long-term nonpulsatile flow can lead to endothelial dysfunction, which may be involved in distention and vascular structure remodeling due to the increase in pulmonary vascular resistance; but it also can lead to increased patency of the arteriovenous shunt, which might be at least partly involved in pulmonary arteriovenous fistula development and exercise limitation after the Fontan operation.




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Z. Yin, C. Wang, H. Zhu, R. Zhang, H. Wang, and X. Li
Exercise Tolerance in Extracardiac Total Cavopulmonary Connection
Asian Cardiovasc Thorac Ann, January 1, 2009; 17(1): 39 - 44.
[Abstract] [Full Text] [PDF]


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