The pulmonary vascular bed in patients with functionally univentricular physiology and a Fontan circulation
| Autor: | Khalid Al Najashi, C. Charles Jain, Alexander C. Egbe, Ahmed Krimly, Ahmed Alzahrani, Gruschen R. Veldtman, Dimpna Albert-Brotons |
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| Rok vydání: | 2021 |
| Předmět: |
Heart Defects
Congenital Pulmonary Circulation Heart Ventricles medicine.medical_treatment Physiology Pulmonary Artery Fontan Procedure Fontan procedure medicine.artery medicine Humans In patient Tricuspid atresia Lung business.industry Hemodynamics General Medicine Blood flow medicine.disease medicine.anatomical_structure Ventricle Pediatrics Perinatology and Child Health Circulatory system Pulmonary artery Vascular resistance Cardiology and Cardiovascular Medicine business |
| Zdroj: | Cardiology in the Young. 31:1241-1250 |
| ISSN: | 1467-1107 1047-9511 |
| Popis: | Fontan palliation represents one of the most remarkable surgical advances in the management of individuals born with functionally univentricular physiology. The operation secures adult survival for all but a few with unfavourable anatomy and/or physiology. Inherent to the physiology is passive transpulmonary blood flow, which produces a vulnerability to adequate filling of the systemic ventricle at rest and during exertion. Similarly, the upstream effects of passive flow in the lungs are venous congestion and venous hypertension, especially marked during physical activity. The pulmonary vascular bed has emerged as a defining character on the stage of Fontan circulatory behaviour and clinical outcomes. Its pharmacologic regulation and anatomic rehabilitation therefore seem important strategic therapeutic targets. This review seeks to delineate the important aspects of pulmonary artery development and maturation in functionally univentricular physiology patients, pulmonary artery biology, pulmonary vascular reserve with exercise, and pulmonary artery morphologic and pharmacologic rehabilitation. |
| Databáze: | OpenAIRE |
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