1. An Artificial Right Ventricle for Failing Fontan: In Vitro and Computational Study 
François G. Lacour-Gayet, MD, Craig J. Lanning, BS, Serban Stoica, MD, Rui Wang, PhD, Bryan A. Rech, BS, Steven Goldberg, MD, Robin Shandas, PhD 
The Annals of Thoracic Surgery 
Volume 88, Issue 1, Pages (July 2009)
DOI: /j.athoracsur
Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

2. Fig 1
This schematic drawing of the artificial right ventricle blood pump model identifies the individual components. Geometric profiles are shown for the pump impeller and diffuser.
The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur )
Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

3. Fig 2
In this new geometry of the extracardiac conduit to prevent retrograde flow in the superior vena cava, the bidirectional Glenn is taken down, and the superior vena cava is connected to the inferior vena cava, using a Gore-Tex conduit (W. L. Gore and Associates, Flagstaff, Ariz). The angle between the caval veins and the extra cardiac conduit is about 45 degrees, but can be varied over a wide range of angles.
The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur )
Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

4. Fig 3
Photograph shows the Fontan circuit in the Research Laboratory in the Children's Hospital in Denver. Notice the recipients and the red valve used to set up the pulmonary vascular resistances (PVR). (LA = left atrium.)
The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur )
Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

5. Fig 4
Drawing of the circuit or the artificial right ventricle (ARV). (CV = central venous; IVC = inferior vena cava; LA = left atrium; LPA = left pulmonary artery; RPA = right pulmonary artery; SVC = superior vena cava; VC = vena cava.)
The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur )
Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

6. Fig 5
In the new artificial right ventricle (ARV) model, the retrograde flow to the superior vena cava (SVC) is avoided. (A) Previous model. (B) New model. (IVC = inferior vena cava; LPA = left pulmonary artery; PA = pulmonary artery; RPA = right pulmonary artery; SVC = superior vena cava.)
The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur )
Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

7. Fig 6
Notice the satisfactory decrease in the central venous (CV) pressure to 5 mm Hg. The blue curve represents the decrease for a CVP at 10 mm Hg. For this nonfailing Fontan value, there could be a risk of collapsing the caval veins.
The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur )
Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

8. Fig 7 The increase of the pulmonary artery (PA) pressure is moderate.
The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur )
Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

9. Fig 8
Increase in cardiac output gain is 2 L/min, depending on the initial central venous pressure (CVP).
The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur )
Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

10. Fig 9
The gradient across the pump, when stopped, is 1.5 mm Hg at 4 liters, theoretically allowing a pump failure without important obstruction of the venous return to the lungs.
The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur )
Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

11. Fig 10
Computational results of pressure contour plot on lumen and artificial right ventricle (ARV) surfaces at (A) minimum flow and (B) peak flow. ARV pump is translated to the right and enlarged for clear view. (IVC = inferior vena cava; LPA = left pulmonary artery; RPA = right pulmonary artery; SVC = superior vena cava.)
The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur )
Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

12. Fig 11
Computational results for flow streamline plot at minimum flow. Notice the flow acceleration at the entrance of the pump showing the suctioning function of the device. (IVC = inferior vena cava; LPA = left pulmonary artery; RPA = right pulmonary artery; SVC = superior vena cava.)
The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur )
Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions