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Pulmonary Capillary Recruitment in Fontan Patients

Pulmonary Capillary Recruitment With Pulmonary Vasodilator Therapy in Patients With Univentricular Heart Physiology and Failing Total Cavo-pulmonary Connection.

Status
UNKNOWN
Phases
Unknown
Study type
Observational
Source
ClinicalTrials.gov
Registry ID
NCT04292483
Enrollment
15
Registered
2020-03-03
Start date
2020-06-11
Completion date
2023-12-31
Last updated
2022-04-07

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Congenital Heart Disease

Brief summary

This study evaluates the effects of pulmonary vasodilator therapy on pulmonary capillary blood flow by measuring the functional capillary surface area (FCSA) at baseline and post nitric oxide inhalation, through the injection of 3H-benzoyl-Phe-Ala-Pro (BPAP). FCSA will be related to flow and other hemodynamic parameters in order to determine if there is capillary recruitment or distention in Fontan patients. We will also compare baseline FCSA measurements with previously studied normal subjects, to assess the difference in hemodynamic pulmonary functional parameters between these single ventricle physiology patients and normal subjects.

Interventions

DRUGNitric Oxide

Inhaled vasodilator to increase pulmonary capillary perfusion

Sponsors

National and Kapodistrian University of Athens
CollaboratorOTHER
Tel Aviv University
CollaboratorOTHER
Old Dominion University
CollaboratorOTHER
Jewish General Hospital
Lead SponsorOTHER

Study design

Observational model
COHORT
Time perspective
PROSPECTIVE

Eligibility

Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
No

Inclusion criteria

Fontan failures will be defined as patients with single ventricle physiology and TCPC with clinical signs of dysfunction defined as any of the following: 1. Decreased functional class WHO/NYHA II or more and clinical signs of congestion (ascites, peripheral edema, increased JVP) and/or NT-proBNP \> 399 pg/ml based on \[17\]. 2. Age \> 18 years 3. Known Fontan's increased pressures a. Fontan mean pressure of ≥15 mmHg and/or transpulmonary gradient ≥ 5 mmHg. b. Pulmonary vascular resistance ≥ 2 woods units. And/or supporting evidence of end-organ damage 1\. Clinical or paraclinical evidence of liver congestion and/or fibrosis a. Evidence in ultrasound or other imaging techniques of liver congestion and/or changes related to cardiac cirrhosis. b. Fibroscan with grade 2 or + 2. Paraclinical signs of portal hypertension defined as 2 or more: 1. Thrombocytopenia defined as platelet count \< 150.0000 2. Leukocytopenia defined as white blood cell less than 4.500 3. Esophageal varices on esophagoduodenoscopy. 4. Splenomegaly on imaging -

Exclusion criteria

1. Presence of fenestration - the shunts include veno-veno collaterals 2. Significant anemia defined as Hgb \< 120 mg/dl 3. Pregnancy at the moment of the procedure. 4. Taking angiotensin-converting enzyme inhibitors or angiotensin receptor blockers. 5. Usage of nitrates, phosphodiesterase inhibitors or calcium blockers within 3 months of the study. \-

Design outcomes

Primary

MeasureTime frameDescription
Functional capillary surface area30 minutesMeasurement of functional capillary surface area pre and post inhaled nitric oxide

Countries

Canada

Contacts

Primary ContactDavid Langleben, MD
david.langleben@mcgill.ca5143407531
Backup ContactJudith Therrien, MD
judith.therrien@mcgill.ca514-340-8232

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026