Fittings and straight pipe of the pilot plant.
\r\n\t
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The performance of the photocatalytic reactor depends directly on the number of photons absorbed by the catalyst surface; and this is related to the geometry of the photoreactor, UV photons source, and how the catalyst interacts with the chemical species. Although the photoreactor models consider practically all these aspects, the use of dimensionless parameters is highly recommended for scaling-up purposes. The four dimensionless numbers needed for the scaling-up process are as follows [1]:
Reynolds number (
Damkohler number (
The optical thickness of the photoreactor (
The scattering albedo of the photocatalyst (
The last two dimensionless numbers (optical thickness and scattering albedo) are the most relevant for scaling up photocatalytic reactors. Both help to describe the dynamics of the UV photon absorption and determine the level of difficulty of the scaling-up process. For example, some thin-film slurry (TFS) photoreactors (Figure 1) can exhibit very low values of scattering albedo (
Thin-film slurry (TFS) photoreactors. © 2005 Elsevier Science Ltd. Originally published in Li Puma [
Although TFS reactors with low scattering albedos are easier to scale-up (regarding photonic effects calculations), they can result not so practical when they need to handle larger volumes of reaction, especially if the dimensionless numbers need to remain constant in the process of scaling-up. Several aspects of scale-up and optimization of heterogeneous photocatalytic reactors are detailed in the following sections of this chapter.
The dimensions of a full-scale TFS reactor can be challenging to handle if, for example, a large plate of several meters of length and width needs to be located in a reduced space. This is not the case for CPC or tubular photoreactors, which can be set up as modular units for larger reaction volumes. This advantage is more relevant when the photon source is the UV solar radiation since the photocatalytic reactors must be located outdoors, and the TFS reactors must have additional protection for weather phenomena. The solar CPC photoreactors, instead, are more robust, and there are several large-scale applications as it has been reported in the literature [1, 2, 3, 4, 5]. Nonetheless, other “geometrically thick” reactors can be considered as feasible options to be scaled-up, regarding the cost-benefit ratio.
The optical thickness, which depends on the catalyst load and the reactor thickness, may be manipulated in order to maximize the photon absorption by the catalyst. Consequently, it is necessary to observe how the LVRPA behaves with different values of optical thickness, considering that the type of reactor is relevant to the behavior of this parameter.
Figure 2 shows how the conversion of an ideal substrate varies with the optical thickness and the type of reactor: falling film laminar flow (FFLF), plug flow (PF), and slit flow (SF) reactors. It is also clear that the lower scattering albedos allow higher conversions of this ideal substrate.
Model simulations for the conversion of a substrate as a function of the optical thickness and scattering albedo for different idealized flow conditions. © 2005 Elsevier Science Ltd. Originally published in Li Puma [
The “optically thick” reactors (
Other dimensionless numbers or parameters can be used. The dimensionless intensity of radiation at the entrance window of the reactor and the dimensionless LVRPA may be useful as well. The following expressions apply for TFS reactors (
where
The dimensionless LVRPA is easily estimated from the dimensionless intensity at the entrance window, the apparent optical thickness (
The dimensionless intensity can be used when a photocatalytic reactor with artificial UV radiation source is going to be scaled-up. Nevertheless, this expression cannot be applied for solar photoreactors because of the variability of the solar incident radiation. For this case, the LVRPA must be calculated based on the solar radiation emission models, considering the location latitude, time, and date and the clearness factor (
The optimization for photocatalytic reactors is usually intended for finding the operating conditions that ensure the best performance regarding the degradation of a specific substrate by photochemical oxidation. For the scaling-up process, this is a necessary step for making the heterogeneous photocatalysis a profitable and competitive technology.
The optimization can be carried out from the experimental data of pilot-scale photoreactors by using a simple empirical model. This model is built from a polynomial expression that involves the most relevant operating variables that affect the interest variable (e.g. relative degradation of the substrate).
Figure 3 shows an example where the surface response methodology was used for optimizing the decolorization of methylene blue (MB) with two bench-scale photoreactors [6].
Surface response plots and contour lines for methylene blue (MB) TiO2-based photocatalytic degradation: (a) CPC reactor and (b) tubular reactor. © 2005 Walter de Gruyter & Co. Originally published in Arias et al. [
In the reported study by Arias et al. [6], the tubular reactor corresponds to a 38 mm-ID borosilicate glass tube of 30 cm of length (Figure 4a), whereas the CPC reactor consists of the same glass tube but with a reflective collector that redistributes the reflected radiation (Figure 4b).
Bench-scale photoreactors used for MB decolorization; (a) tubular and (b) CPC.
For each case, the slurry was recirculated during 30 min under darkness conditions, in order to achieve the adsorption equilibrium of the dye on the catalyst surface. In previous results, the adsorption removal of the dye was around 10–15%. It was possible to build the polynomial models from results of a full-composite experimental design, where the TiO2 load and the initial pH of the slurry were selected as the controllable factors and the relative decolorization was the response variable. The optimization was made by using the first-derivative method for the obtained empirical expressions, and the optimal catalyst load and pH were found for each photoreactor [6].
This method allows finding optimums without a significant mathematical effort; however, its results only are scalable within the experimental conditions used for the pilot or bench-scale tests. Besides, the effects of mass transfer and the photon absorption effects are not considered in this empirical model. This leads to using of photoreactors of the same dimensional and hydrodynamic features than that used for the experimental tests. Therefore, this optimization method is limited because of its empirical nature, and it is necessary to consider a method that involves dimensionless numbers, more suitable for scaling-up.
The other method consists of optimizing the mathematical expressions of the photoreactor model. The first derivative (as optimization tool) might not be practical for finding the maximums or minimums of these mathematical expressions due to their intrinsic complexity, especially for “geometrically thick” photoreactors. Therefore, it is more recommendable to evaluate the property to be optimized in a wide range of the dependent variables. Despite the demanding calculation time of this type of optimization, this strategy is more applicable for the scaling-up process since the use of dimensionless numbers in the optimization ensures the similarity between scales.
The most suitable dimensionless parameter being used in the optimization is
From the LVRPA expression and supposing a constant UV radiation flux (
Volumetric rate of photon absorption per reactor length unit (VRPA/H) vs. TiO2 catalyst load; dashed line, tubular, and solid line, CPC reactor, with 30 W/m2 of incident UV radiation flux. © 2010 American Chemical Society. Originally published in Colina-Márquez et al. [
The plots shown in Figure 6 describe the behavior of the VRPA/H with tubular and CPC reactors of 32 mm ID and AEROXIDE® P-25 as the catalyst. From the previous definitions, these reactors are considered “optically thick,” and the LVRPA must be calculated using the six-flux model (SFM) approach. It is important to note that these plots are only applicable to the conditions of radiation and the tube diameter specified [7]. Although for scaling-up modular photoreactors, such as the CPC or tubular, the tube diameter can remain constant in the process. In the case of different diameter (or different reactor thickness),
Volumetric rate of photon absorption per reactor length unit (VRPA/H) vs. apparent optical thickness; dashed line, tubular and solid line, CPC reactor, with 30 W/m2 of incident UV radiation flux. © 2010 American Chemical Society. Originally published in Colina-Márquez et al. [
The design of full-scale photocatalytic plants keeps several similarities with the design of conventional plants. It is essential to consider the following parameters before starting to make the engineering calculations for the photocatalytic plant:
Type of reactor and reactor geometry.
Type of process regime (batch or continuous).
Photon source (artificial or solar).
Catalyst (supported or slurry).
Oxygen supply (artificial or natural).
Total handled volume.
Considering the amount of data and information gathered during the pilot-scale tests, the most relevant aspects of the plant design must be detailed in this phase.
The selection of the photoreactor is determinant for the photocatalytic performance. The rate of photon absorption is directly related to the type of photoreactor and construction materials. The selection depends on the type of photon source and the type of catalyst as well. A reactor with a fixed catalyst can have different geometry and specifications than a slurry reactor. The same considerations apply for solar photoreactors and artificial UV-based ones.
The type of regime defines, among other parameters, the size of the photocatalytic reactor. The plant size for a batch regime is usually larger than the size of a continuous regime; nonetheless, most of the literature about photocatalytic reactors [8, 9, 10] has been focused on the batch and the semi-batch regimes. This is generally associated with the small volumes (1–100 L) handled by the pilot-scale photocatalytic reactors.
The UV photon sources can be from UV-lamps (artificial) or the sun (natural). The main advantage of the UV-lamps is that they supply a constant flux of radiation, but their energy consumption supposes an additional cost for the operation of a full-scale plant. whereas, the solar radiation is a cheap and abundant form of UV photon supply (depending on the location). However, the radiation flux is highly variable, and it is only available during the daytime hours.
The fixed catalyst does not need to be separated in a later stage of the process, but it has mass transfer and photon absorption limitations; whereas the slurry catalyst can be more effective (especially for photon absorption effect), but it needs an additional separation stage that increases the costs for a full-scale plant.
The concentration of dissolved oxygen in water must be kept near to the saturation in order to avoid slower oxidation rates in the photocatalytic process. This oxygen can be supplied by the free contact of the falling stream with the atmospheric air, or with an air compressor with a sparging device. The free contact can be more suitable with small volumes, where the flow rate supplies enough turbulence to favor the vigorous contact between the water and the atmospheric air. Otherwise, the installation of an air compressor with the corresponding sparging system would be mandatory.
One of the limitations of the heterogeneous photocatalysis, aimed for wastewater treatment, is the total volume handled by the reaction system. The larger volumes require larger installed areas for the photoreactors. Although the size of the plant depends on the kinetics of the photocatalytic reaction, the total volume determines the final dimensions of the full-scale plant.
The criterion for selecting a reactor type considers two main aspects: performance and cost. The pilot-scale tests must provide the required information about these two features. Although we can find a wide variety of lab-scale and pilot-scale photocatalytic reactors in the scientific literature, we must ensure that the selected reactor is commercially available for full-scale applications or at least its assembling costs are affordable.
The photoreactors shown in Figure 7 can use artificial or solar radiation as a UV photon source, except for the annular reactor that only can use artificial UV radiation. Besides, catalysts can be used as slurry or fixed plates in any of the depicted reactors. Regarding the selection of the UV-photon source, the suggested strategy consists of decreasing costs by using solar radiation whenever is possible. If the solar radiation is feasible as a UV photon source, the photoreactor should be selected based on its performance, considering the variability of the radiation intensity.
Photocatalytic reactors: (a) flat plate, (b) tubular, (c) CPC, and (d) annular. © 2010 American Chemical Society. Originally published in Romero et al. [
Figure 7b shows a bench-scale tubular reactor. This reactor geometry is quite simple because it only consists of a tube made of a material with good UV radiation transmittance. As the catalyst is usually used as slurry, this reactor must operate under the turbulent regime in order to avoid that the catalyst precipitates.
This technology can receive direct and diffuse solar radiation on the reactor part that is directly exposed. However, some disadvantages can appear due to the soiling or the reactor wall due to the catalyst, such as mass transfer limitations and a low photon penetration inside the reactor bulk [11].
The compound parabolic collector (CPC) consists of two reflective screens located at the bottom of the tubular reactor [12]. These reflective screens are able to reflect the radiation to the bottom of the reactor, which improves the performance of this reactor over the tubular reactor (without collectors). The CPC configuration is one of the most used in reactors for solar applications [4, 5, 13, 14]. These collectors can redistribute the radiation and reflect it without concentrate, avoiding that the fluid temperature increases [15]. This reactor uses the diffuse and direct solar radiation as a UV photon source.
Figure 8 depicts the manner how solar radiation can be redistributed around the tubular receiver surface without concentrating the radiation. The equations that describe the curvature of the involute are as follows:
Solar radiation modeled with the ray-tracing technique: (a) direct radiation and (b) diffuse radiation.
where
The tilted flat plate reactor is also known as the falling film reactor, and it does not have concentrators. Because of its simplicity and low-cost construction, it is one of the most used reactors for pilot-scale studies. Figure 9 shows a solar flat plate with a supported catalyst. The main advantage of this configuration is that the entire falling film is exposed to solar radiation with no barriers. The optical thickness is smaller than the one observed in the tubular and the CPC reactors, which permits using higher catalyst loads and achieving better photon absorption rates. However, the most significant drawback of this type of reactor is the larger area occupied compared to that used in tubular reactors. In addition, there is no possibility of setting up this photoreactor like a modular unit because it would require a pump for each module.
Pilot-scale solar flat plate reactor used for degradation of a model pollutant.
The selection of the most suitable photoreactor depends not only on the reactor performance but also on its potential for being scaled-up. Moreover, the type and the concentration of the substrate are determinant for the photocatalytic reactor performance. A comparative assessment can provide useful information in order to make the right decision. This means that the pilot-scale tests must be carried out under the same operating conditions, or at least under very similar ones than the expected conditions of the full-scale plant.
Previous reports about photoreactor comparisons have been carried out with artificial UV-based and UV solar-based systems [16, 17, 18, 19]. Bandala et al. [17] study focused on the comparison of several solar tubular reactors with different types of collectors and without collectors for oxalic acid degradation. Although there was no significant difference between the performances of the photoreactors with collectors, their performance was higher than that of the photoreactor without collectors.
Figure 10 shows a case where a robust experimental design was used for showing the performance of three different solar photoreactors in the degradation of a mixture of commercial pesticides. This criterion for choosing the more suitable reactor was based on the higher signal-to-noise ratio exhibited. The signal is the overall photocatalytic removal, and the noise is the noncontrolled parameter that affects the performance significantly. This noise parameter corresponds to the accumulated UV solar radiation within a fixed time lapse.
Signal-to-noise ratio (S/N) for pesticides degradation with three different solar photoreactors.
In short, the most robust photoreactor was the flat plate, followed very closely by the CPC. This means that the selected reactor would be the flat plate for this case; however, there is a critical drawback for this reactor: a large flat plate would be needed for treating higher volumes of polluted wastewater. Therefore, the scaling-up of the flat plate would be impractical, and the best option would be then the CPC reactor. Additionally, this photoreactor can be used in modules, which can be mounted or dismounted easily.
The construction materials can vary depending on the reactor geometry and type. Nonetheless, all the materials considered must fulfill a common condition: they must be resistant to the atmospheric corrosion or at least, they must have protection against this phenomenon. In the case of outdoor plants, such as the solar photocatalytic reactors, the materials must resist prolonged solar radiation exposition or not undergo photodegradation under these conditions.
For photoreactors with tubular geometry, the optical properties of the construction material of the reactor must ensure the maximal use of the available photons that reach the reaction space. Regarding this aspect, the material must permit the free pass of the UV photons through it. This means that must have a high transmittance within the UV absorption range of the catalyst (e.g., 275–390 nm for the commercial P25 TiO2).
Figure 11 shows the transmittance of different materials used in photoreactors. According to Cassano et al. [20], the material with the best transmittance is the quartz, but commercial applications with this material would be expensive. The most feasible is then the borosilicate glass with low contents of iron (Pyrex® and Duran® commercial brands). However, polytetrafluoroethylene (PTFE) can be a cheaper option with comparable transmittance respect to the borosilicate glass.
Transmittance of different materials used in photoreactor design.
Figure 12 shows an example of a pilot-scale plant with a TiO2-based LFFS photocatalytic reactor aimed to degrade salicylic acid [21]. The kinetic law and the mass balance can be estimated from the concentrations measured at the sample ports and the proposed model for this photocatalytic reactor. The feed tank must be kept continuously agitated in order to maintain a uniform distribution of the concentration. Furthermore, it is essential to ensure a constant oxygen supply for avoiding that the photochemical reaction rate decreases because of the oxygen consumption. The following features must be considered for full-scale plant design:
Type, geometry, and construction materials of the photocatalytic reactor must remain the same for a full-scale plant.
Fluid regime (Reynolds number must be kept as constant).
Sampling ports located at relevant streams for collecting information about substrate concentrations along the process.
Instruments and process control for obtaining data of the operating variables such as temperature, UV radiation, pH, and dissolved oxygen.
Easy operation.
Pilot plant for a laminar flow falling film slurry (LFFS) photocatalytic reactor. © 1998 Elsevier Science Ltd. Originally published in Li Puma and Yue [
Although the temperature may not vary significantly during the tests, it is recommendable to include cooling or heating systems for controlling the temperature, especially with systems that use UV artificial light as a photon source. Regarding the pH, it is not necessary to control it. Besides the tremendous difficulties for controlling the pH, the improvement in the photocatalytic reactor performance is not considered significant enough.
The full-scale plant can resemble the pilot-scale plant in many aspects; however, there are other stages of the process that need to be considered. Despite the process simplicity, details such as the auxiliary equipment, pumping, and storage tanks cannot be underestimated.
The photocatalytic plants are aimed usually for wastewater treatment. Thus, the final product plant (the treated water) can be reused or spilled on the surface water bodies. This aspect must be considered in the plant layout (e.g., temporal storage tanks or pipelines for conducting the treated water to its final destination). Another essential feature is the catalyst recovery. Since the catalyst is used as a slurry in most of the cases, a separation-recovery subprocess should be considered.
Figure 13 shows the isometric drawing of a demonstration plant where 2 m3 of wastewater polluted with NBCS were treated. It is recommended to simplify the subprocess for recovering the TiO2 because of the installation and operation costs of a full-scale plant increase significantly. It is essential to specify the pump size correctly and consider the discharge pressure in order to avoid leaks or tubes breakage. As seen in the plant layout depicted in Figure 13, the modules were set up in two rows of 21 reactors each. This was done to reduce the pressure at the tube’s joints, but the Reynolds number must remain constant to avoid mass transfer limitations [22].
Isometric drawing of a demonstration solar photocatalytic plant for treatment of water contaminated with non-biodegradable chlorinated solvents (NBCS). © 1999 Elsevier Science Ltd. Originally published in Blanco et al. [
This section presents the main aspects that were considered in the construction and the operation of a full-scale solar photocatalytic plant for treating industrial wastewater from a flexographic industry. This full-scale plant is the first commercial solar photocatalytic installation in America.
Previous studies on laboratory and pilot-scale photoreactors were conducted to determine the technical feasibility of using photocatalysis as a viable treatment of 2 m3/d of water contaminated with industrial dyes, and consequently, it served as the basis for a technology-transfer deal with the company and a patent application [23, 24].
A major company in Colombia that manufactures notebooks was facing issues with the treatment of the wastewater produced after washing the rolls used for printing the lines of the notebooks. This residual effluent was contaminated with the industrial dye, which has proven to be resistant to biological treatments. Therefore, it was necessary to apply a novel technology (such as heterogeneous photocatalysis) that could ensure the color removal.
The primary objective was the reuse of the treated water for washing the printing rolls. The most important innovation of this photocatalytic process was the simple way in which the solid catalyst is reused without using complex and expensive systems to recover after each treatment process. The use of solar radiation was another significant advantage since the location has good solar light availability.
The process flow diagram of the full-scale solar photocatalytic plant is shown in Figure 14. This scheme can be used for different kinds of wastewater and which can be treated by photocatalysts. This photocatalytic process was applied for treating industrial residual wastewaters contaminated with recalcitrant compounds, in this case, flexographic dye residues. The industrial wastewater is generated from washing the printing rolls soiled with dye residues after a typical work cycle. This wastewater is collected in the tank T-1 and then pumped to the recycling-feed tank T-2 using the pump P-1. The wastewater stored in this tank is diluted with water in a ratio of 4:1. The first dilution of the process was made with fresh water; after that, treated water is used for this purpose. Once the tank was full, the catalyst was added for the first and the only time as far. The same catalyst has been reused in the subsequent treatments, since the plant started up in September 2009, and it will be removed when it has lost its activity.
Process flow diagram of the full-scale wastewater treatment photocatalytic plant.
The pump P-2 recirculates the slurry through the CPC photoreactors. As it was previously mentioned, the process has an average duration because it depends on the availability of solar radiation. The process is suspended under the following conditions: color removal from the contaminated effluent, adverse weather conditions (hard rain or strong winds), or if the sun has set. In case of the color removal, the next step is the catalyst settled down in order to separate the clear supernatant. This process lasts between 12 and 24 h, depending on the amount of treated water to be reused to wash the rollers.
Between 10 and 25% of the treated water from the recirculation tank T-2 are transferred by gravity to the intermediate storage tank T-3. When this tank has enough volume (1.5–2.5 m3), the treated water is pumped via P-3 to the secondary storage tank T-4. Finally, according to plant requirements, it is pumped via P-4 to the tank T-5, which is used to provide clean water for washing the soiled printing rolls, thus closing the treatment cycle [24].
Each photoreactor module comprises 10 tubes placed in five rows over the CPCs (Figure 15). The glass tubes are 32 mm ID and 1.4 mm of thickness manufactured by Schott Duran®. The tubes were cut from their original length of 1.5 m to 1.2 m in order to correspond the length of the sheets used for constructing the collectors. The tubes diameter must be selected between 25 and 50 mm, since diameters smaller than 25 mm are not feasible because of pressure drop limitations; whereas, diameters larger than 50 mm present photon absorption issues due to a significant photon scattering.
Main structure of the CPC photoreactor type and cross section of tubes and manifolds for CPC.
The collectors were constructed in high-reflectivity aluminum (80–90% of reflectivity), which should be weather resistant as well. The involutes, characteristic of the CPCs, as seen in Figure 15, were molded using a folding machine based on numerical control. The supporting structure was constructed with galvanized zinc sheets, as well as the guides that supported the collectors and the glass tubes. Between the glass tubes, anti-slip PVC joints were located (red-colored joints shown in Figure 15), which could permit torsion without damaging the glass tube during maintenance processes.
As mentioned before, the flow regime is another crucial aspect to be considered in the pilot plant design and the scaling process. The recycling pump must be specified in order to ensure the turbulent regime of the flow through the photoreactor [23]. The Reynolds number must be larger than 15,000, and this means that the flow rate must be larger than 24 L/min (for a 32-mm tube diameter). Table 1 shows the main accessories for hydraulic calculus.
Quantity per meter | Keq | |
---|---|---|
Elbows | 15 | 0.69 |
Connections | 5 | 0.50 |
Valve | 1 | 340.00 |
Tank outlet | 1 | 0.50 |
Straight pipe | 17 | — |
Fittings and straight pipe of the pilot plant.
From a simple mechanical energy balance (Bernoulli’s equation), the pump theoretical power was estimated (0.241 HP or 179.5 W). The commercially available pump had a nominal power of 0.5 HP with a maximum flow rate of 35 L/min.
A set of pilot plant tests with a simulated mixture of effluent were performed to assess the technical feasibility of heterogeneous photocatalysis for the removal of color from industrial wastewater polluted with a printing dye. The aim was to find suitable conditions for the operation of a larger-scale plan that would allow total discoloration of the industrial effluent. For this purpose, it was considered a robust experimental design. Subsequently, a rate law was obtained, considering the UV accumulated radiation as the independent variable.
The procedure used for the experimental work consisted in treating a constant volume of the diluted mixture with different concentrations of catalyst and fixing the treatment time. The accumulated radiation was measured for sunny and cloudy days in order to observe the solar CPC photoreactor performance under these weather conditions.
The color removal was measured by UV–Vis spectrophotometry, whereby the concentration of the mixture of dyes was indirectly obtained. Table 2 shows the conditions of the experimental pilot-scale tests.
Item | Description |
---|---|
Photoreactor | CPC with ten tubes Schott Duran® (32 mm ID) |
Area exposed | 1.25 m2 |
Pump | Centrifugal pump—½ HP of nominal power |
Flow rate | 32 L/min |
Total volume | 40 L |
Dye composition | Black Flexo: 50% w/w; Basonyl Blue 636®: 50% w/w |
Catalyst | Aeroxide® TiO2 P-25 |
Process water | Tap water |
Initial pH | 7.5 |
Temperature | 25–35°C |
Time of tests | 10 am to 4 pm |
Experimental conditions.
The experimental results are shown in Table 3, and Figure 16 shows samples collected before and after the photocatalytic treatment. The color was removed entirely, confirming the satisfactory performance of the solar photocatalytic reactor. This evidenced that the chromophore was eliminated. From these results, it was necessary to estimate the size of the full-scale plant for treating 2 m3/d of wastewater. The signal-to-noise ratios for the controllable factors (dilution and catalyst load) are shown in Table 4.
Internal arrangement | External arrangement (Noise) | |||
---|---|---|---|---|
Design parameter | UV accumulated radiation (KJ/m2) | |||
Exp | [TiO2] (g/L) | Dilution | High (>700) | Low (<700) |
1 | 0.4 | 1:8 | 89.3% | 70.4% |
2 | 0.8 | 1:8 | 90.0% | 48.4% |
3 | 0.4 | 1:4 | 47.4% | 29.3% |
4 | 0.8 | 1:4 | 91.5% | 50.0% |
Color removal corresponding to the pilot-scale experiments. © 2009 Walter de Gruyter & Co. Originally published in Colina-Márquez et al. [23] under CC BY-NC-ND 4.0 license.
Samples collected during a typical experiment before (left) and after (right) photocatalytic treatment.
Factor | Level | S/N ratio |
---|---|---|
Dilution | 1:4 | 32.74 |
1:8 | 36.59 | |
[TiO2] g/L | 0.4 | 33.15 |
0.8 | 35.73 |
Signal-to-noise ratio (S/N) for the robust experimental design.
© 2009 Walter de Gruyter & Co. Originally published in Colina-Márquez et al. [23] under CC BY-NC-ND 4.0 license.
Table 5 showed the experimental data obtained for the color removal respect to the time and the accumulated UV solar radiation. This data was used for fitting parameters of a Langmuir-Hinshelwood modified model, as seen in Table 6.
Time (min) | % Discoloration (sunny day) | Quv, KJ/m3 (sunny day) | % Discoloration (cloudy day) | Quv, KJ/m3 (cloudy day) |
---|---|---|---|---|
−30 | 0 | — | — | — |
0 | 58.1 | 0 | 0 | 0 |
20 | 64.5 | 5493.75 | 48.3 | 4481.25 |
40 | 71.0 | 12243.75 | 51.7 | 8953.13 |
60 | 74.2 | 18609.38 | 58.6 | 13312.50 |
80 | 80.7 | 25734.37 | 58.6 | 17690.63 |
100 | 83.9 | 32868.75 | 62.1 | 21881.25 |
120 | 83.9 | 40003.12 | 62.1 | 25218.75 |
180 | 90.4 | 59765.63 | 65.5 | 32681.25 |
240 | 90.4 | 73490.63 | 65.5 | 37762.50 |
Experimental data of the kinetic tests.
Type of day | Apparent rate constant (ppm·KJ/m3) | Adsorption equilibrium constant (1/ppm) |
---|---|---|
Sunny | 6.506 × 10−2 | 3.213 × 10−4 |
Cloudy | 1.507 × 10−3 | 9.419 × 10−3 |
Kinetics parameters from Langmuir-Hinshelwood model.
The apparent rate constants seem to be dependent on the accumulated energy and the type of the day. This implies that the color removal will be faster on a sunny day with the same accumulated UV radiation.
Finally, for treating 2 m3/day of contaminated wastewater with a dilution ratio of ratio 1:4, a total of 31 modules of CPC photoreactors were estimated. Nonetheless, during the project development, there were modifications to the design considerations, and 15 modules were implemented at last. An initial isometric drawing is shown in Figure 17.
Isometric draw of the solar photocatalytic plant with 15 CPC modules.
It is important to note that a conical-bottom tank and no secondary storage tank (for clear treated wastewater) were considered at first instance. Nonetheless, the tank was sized to handle 10 m3 per batch, and this was kept until the final design. The conical-bottom tank was selected as the first alternative in order to facilitate the catalyst precipitation and a future removal (when the catalyst was deactivated after several reuses).
Two standard plastic tanks were selected for being installed in the solar photocatalytic plant: one of 10 m3, designed for handling the recirculating wastewater, and another one of 4 m3, for storing the treated wastewater. The air-sparging system in the bottom of the recirculation-feed tank was installed in order to maintain the wastewater saturated with oxygen and to avoid limitations in the photocatalytic rate due to the consumption of this chemical species. Moreover, the constant agitation of the water due to the air bubbling helped to maintain the catalyst in suspension and avoid mass transfer limitations because of the solid precipitation during the operation.
The catalyst was settled down after each operation day after turning off the air sparging system. The plant shut down at sunset and the catalyst precipitated overnight. The clear water was transferred to the secondary storage tank and later reused for washing the printing rolls. Figure 18 shows an overview of the full-scale plant during its first day of steady operation in August 2009.
Full-scale solar photocatalytic plant for dye-polluted wastewater treatment: (a) CPC photoreactors and (b) recirculation-feed and treated water storage tanks.
Currently, this plant is operating at full capacity (4 m3 per day of wastewater). Some other contaminants are being fed to the photocatalytic system; therefore, it was necessary to include a pretreatment consisting of adsorption with activated carbon and a system for adding hydrogen peroxide.
Following the initial description of the physiologically corrective operation for tricuspid atresia by Fontan and Baudet [1] and Kreutzer and his associates [2] almost simultaneously, such surgery was widely adapted by most pediatric cardiologists and pediatric cardiac surgeons. This concept of bypassing the right ventricle (RV) was further extended to manage other cardiac defects with a functionally single ventricle.
The original surgery as described by Fontan and Baudet [1] consisted of (1) end-to-end anastomosis of superior vena cava (SVC) with the right pulmonary artery (PA) (classical Glenn procedure [3]), (2) connection of the separated right PA to the right atrium (RA) either directly or through an aortic homograft, (3) closure of the defect in the atrial septum, (4) insertion of a pulmonary valve homograft into the orifice of the inferior vena cava (IVC), and (5) ligation of the main PA, to entirely bypass the RV. On the basis of the procedures performed, one must infer that Fontan’s concept was to use the right atrium as a pumping chamber; therefore, he inserted a prosthetic valve into the IVC and right atrial-pulmonary artery junction.
On the contrary, Kreutzer et al. [2] anastomosed the right atrial appendage to the PA directly or by a pulmonary homograft and closed the ASD. Neither a Glenn procedure was performed nor a prosthetic valve was inserted in the IVC. Kreutzer’s view appears to be that the RA does not function as a pump and that the left ventricle functions as a suction pump in the system.
The surgical procedure as generally performed appears to shadow Kreutzer’s principle, and consequently, I have used the term “Fontan-Kreutzer operation” to describe this procedure [4, 5, 6, 7, 8]. However, because of priority of publication and more common usage in the literature, I will use the term “Fontan operation” in this chapter.
In this review, I will discuss the evolution of the Fontan concepts, the indications for Fontan operation, the Fontan procedure as used currently, and the results of old and current types of Fontan.
A number of modifications of the aforementioned surgery were made by these [1, 2] and other groups of investigators [9, 10] in the field. In this section, these concepts/procedures will be reviewed.
During the first 20 years after Fontan’s [1] and Kruetzer’s [2] description of the procedure, a number of modifications of the surgery were undertaken by several surgeons, as extensively reviewed and referenced elsewhere [9, 10]. In general, there was a consensus that there is no need for a classic Glenn anastomosis and that a prosthetic valve is not necessary in the IVC. Detailed review of these papers revealed that four major types of Fontan operations were being performed for physiologic correction of tricuspid atresia. These include (1) RA-PA anastomosis, direct or through a non-valved conduit; (2) RA-PA anastomosis through a valved conduit; (3) RA-RV anastomosis, direct or non-valved anastomosis; and (4) RA-RV anastomosis through a valved conduit.
In order to understand the advantages of one operation over the other, 17 papers published as of December 1990 that have documented adequate information to evaluate mortality and reoperation rates for each of the four types of Fontan surgery were reviewed. Pooled data from these 17 articles and statistical comparisons were presented in Tables I–IV for the interested reader [9]. This analysis revealed that atriopulmonary (RA-PA) connection appears to be better than atrioventricular (RA-RV) anastomosis and direct connection is better than valved or non-valved conduit anastomosis. Nevertheless, atrioventricular valved (homograft) conduit anastomosis appears to have advantages of (1) restoring a four-valved, four-chambered, biventricular heart and (2) lower right atrial pressure than with atriopulmonary connection. Based on these data [9, 10], the following conclusions were drawn: (1) direct atriopulmonary connection for children with tricuspid atresia with normally related great arteries and a small (<30% of normal) right ventricle without trabecular right ventricular component and for patients who had tricuspid atresia with transposition of the great arteries and (2) atrioventricular valved (homograft) conduit anastomosis for patients with tricuspid atresia and normally related great arteries but with a right ventricular size greater than 30% of normal and a trabecular right ventricular component [9, 10].
Bidirectional cavopulmonary anastomosis is a modified version of classic Glenn procedure in which the upper end of the divided SVC is anastomosed end to side to the right PA without disconnecting the latter from the main PA. Thus, the SVC blood is diverted into both the right and left PAs, justifying the term, “bidirectional.”
Experimental bidirectional cavopulmonary anastomosis was first studied by Haller et al. [11] in animal models, and its first clinical use was described by Azzolina et al. [12] in 1972. Other investigators [13, 14, 15, 16, 17] later applied this technique to palliate complex heart defects with decreased pulmonary blood flow. Hemodynamic advantages of the bidirectional Glenn procedure are improvement of effective pulmonary blood flow, decrease in total pulmonary blood flow, and reduction of left ventricular volume overloading. In addition, preservation of continuity of the pulmonary artery is an added advantage and may help facilitate a low-risk Fontan procedure. When both right and left SVCs are present, bilateral bidirectional Glenn shunts should be performed, especially if the bridging innominate vein is absent or small. Based on our own experience and that published in the literature [13, 14, 15, 16, 17], the author recommended serious consideration in employing bidirectional cavopulmonary anastomosis as an interim palliative procedure for patients who are at an increased risk for the Fontan procedure [9, 10].
Puga et al. [18] positioned a patch inside the right atrium to divert the IVC blood into the PAs; they had good results in the 12 patients that they used this technique. This was later called lateral tunnel and was widely used until extra-cardiac conduits came into vogue.
To better understand the valve-less atriopulmonary anastomosis type of Fontan, de Leval et al. [19] performed hydrodynamic studies and found that (1) the right atrium is not an efficient pump in non-valved atriopulmonary connections, (2) pulsations in a non-valved circulation truly generate turbulence with consequent decrease in net flow, and (3) energy losses occur in the non-pulsatile chambers, corners, and obstructions. In an attempt to address these deficiencies, they developed a procedure which they named “total cavopulmonary connection.” In this procedure, they connected the divided SVC, end to side, to the undivided right pulmonary artery (bidirectional Glenn), and the IVC blood is diverted through a composite intra-atrial tunnel (with the use of posterior wall of the right atrium as posterior wall of the tunnel) into the cardiac end of the divided superior vena cava, which in turn was connected to the PA. They felt that technical simplicity, maintenance of low right atrial and coronary sinus pressure, and reduction of risk of atrial thrombus formation are advantages of this type of operation. They performed this procedure on 20 patients and observed two early deaths and one late death. Postoperative hemodynamic studies were performed in 10 of the survivors which indicated good results. They recommended this type of operation for patients with a non-hypertrophied right atrium. While the total cavopulmonary connection was initially devised for patients with complex atrial anatomy and/or systemic venous anomalies, it has since been used extensively for all types of cardiac anatomy with one functioning ventricle and irrespective of venous anomalies.
Subsequent experimental studies by Sharma and his associates [20] indicated that complete or minimal offset between the orifices of the SVC and IVC into the right pulmonary artery decreases energy losses.
Marcelletti et al. [21, 22] used an interposition extra-cardiac conduit from the IVC to the PA in place of lateral tunnel used in total cavopulmonary connection in 1990. Subsequently, most surgeons adopted this modification of total cavopulmonary connection, and currently extra-cardiac conduits are used in most Fontan operations.
Since the vast majority of patients requiring Fontan operation present as neonates or in the early infancy, palliative procedures are performed at the time of presentation, and subsequently (at 12–18 months of age) the Fontan operation is undertaken. A considerable mortality (~16%) was seen with primary Fontan surgery, largely related to the impact of rapid changes in ventricular geometry and development of ventricular diastolic dysfunction. The concept of further staging the procedure by performing bidirectional Glenn procedure around 6 months of age followed by final Fontan between 12 and 18 months of age was introduced in early 1990s [23, 24]. Performing the Fontan procedure in stages appears to decrease overall mortality, most likely related to improving the ventricular function by correction of the afterload mismatch that is associated with one-stage Fontan procedure. At the current time, most centers prefer staged Fontan with bidirectional Glenn initially, followed later by extra-cardiac conduit diversion of the inferior vena caval blood into the PA.
In 1978, Choussat et al. proposed several criteria for performing Fontan operation [25]. Many cardiologists and surgeons have modified these criteria. Patients not meeting these criteria were deemed to be at a higher risk for a poor prognosis following a Fontan operation than patients who are within the limits of the set criteria. For the high-risk group, several investigators have proposed the concept of leaving a small atrial septal defect (ASD) open to facilitate decompression of the right atrium [26, 27, 28]. Laks et al. advocated closure of the atrial defect by constricting the preplaced suture in the postoperative period [28], while Bridges et al. [27] used a transcatheter closure method at a later date.
Higher cardiac output and significant decreases in the postoperative pleural effusions and systemic venous congestion were noted after a fenestrated Fontan procedure. In addition, the duration of hospitalization appears to have decreased. Nonetheless, these beneficial effects are at the expense of mild arterial hypoxemia and potential for paradoxical embolism.
While the fenestrated Fontan procedure was initially designed for patients at high risk for Fontan surgery, it has since been used in patients with modest or even low risk. Although rare, reports of cerebrovascular or other systemic arterial embolic events occurring after a fenestrated Fontan operation tend to contraindicate the use of fenestrations in patients with low or usual risk. In following years, fenestrated Fontan have been routinely used at most institutions. Some data indicate that routine fenestration is not necessary [29].
Patients who have undergone a fenestrated Fontan operation or patients who have a residual atrial defect, despite correction, may have clinically significant right-to-left shunt causing varying degrees of hypoxemia. These residual defects should be closed not only to address arterial desaturation but also for prevention of paradoxical embolism [30, 31]. Although two types of fenestration closure, namely, constriction of the preplaced suture in the postoperative period [26, 28] and device closure later [27] were described, device closure is opted at most institutions. Closure of such defects can be performed by using transcatheter techniques [32, 33, 34, 35]. The procedure is usually performed 6–12 months following fenestrated Fontan procedure. Although a number of devices have been used in the past [32, 33, 34, 35], at the present time, Amplatzer septal occluders are the most commonly used devices to accomplish such closures.
The indications for opting for a Fontan operation are patients who have one functioning ventricle. At first, patients with tricuspid atresia were selected for this procedure [1, 2]. Shortly thereafter, patients with double-inlet left (single) ventricle were added to the indications for Fontan [36]. Following description of surgical palliation of hypoplastic left heart syndrome (HLHS) by Norwood et al. [37, 38] in the early 1980s, HLHS became the major lesion requiring Fontan operation. Subsequently, mitral atresia (with normal aortic root), unbalanced atrioventricular septal defects (AVSDs), pulmonary atresia with intact ventricular septum with markedly hypoplastic right ventricle, and other complex heart defects with one functioning ventricle were selected for Fontan surgery.
Attempts to insert prosthetic ventricular septum for single ventricle patients met with problems, leading to abandoning such procedures. Thereafter, Fontan became a preferred treatment method. With reasonably good results of Fontan, the pendulum swung so that any patient who could not undergo complete repair became a candidate for Fontan.
A middle of the road method, the so-called one-and-one-half ventricle repair was developed for patients with pulmonary atresia with intact ventricular septum with modest-sized right ventricle. In this procedure, a bidirectional Glenn procedure to divert the SVC flow into the PA is performed and allows the small right ventricle to pump the IVC blood into the pulmonary circuit, and the patent foramen ovale is closed. It is generally considered to be a better option than Fontan, although, to my knowledge, there are no comparative studies to assess this issue.
Because of relatively high mortality rates (17.0–31.7%) [39, 40] and low actuarial survival rates (66.5% at 5 years and 64.4% at 15 years) [41] for unbalanced AVSD patients following Fontan, a number of institutions attempted single stage or staged biventricular repair or conversion from single ventricle (Fontan) to biventricular repair [39, 42, 43, 44, 45, 46, 47]. Detailed analysis by Nathan et al. [39] suggested that the biventricular repair and conversion from single ventricle (Fontan) to biventricular repair groups had reasonably similar mortality rates and a similar need for cardiac transplantation, but these parameters were lower than those seen in the Fontan palliation cohort.
Cardiac transplantation is a surgical alternative in the management of HLHS [48] and other single ventricle lesions. While heart transplantation was used at several institutions initially for HLHS, because of non-availability of donor hearts, most institutions have reverted to the Norwood/Fontan route. In addition, following successful cardiac transplantation, multiple medications for the prevention of graft rejection, frequent outpatient visits and periodic endomyocardial biopsy, to recognize rejection very early, are necessary in the management of these children. At the present time, cardiac transplantation is used for patients failing Fontan operation at a limited number of institutions.
As reviewed above, since the original description in the early 1970s, the Fontan procedure has undergone numerous modifications, and, at the present time it is best described as staged total cavopulmonary connection (TCPC) with an extra-cardiac conduit and fenestration. It is performed in three stages.
The majority, if not all, of patients who require Fontan operation (see Section 3. Indications for Fontan Operation) present during the neonatal and early infancy period, and the Fontan cannot be performed at that time because of naturally high PA pressure and high pulmonary vascular resistance (PVR). Therefore, Fontan, by necessity, becomes a multistage procedure. These babies should receive palliative intervention to allow them to reach the age and size to undergo successful Fontan surgery. The type of palliation is largely dependent upon the hemodynamic disturbance produced by multiple defects associated with a given congenital heart defect (CHD).
In neonates with decreased pulmonary blood flow, the ductus arteriosus should be kept open by administration of prostaglandin E1 (PGE1) intravenously at a dose of 0.05–0.1 mcg/kg/min. Once the O2 saturation improves, the dosage of PGE1 is gradually reduced to 0.02–0.025 mcg/kg/min to minimize the side effects of the prostaglandins. Following stabilization and diagnostic studies, as necessary to confirm the diagnosis, a more permanent way of providing pulmonary blood flow should be instituted. A number of methods to augment pulmonary blood flow have been used over the years [49, 50]. These include subclavian artery to ipsilateral PA anastomosis (classic Blalock-Taussig shunt), descending aorta to the left PA anastomosis (Potts shunt), ascending aorta to the right PA anastomosis (Waterston-Cooley shunt), SVC to right PA anastomosis, end-to-end (classic Glenn shunt), enlargement of the ventricular septal defect (VSD), formalin infiltration of the wall of the ductus arteriosus, central aortopulmonary fenestration or expanded polytetrafluoroethylene (Gore-Tex; W. L. Gore and Associates, Inc., Newark, Delaware) shunt, Gore-Tex interposition graft between the subclavian artery and the ipsilateral PA (modified Blalock-Taussig shunt), balloon pulmonary valvuloplasty, and stent implantation into the ductus arteriosus. Currently modified Blalock-Taussig (BT) shunt [51] by insertion of a Gore-Tex graft between the subclavian artery to the ipsilateral PA (Figure 1a) is performed by most surgeons to address pulmonary oligemia. More recently connecting the RV outflow tract with the PA via non-valve Gore-Tex graft is being used at several institutions to palliate pulmonary oligemia. Placement of a stent in the ductus arteriosus [52, 53, 54] and balloon pulmonary valvuloplasty (if the predominant obstruction is at the pulmonary valve level) [55, 56, 57] are other available options to augment the pulmonary blood flow.
Stage I Fontan. Selected frames form cineangiograms in two different babies; the first with pulmonary oligemia who received Blalock-Taussig (BT) shunt (a) and the second with pulmonary plethora who had pulmonary artery banding (PB) (b). C, catheter; LPA, left pulmonary artery; RPA, right pulmonary artery (Reproduced from [
In babies with increased pulmonary blood flow, optimal anti-congestive measures should be started immediately. Once the congestive heart failure (CHF) is adequately addressed, PA banding (Figure 1b) is performed [58] irrespective of control of CHF.
Infants with near normal pulmonary blood flow with O2 saturations in the low 80s do not need intervention and are clinically followed until Stage II.
Neonates with hypoplastic left heart syndrome usually have Norwood palliation (Figure 2) [37, 59] in the neonatal period; in this operation, the following procedures are performed: (1) the main pulmonary artery and the aorta are anastomosed together; additional prosthetic material is used as needed; (2) the pulmonary circulation receives blood supply by connecting the aorta to the PA via a modified BT shunt [51] (Figure 2b); (3) atrial septum is excised to allow unhindered blood flow from the left to the atrium; and (4) ductal tissue is removed, and coarctation of the aorta, if present is repaired. Some surgeons use alternative Sano shunt [60], connecting the RV outflow tract to the PA (Figure 2c) instead of BT shunt.
Stage I Fontan for hypoplastic left heart syndrome. Selected frames from cineangiograms demonstrating Norwood operation in which the neoaorta (NAo) and hypoplastic aorta (HAo) perfuse the coronary arteries (CAs) as shown in (a), Blalock-Taussig (BT) shunt as illustrated in (b) and Sano shunt as depicted in (c). (b) and (c) are from two different babies. LPA, left pulmonary artery; RPA, right pulmonary artery (Reproduced from [
In patients with inter-atrial obstruction, it should be relieved either by transcatheter methodology or by surgery as deemed appropriate for a given clinical scenario. If there is associated coarctation of the aorta, it should also be relieved. Some patients with double-inlet left ventricle may have significant obstruction at the level of bulboventricular foramen [61]. Similarly some babies with tricuspid atresia with transposition of the great arteries may have obstruction at the VSD level, causing obstruction to systemic blood flow [61, 62]. Such babies require Damus-Kaye-Stansel (connection of the aorta to the PA) [63] along with a BT shunt. Inter-atrial obstruction may be present frequently in babies with mitral atresia and single ventricle [64]. In such babies, predictable fall in PVR occurs following balloon or surgical relief of inter-atrial obstruction [64]; consequently, PA banding should be undertaken without hesitation at the time of relieving the atrial septal obstruction, so as to reduce the probability for CHF, lower the PVR and PA pressure, prevent pulmonary vascular obstructive disease (PVOD), and pave the way for Fontan approach [64].
Irrespective of the type of palliative surgery in the neonatal period, bidirectional Glenn procedure [12, 13, 14, 17, 23], namely, anastomosis of the SVC to the right PA, end-to-side (Figure 3) is performed around the age of 6 months. The previously performed BT or Sano shunt is ligated at the same time. Although performing the procedure at 6 months is generally adopted, it can be performed as early as 3 months provided normalcy of PA pressure and anatomy can be documented.
Stage II of Fontan. Selected frames from cineangiograms in two different children illustrating bidirectional Glenn operation in which the superior vena cava is anastomosed to the right pulmonary artery (RPA). Unobstructed flow from the SVC to the right (RPA) and left (LPA) pulmonary arteries is clearly seen. (Reproduced from [
In patients with persistent left SVC, bilateral bidirectional Glenn (Figure 4) is undertaken especially in patients with a small or absent left innominate vein. A bidirectional Glenn procedure may also be performed for patients with infrahepatic interruption of the IVC with azygos or hemiazygos continuation, and such a procedure is called a Kawashima procedure by some authorities.
Stage II Fontan. Selected frames from cineangiograms in a different child than shown in
Prior to the bidirectional Glenn procedure, normal PA pressures and adequate size of the branch PAs should be ensured by cardiac catheterization and cineangiography. Echo-Doppler or other imaging studies (magnetic resonance imaging [MRI] or computed tomography [CT]) is advocated at some institutions.
If PA stenosis is present, it may be addressed with balloon angioplasty or stent implantation, as deemed appropriate, or it may be addressed during the bidirectional Glenn procedure. Atrioventricular valve regurgitation, aortic coarctation, subaortic obstruction, and other abnormalities should also be repaired/addressed at the time of this operation.
During the final Stage III, the IVC flow is diverted into the PA along with creation of a fenestration. We arbitrarily divided [30] these procedures into Stage IIIA (diversion of IVC into the PA) and Stage IIIB (closure of the fenestration).
In the final Stage III, the total cavopulmonary connection is achieved by diverting the IVC flow into the PA either by a lateral tunnel [18, 65] or by an extra-cardiac, non-valved conduit (Figures 5 and 6) [21, 22]; the procedure is usually performed between the ages of 1 and 2 years, usually 1 year following the bidirectional Glenn procedure. Most surgeons seem to prefer extra-cardiac conduit to accomplish this final stage of Fontan. The majority of surgeons construct a fenestration, 4–6 mm in size, between the conduit and the atria (Figures 5 and 6) [27]. While the creation of fenestration during the Fontan operation was initially proposed for high-risk patients [27, 28], most surgeons now seem to prefer fenestration, since fenestration during the Fontan improves mortality rate and reduces morbidity during the immediate postoperative period [30].
Selected cine frames in posteroanterior (a) and lateral (b) views, demonstrating Stage IIIA Fontan procedure diverting the inferior vena caval flow into the pulmonary arteries via a non-valve conduit (Cond). Flow across the fenestration (fen) is shown by arrows in (a) and (b). HV, hepatic veins; LPA, left pulmonary artery; PG, pigtail catheter in the descending aorta; RPA, right pulmonary artery.
Selected cine frames in posteroanterior (a) and lateral (b) views in a different patient to the one shown in
Cardiac catheterization and selective cineangiography are usually performed shortly prior to Fontan conversion in order to assess the PA anatomy and pressures, trans-pulmonary gradient, PVR, and ventricular end-diastolic pressure and to assure that they are normal prior to proceeding with Fontan completion. At some institutions, MRI is used for this assessment instead of catheterization and angiography; however, the author’s preference is catheterization. During this catheterization, any significant collateral vessels that are present are also transcatheter-occluded by most cardiologists.
In the final stage, Stage IIIB, the fenestration is closed (Figures 7b, 8b, and 9B and C) by transcatheter methodology [27, 30, 31, 32, 33, 34, 35], usually 6–12 months after Fontan Stage, IIIA. In the past, most devices used to occlude ASDs [32, 33, 34, 35] were employed for this purpose, but at the present time, Amplatzer septal occluders are the most commonly used devices to accomplish such closures. If there are any other residual shunts, they should also be occluded (Figure 10) by device closure.
Stage IIIB. (a) Selected frames from cineangiograms in anteroposterior projection illustrating Stage IIIA of the Fontan operation in which the inferior vena caval (IVC) flow is diverted into the pulmonary arteries by a non-valve conduit (Cond). The fenestration (fen) is shown by the arrow in (a). (b) Closure of the fenestration with an Amplatzer septal occluder device (D) is shown with an arrow in (b). HV, hepatic veins; LPA, left pulmonary artery; RPA, right pulmonary artery (Reproduced from [
Stage IIIB. (a) Selected frames from cineangiograms in lateral view of the same patient illustrated in
(A) Selected cine frame from a Fontan conduit cineangiogram in anteroposterior view, demonstrating tubular fenestration (Tu fen) with opacification of the left atrium (LA). (B) The Tu fen is closed with an Amplatzer vascular plug (AVP). (C) A follow-up conduit cineangiogram after AVP implantation, showing complete occlusion of the Tu fen. TEE, transesophageal probe.
(A) A selected cineangiographic frame showing the Fontan conduit in lateral view, demonstrating a residual shunt (RS) at the superior aspect of the conduit (Cond). (B) The RS was occluded with an Amplatzer septal occluder device (AD); the residual shunt is no longer seen. TEE, transesophageal echo probe.
In children who have one functioning ventricle requiring Fontan correction, the systemic and pulmonary circulations work in-parallel in place of the usual in-series circulation. A fragile equilibrium between the two circulations must be preserved so that adequate systemic and pulmonary perfusions are maintained. There is substantial interstage mortality ranging from 5 to 15% [66, 67, 68] which may be due to restrictive atrial communication, obstruction of the aortic arch, blockage of the shunt, distortion of the PAs, atrioventricular valve insufficiency, or a combination thereof [66]. Intercurrent illnesses such as dehydration, respiratory tract illness, or fever disturb this balance and make the patients to become critically ill and have been blamed for interstage mortality [66, 68]. The surgically created BT and Sano shunts may also get thrombosed producing severe hypoxemia [69]. Indeed, these abnormalities produce significant interstage mortality [67]; these appear to occur more frequently between Stages I and II than between Stages II and III. Consequently, extreme vigilance in managing these patients should be maintained by the caregiver [68, 70]; even trivial illnesses must be aggressively monitored and addressed as appropriate.
Immediate and follow-up results of both older and current types of Fontan will be reviewed in this section.
The results of original Fontan [1, 2] and its earlier modifications, namely, RA-to-PA or RA-to-RV anastomosis either directly or via valved or non-valved conduits, revealed high initial mortality rates. The initial mortality rates ranged from 10 to 26% [9, 10, 71, 72]. Furthermore, the postoperative stay in the intensive care setting was prolonged.
The initial mortality following staged, total cavopulmonary connection has decreased remarkably [73, 74, 75, 76, 77, 78]. Patients who had total cavopulmonary connection without fenestration had initial mortality rates ranging from 8 to 10.5% [73, 74, 75], while subjects who had total cavopulmonary connection with fenestration had slightly lower (4.5–7.5%) initial mortality rates [76, 77, 78].
In one large single institutional study examining the results of 500 consecutive Fontan surgery patients [77], early failure was associated with high (≥19 mm Hg) mean PA pressure, young age at surgery, heterotaxy syndrome, a right-sided tricuspid valve as systemic atrioventricular valve, distorted pulmonary arteries, an atriopulmonary connection, no Fontan fenestration, and longer cardiopulmonary bypass time.
These investigators also observed that a significant improvement in morbidity and mortality from early (first quartile—early failures: 27.1%) to the more recent time (last quartile—early failures: 7.5%) occurred [77]. This progress appears to be related to increasing surgical and intensive care experience as well as to more recently introduced Fontan modifications.
Long-term follow-up results were also poor with older types of Fontan [9, 10]. The late mortality rates varied from 1 to 11%, and when early and late mortality rates were combined, they varied between 11 and 25%. The need for reoperations was present in 1–11% of patients. Factors adversely influencing late mortality and reoperation rates are earlier calendar year of operation, age of patient at the time of surgery, type of prior palliative procedures, hypoplasia, distortion or obstruction of PAs, subaortic obstruction, significant mitral valve insufficiency, elevated PA pressure or resistance, decreased left ventricular function, increased left ventricular muscle mass, asplenia syndrome, and others [9, 10].
Following the introduction of staged cavopulmonary anastomosis (both lateral tunnel and extra-cardiac conduit diversion of IVC blood to the PA), the long-term outcomes have improved. In one study in which results of follow-up for 10.2 ± 0.6 years of 196 patients were examined, the estimated Kaplan-Meier survival was 93 and 91% at 5 and 10 years, respectively [79]. An equally impressive finding was freedom from supraventricular arrhythmias in 96 and 91% of patients at 5 and 10 years following surgery. In a different study, the actuarial survival 15 years following surgery was 85% [80]. But, late re-interventions were necessary in 12.7% of patients. When lateral tunnel and extra-cardiac conduit types of Fontan were compared, the outcomes were found to be similar for both groups [81, 82].
Using fenestration during Fontan appears to improve early mortality and morbidity, particularly demonstrated in high-risk patents [83]. A more recent analysis in a smaller group of patients did not demonstrate significant advantage of fenestrated Fontan over the non-fenestrated [84]. However, the general consensus is that using fenestration during Fontan decreases mortality and morbidity during the postoperative period [30, 76, 77, 78].
Periodic follow-up following Fontan is generally recommended. These patients are evaluated at 1, 6, and 12 months after Stage IIIB (device closure of fenestration) and yearly thereafter. During the follow-up, platelet-inhibiting doses of aspirin 2–5 mg/kg/day in children or clopidogrel 75 mg/day in adults to prevent thrombus formation and angiotensin-converting enzyme inhibitors for afterload reduction are generally prescribed. Electrocardiograms and echocardiograms are generally performed during evaluation of these patients with additional imaging studies, as indicated. Any abnormalities, as and when detected, are addressed.
During follow-up, a number of complications were reported, and these include arrhythmias, obstructed Fontan pathways, cyanosis, paradoxical emboli, thrombi, development of collateral vessels, and protein loosing enteropathy [30, 31, 85]. These complications appear to be more frequent with older types of Fontan than with the currently used staged, total cavopulmonary connection with extra-cardiac conduit and fenestration. When such complications develop, they should be promptly investigated and treated. In the ensuing paragraphs, a brief review of some of these complications will be presented.
Arrhythmias were more frequently seen in patients with old Fontan (atriopulmonary connection) than with staged TCPC. The observed arrhythmias were typically atrial arrhythmias, namely, atrial flutter/fibrillation and supraventricular tachycardia. Initially, anti-arrhythmic medications are used to control the rhythm disturbance. This should be followed by hemodynamic and angiographic assessment to identify obstructive lesions in the Fontan pathways. The obstructive lesions should be treated with balloon angioplasty, stent, or surgery, as applicable. Continued rhythm abnormality calls for radiofrequency ablation. Although the success rate of radiofrequency ablation is high in 80% range [86], rates of recurrence range from 30 to 40%. In subjects who have resistant arrhythmias, reducing the atrial mass, switch to TCPC with concomitant Maize procedure is advisable [87]. A few patients develop atrioventricular block or sick sinus syndrome which may require pacemaker implantation. Fortunately, ventricular arrhythmias are less frequent.
Obstructions in Fontan circulation may occur. Obstructive lesions in the SVC or IVC may arise but are less frequently seen. However, branch pulmonary artery stenoses may be seen more often. Obstructions within the lateral tunnel or extra-cardiac conduit are also uncommon, but may occur due to thrombus formation and will be addressed in the section on “Thrombus formation.” In the presence of signs and symptoms indicative of obstruction in the Fontan pathway, prompt investigation to confirm such obstruction should be made. While echo studies are useful in young children, poor echo windows in adolescents and adults may require MRI and CT, and/or angiographic studies to confirm or exclude such obstructive lesions. If the obstructive lesions are detected, they should be promptly relieved by balloon angioplasty or stent implantation (Figure 11) [88]. Surgery may be needed in rare occasions.
Selected frames from cineangiograms of the pulmonary artery in posteroanterior view illustrating normal right pulmonary artery (RPA) and narrowed (arrow) left pulmonary artery (LPA) prior to (a) and after (b) stent (arrow) placement in an adolescent who had Fontan surgery several years earlier (Reproduced from [
Sometimes connections between lateral tunnel and extra-cardiac conduit on the one hand and the atrium on the other persist. These residual defects and intentionally created Fontan fenestrations result in right-to-left shunt because the pressure in the Fontan conduit is higher than that of the atrial pressures. These residual defects will result in arterial desaturation and may become the site of paradoxical embolism with consequential transient ischemic attacks (TIAs), cerebrovascular accidents (CVAs), and systemic emboli. These residual defects as well as Fontan fenestrations should be occluded by transcatheter techniques to return O2 saturations to normal and decrease the likelihood for paradoxical embolism [30, 32, 33, 83, 88, 89]. Amplatzer septal occluder (St. Jude Medical, Inc., St Paul, MN) is currently most common device used to accomplish this (Figures 7,8, and 10). Tubular fenestrations may be closed with Amplatzer vascular plug devices (St. Jude Medical, Inc.) (Figure 9). Test occlusion of the residual defect or fenestration is suggested to ensure that adequate cardiac output is maintained following defect occlusion [89, 90], especially if the procedure is performed shortly after fenestrated Fontan. Late follow-up results of fenestration closure are good [33].
There is a tendency for thrombus formation in the Fontan pathway; the reported prevalence was 15–30% [91, 92]. Regrettably the usual transthoracic echo-Doppler evaluation may not discover these thrombi. However, transesophageal echocardiography, MRI, or CT studies may be necessary to detect these thrombi. In an attempt to prevent thrombus formation in the Fontan circuit, thromboprophylaxis is commonly recommended; both warfarin and aspirin have been utilized in the past for this purpose. A multicenter, randomized trial was conducted to compare the efficacy of these two drugs; results showed less than optimal results with both drugs and no significant difference between the two regimens [93]. In the author’s experience, most children are prescribed with aspirin for thromboprophylaxis which may be switched to clopidogrel (Plavix) as the children approach adulthood.
Despite seemingly adequate thromboprophylaxis, some patients develop thrombosis of the Fontan conduits (Figure 12A). We initially employ thrombus dissolving drug therapy (tPA, heparin, etc.). If the thrombi do not resolve, we have employed stenting of the conduit to compress the thrombi against the conduit wall [94]. An example from our experience is shown in Figure 12.
(A) Selected frame from a cineangiogram of a Fontan conduit in lateral view, illustrating a thrombus (arrow in (A)). (B) and (C) position of a stent (St) before (B) and after (C) its complete expansion. (D) Cineangiographic frame demonstrating the widely patent stent after stent deployment. Also, note the residual shunt (RS) at the superior aspect of the conduit (seen in (A) and (D)). The RS was occluded with an Amplatzer septal occluder device (AD) shortly after the cine shown in (D). (F) A follow-up cineangiogram 1 year later shows the continued patency of the conduit with no RS. TEE, transesophageal echo probe (Reproduced from [
Systemic venous to pulmonary venous and systemic arterial to pulmonary arterial collateral vessels may develop in some patients after the Fontan procedure [88, 95]. These may develop both shortly after the procedure and during late follow-up. Systemic venous to pulmonary venous collateral vessels produce arterial hypoxemia. In addition, they may also become potential sites for paradoxical embolism. Systemic arterial to pulmonary arterial (or venous) collateral vessels produce left ventricular volume overload. These abnormal vessels should be transcatheter-occluded with coils, vascular plugs, and ductal occluding devices depending upon the size and accessibility. Examples from the author’s experience of occluding these vessels are shown in Figures 13–16 [88, 95, 96].
(a) Selected frame from a left innominate vein (L inn) cineangiogram in posteroanterior view demonstrating an anomalous vein (AV) opacifying the atrial mass (not marked). (b) Following occlusion with Gianturco coil (arrow), the AV is completely occluded and the systemic arterial saturation improved (Reproduced from [
(A) Selected frame from a cineangiogram in lateral view with the catheter positioned at the superior vena cava/azygos junction illustrating a fistula which results in opacification of the left atrium (LA). (B) The fistula was occluded with an Amplatzer vascular plug (arrow—AVP) with some residual flow. (C) Follow-up SVC injection shows complete occlusion by the AVP (Reproduced from [
(A) Selected cine frame from an internal mammary artery (IMA) cineangiogram in the lateral view, demonstrating multiple small collateral vessels arising from the pericardiophrenic (PCP) branch, which resulted in a significant levophase (not shown). (B) Following occlusion with a Gianturco coil (C), there is complete occlusion of this vessel (Reproduced from [
(A) Selected cine frame from a right subclavian artery (RSA) cineangiogram showing branches (white arrows) of the thyrocervical (TC) trunk which supplied a number of small vessels, giving a good degree of levophase. (B) Complete occlusion occurred following the implantation of a Gianturco coil (C) (Reproduced from [
Protein losing enteropathy (PLE) is a grave long-term complication of Fontan with a prevalence of 11.1% in older types of Fontan [85, 97]. However, the incidence appears to have come down to 1.2% with staged TCPC [85, 98]. The reason for development of PLE is not understood. Intestinal protein loss secondary to lymphatic distension which in turn may be due to elevated pressure in systemic veins is considered to be a pathogenic mechanism. But, PLE has been seen even in patients with “normal” Fontan circuit pressures. Therefore, the true cause of PLE remains a mystery. The symptoms and signs of PLE are diarrhea, edema, ascites, and/or pleural effusions. Laboratory abnormalities include reduced serum albumin and elevated fecal alpha-1 antitrypsin levels. The PLE diagnosis may be confirmed with technetium 99m-labeled human serum albumin scintigraphy [99].
Because of high mortality rate seen with PLE, speedy diagnosis and implementing aggressive management strategies are important [85]. At first, supportive therapy such as medium-chain triglycerides diet, infusion of intravenous albumin, and replacement of immunoglobulins should be undertaken. Obstructive lesions in the Fontan pathway should be scrutinized, and aortopulmonary connections should be screened for. If identified, they should be treated with appropriate transcatheter measures. Surgical therapy is indicated if they cannot be adequately addressed with transcatheter intervention. A variety of other treatment regimens, including prednisone, elementary diet, calcium replacement, regular high-molecular-weight heparin, low-molecular-weight heparin, somatostatin, high-dose spironolactone, sildenafil, and resection of localized intestinal lymphangiectasia, have been utilized in the past with varying degrees of success [85].
Following a short trial of any of the above treatment modes, largely on the basis of the cardiologist’s preference, a more definitive treatment methods such as lessening the conduit pressure by creating a fenestration between the conduit and the atrium [99, 100, 101], converting atriopulmonary type of Fontan to TCPC [87, 102, 103], instituting sequential atrioventricular pacing [104, 105], and performing cardiac transplantation [106, 107, 108] should all be considered. Again, it is essential to emphasize that timely treatment should be instituted as soon as PLE is identified [85]. Fortunately, the need for use of these methods has progressively diminished since the wide use of staged TCPC.
Since the initial description of the Fontan operation in the early 1970s by Fontan, Kruetzer, and their associates, several modifications have been introduced. These include avoiding classic Glenn anastomosis; not using a prosthetic valve in the IVC; RA-PA anastomosis, direct or through a non-valved conduit; RA-PA anastomosis through a valved conduit; RA-RV anastomosis, direct or non-valved anastomosis; RA-RV anastomosis through a valved conduit; bidirectional Glenn procedure (cavopulmonary anastomosis); lateral tunnel; total cavopulmonary connection; extra-cardiac conduit, staged Fontan; fenestrated Fontan; and closure of Fontan fenestration. Currently staged, total cavopulmonary connection with extra-cardiac conduit and fenestration has become the most commonly used multistage surgery in accomplishing the Fontan.
The indications for Fontan are patients who have one functioning ventricle, and these include tricuspid atresia, double-inlet left ventricle, HLHS, mitral atresia with normal aortic root, unbalanced AVSDs, pulmonary atresia with intact ventricular septum with markedly hypoplastic right ventricle, and other complex heart defects with one functioning ventricle. Recently there has been a trend for biventricular repair, particularly for patients with unbalanced AVSDs.
Stage I consists of performing palliative procedures on the basis of pathophysiology of the defect complex at presentation, usually in the neonatal period. Stage II involves performing a bidirectional Glenn procedure (diversion of the superior vena caval blood flow into both lungs) usually at about the age of 6 months. During stage IIIA diversion of the IVC blood flow into the lungs, usually by an extra-cardiac conduit plus a fenestration, usually at about the age of 2 years. Stage IIIB consists of transcatheter closure of the fenestration 6–12 months after Stage IIIA.
Both the immediate and follow-up results have remarkably improved, both in terms of mortality and morbidity, following the introduction of staged total cavopulmonary connection with extra-cardiac conduit and fenestration with subsequent catheter closure of Fontan fenestration. Complications do occur during follow-up, and they should be addressed as and when they are detected.
The author declares no conflict of interest.
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",metaTitle:"Prior Publication Policy",metaDescription:"Prior Publication Policy",metaKeywords:null,canonicalURL:"/page/prior-publication-policy",contentRaw:'[{"type":"htmlEditorComponent","content":"A significant number of working papers, early drafts, and similar work in progress are openly shared online between members of the scientific community. It has become common to announce one’s own research on a personal website or a blog to gather comments and suggestions from other researchers. Such works and online postings are, indeed, published in the sense that they are made publicly available. However, this does not mean that if submitted for publication by IntechOpen they are not original works. We differentiate between reviewed and non-reviewed works when determining whether a work is original and has been published in a scholarly sense or not.
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\\n"}]'},components:[{type:"htmlEditorComponent",content:'A significant number of working papers, early drafts, and similar work in progress are openly shared online between members of the scientific community. It has become common to announce one’s own research on a personal website or a blog to gather comments and suggestions from other researchers. Such works and online postings are, indeed, published in the sense that they are made publicly available. However, this does not mean that if submitted for publication by IntechOpen they are not original works. We differentiate between reviewed and non-reviewed works when determining whether a work is original and has been published in a scholarly sense or not.
\n\nThe significance of Peer Review cannot be overstated when it comes to defining, in our terms, what constitutes a published scientific work. Peer Review is widely considered to be the cornerstone of modern publishing processes and the key value-adding contribution to a scholarly manuscript that a publisher can make.
\n\nOther than the issue of originality, research misconduct is another major issue that all publishers have to address. IntechOpen’s Retraction & Correction Policy and various publication ethics guidelines identify both redundant publication and (self)plagiarism to fall within the definition of research misconduct, thus constituting grounds for rejection or the issue of a Retraction if the work has already been published.
\n\nIn order to facilitate the tracking of a manuscript’s publishing history and its development from its earliest draft to the manuscript submitted, we encourage Authors to disclose any instances of a manuscript’s prior publication, whether it be through a conference presentation, a newspaper article, a working paper publicly available in a repository or a blog post.
\n\nA note to the Academic Editor containing detailed information about a submitted manuscript’s previous public availability is the preferred means of reporting prior publication. This helps us determine if there are any earlier versions of a manuscript that should be disclosed to our readers or if any of those earlier versions should be cited and listed in a manuscript’s references.
\n\nSome basic information about the editorial treatment of different varieties of prior publication is laid out below:
\n\n1. CONFERENCE PAPERS & PRESENTATIONS
\n\nGiven that conference papers and presentations generally pass through some sort of peer or editorial review, we consider them to be published in the accepted scholarly sense, particularly if they are published as a part of conference proceedings.
\n\nAll submitted manuscripts originating from a previously published conference paper must contain at least 50% of new original content to be accepted for review and considered for publication.
\n\nAuthors are required to report any links their manuscript might have with their earlier conference papers and presentations in a note to the Academic Editor, as well as in the manuscript itself. Additionally, Authors should obtain any necessary permissions from the publisher of their conference paper if copyright transfer occurred during the publishing process. Failure to do so may prevent Us from publishing an otherwise worthy work.
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\n\nNewspaper and magazine articles usually do not pass through any extensive peer or editorial review and we do not consider them to be published in the scholarly sense. Articles appearing in newspapers and magazines rarely possess the depth and structure characteristic of scholarly articles.
\n\nSubmitted manuscripts stemming from a previous newspaper or magazine article will be accepted for review and considered for publication. However, Authors are strongly advised to report any such publication in an accompanying note to the External Editor.
\n\nAs with the conference papers and presentations, Authors should obtain any necessary permissions from the newspaper or magazine that published the work, and indicate that they have done so in a note to the External Editor.
\n\n3. GREY LITERATURE
\n\nWhite papers, working papers, technical reports and all other forms of papers which fall within the scope of the ‘Luxembourg definition’ of grey literature do not pass through any extensive peer or editorial review and we do not consider them to be published in the scholarly sense.
\n\nAlthough such papers are regularly made publicly available via personal websites and institutional repositories, their general purpose is to gather comments and feedback from Authors’ colleagues in order to further improve a manuscript intended for future publication.
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\n\nNevertheless, Authors are encouraged to disclose the existence of any internet postings in which they outline and describe their research or posted passages of their manuscripts in a note to the Academic Editor. Please note that we will not strictly enforce this request in the same way that we would instructions we consider to be part of our conditions of acceptance for publication. We understand that it may be difficult to keep track of all one’s internet postings in which the researcher´s current work might be mentioned.
\n\nIn cases where there is any overlap between the Author´s submitted manuscript and related internet postings, we will generally not consider it to be an instance of self-plagiarism. This also holds true for any co-Author as well.
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Tan",authors:[{id:"105182",title:"Dr.",name:"Khaled",middleName:null,surname:"Elraies",slug:"khaled-elraies",fullName:"Khaled Elraies"},{id:"110813",title:"Dr.",name:"Isa",middleName:null,surname:"Tan",slug:"isa-tan",fullName:"Isa Tan"}]},{id:"37036",doi:"10.5772/45947",title:"Advances in Enhanced Oil Recovery Processes",slug:"advances-in-enhanced-oil-recovery",totalDownloads:26772,totalCrossrefCites:14,totalDimensionsCites:19,abstract:null,book:{id:"1589",slug:"introduction-to-enhanced-oil-recovery-eor-processes-and-bioremediation-of-oil-contaminated-sites",title:"Introduction to Enhanced Oil Recovery (EOR) Processes and Bioremediation of Oil-Contaminated Sites",fullTitle:"Introduction to Enhanced Oil Recovery (EOR) Processes and Bioremediation of Oil-Contaminated Sites"},signatures:"Laura Romero-Zerón",authors:[{id:"109465",title:"Dr.",name:"Laura",middleName:null,surname:"Romero-Zerón",slug:"laura-romero-zeron",fullName:"Laura Romero-Zerón"}]},{id:"37040",doi:"10.5772/48016",title:"Microorganisms and Crude Oil",slug:"microorganisms-and-crude-oil",totalDownloads:5535,totalCrossrefCites:5,totalDimensionsCites:16,abstract:null,book:{id:"1589",slug:"introduction-to-enhanced-oil-recovery-eor-processes-and-bioremediation-of-oil-contaminated-sites",title:"Introduction to Enhanced Oil Recovery (EOR) Processes and Bioremediation of Oil-Contaminated Sites",fullTitle:"Introduction to Enhanced Oil Recovery (EOR) Processes and Bioremediation of Oil-Contaminated Sites"},signatures:"Dorota Wolicka and Andrzej Borkowski",authors:[{id:"111706",title:"Dr.",name:"Dorota",middleName:null,surname:"Wolicka",slug:"dorota-wolicka",fullName:"Dorota Wolicka"}]},{id:"32407",doi:"10.5772/37392",title:"Spreading and Retraction of Spilled Crude Oil on Sea Water",slug:"spreading-and-retraction-of-spilled-crude-oil-on-sea-water",totalDownloads:3460,totalCrossrefCites:2,totalDimensionsCites:11,abstract:null,book:{id:"2287",slug:"crude-oil-exploration-in-the-world",title:"Crude Oil Exploration in the World",fullTitle:"Crude Oil Exploration in the World"},signatures:"Koichi Takamura, Nina Loahardjo, Winoto Winoto, Jill Buckley, Norman R. Morrow, Makoto Kunieda, Yunfeng Liang and Toshifumi Matsuoka",authors:[{id:"112525",title:"Dr",name:"Norman",middleName:null,surname:"Morrow",slug:"norman-morrow",fullName:"Norman Morrow"},{id:"112695",title:"Dr.",name:"Koichi",middleName:null,surname:"Takamura",slug:"koichi-takamura",fullName:"Koichi Takamura"},{id:"112889",title:"Dr.",name:"Nina",middleName:null,surname:"Loahardjo",slug:"nina-loahardjo",fullName:"Nina Loahardjo"},{id:"112890",title:"Dr.",name:"Winoto",middleName:null,surname:"Winoto",slug:"winoto-winoto",fullName:"Winoto Winoto"},{id:"112891",title:"Dr.",name:"Jill",middleName:null,surname:"Buckley",slug:"jill-buckley",fullName:"Jill Buckley"},{id:"114293",title:"Mr.",name:"Makoto",middleName:null,surname:"Kunieda",slug:"makoto-kunieda",fullName:"Makoto Kunieda"},{id:"114294",title:"Dr.",name:"Yunfeng",middleName:null,surname:"Liang",slug:"yunfeng-liang",fullName:"Yunfeng Liang"},{id:"114296",title:"Dr.",name:"Toshifumi",middleName:null,surname:"Matsuoka",slug:"toshifumi-matsuoka",fullName:"Toshifumi Matsuoka"}]}],mostDownloadedChaptersLast30Days:[{id:"66537",title:"Gases Reservoirs Fluid Phase Behavior",slug:"gases-reservoirs-fluid-phase-behavior",totalDownloads:1275,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"This chapter discusses the fundamentals of the phase behavior of hydrocarbon fluids. Real reservoir fluids contain many more than two, three, or four components; therefore, phase-composition data can no longer be represented with two, three or four coordinates. Instead, phase diagrams that give more limited information are used. The behavior of reservoir of a reservoir fluid during producing is determined by the shape of its phase diagram and the position of its critical point. Many of producing characteristic of each type of fluid will be discussed. Ensuing chapters will address the physical properties of these three natural gas reservoir fluids, with emphasis on retrograde gas condensate gas, dry gas, and wet gas.",book:{id:"8229",slug:"oil-and-gas-wells",title:"Oil and Gas Wells",fullTitle:"Oil and Gas Wells"},signatures:"Eman Mohamed Mansour, Mohamed El Aily and Saad Eldin Mohamed Desouky",authors:[{id:"277274",title:"Dr.",name:"Eman M.",middleName:null,surname:"Mansour",slug:"eman-m.-mansour",fullName:"Eman M. Mansour"}]},{id:"37036",title:"Advances in Enhanced Oil Recovery Processes",slug:"advances-in-enhanced-oil-recovery",totalDownloads:26772,totalCrossrefCites:14,totalDimensionsCites:19,abstract:null,book:{id:"1589",slug:"introduction-to-enhanced-oil-recovery-eor-processes-and-bioremediation-of-oil-contaminated-sites",title:"Introduction to Enhanced Oil Recovery (EOR) Processes and Bioremediation of Oil-Contaminated Sites",fullTitle:"Introduction to Enhanced Oil Recovery (EOR) Processes and Bioremediation of Oil-Contaminated Sites"},signatures:"Laura Romero-Zerón",authors:[{id:"109465",title:"Dr.",name:"Laura",middleName:null,surname:"Romero-Zerón",slug:"laura-romero-zeron",fullName:"Laura Romero-Zerón"}]},{id:"32409",title:"Crude Oil Transportation: Nigerian Niger Delta Waxy Crude",slug:"crude-oil-transportation-nigerian-niger-delta-waxy-crude-oil",totalDownloads:9819,totalCrossrefCites:6,totalDimensionsCites:10,abstract:null,book:{id:"2287",slug:"crude-oil-exploration-in-the-world",title:"Crude Oil Exploration in the World",fullTitle:"Crude Oil Exploration in the World"},signatures:"Elijah Taiwo, John Otolorin and Tinuade Afolabi",authors:[{id:"105162",title:"Dr.",name:"Elijah",middleName:"Adekunle",surname:"Taiwo",slug:"elijah-taiwo",fullName:"Elijah Taiwo"},{id:"111892",title:"Mr.",name:"John",middleName:null,surname:"Otolorin",slug:"john-otolorin",fullName:"John Otolorin"},{id:"111893",title:"Dr.",name:"Tinuade",middleName:null,surname:"Afolabi",slug:"tinuade-afolabi",fullName:"Tinuade Afolabi"}]},{id:"37042",title:"Hydrocarbon Pollution: Effects on Living Organisms, Remediation of Contaminated Environments, and Effects of Heavy Metals Co-Contamination on Bioremediation",slug:"heavy-metals-interference-in-microbial-degradation-of-crude-oil-petroleum-hydrocarbons-the-challenge",totalDownloads:8881,totalCrossrefCites:20,totalDimensionsCites:43,abstract:null,book:{id:"1589",slug:"introduction-to-enhanced-oil-recovery-eor-processes-and-bioremediation-of-oil-contaminated-sites",title:"Introduction to Enhanced Oil Recovery (EOR) Processes and Bioremediation of Oil-Contaminated Sites",fullTitle:"Introduction to Enhanced Oil Recovery (EOR) Processes and Bioremediation of Oil-Contaminated Sites"},signatures:"Shukla Abha and Cameotra Swaranjit Singh",authors:[{id:"107491",title:"Dr.",name:"Swaranjit Singh",middleName:null,surname:"Cameotra",slug:"swaranjit-singh-cameotra",fullName:"Swaranjit Singh Cameotra"},{id:"120073",title:"M.Sc.",name:"Abha",middleName:null,surname:"Shukla",slug:"abha-shukla",fullName:"Abha Shukla"}]},{id:"69187",title:"Damage Formation: Equations of water block in oil and water wells",slug:"damage-formation-equations-of-water-block-in-oil-and-water-wells",totalDownloads:713,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"Water block or invasion of water into the pores of reservoir forms during the operations of water-based drilling, injection, many perforations, completion fluids, and some other particular processes in the reservoir (such as fingering and conning). Subsequently, the alteration in the shape or composition of the fine particles such as clay (water-wet solids), as a result of the stress on it, in the flow path of the second phase can lead to the permeability decline of reservoir. Consequently, the solvents such as surfactants (as demulsifiers) to lower the surface tension as a phenomenon associated with intermolecular forces (known as capillary action) during flowback are consumed to avoid the emulsions and sludge mostly in the near-wellbore zone or undertreatment and under-injection radius of the reservoir. However, in addition to surging or swabbing the wells to lower the surface tension, using solvents as the wettability changing agent along with base fluid is a common method in the water block elimination from the wellbore, especially in the low permeability porous media or the reservoirs latter its average pressure declined below bubble point. For more profitability, after using solvents in various reservoir characterizations, the trend of their behavior variations in the different lithologies is required to decide on the removed damage percentage. The investigations on this subject involve many experimental studies and have not been presented any mathematical formulas for the damage of water block in the water, oil, and gas reservoirs. These formulas determine selection criteria for the applied materials and increase variable performance. An integrated set of procedures and guidelines for one or more phases in a porous media is necessary to carry out the step-by-step approach at wellhead. Erroneous decisions and difficult situations can also be addressed in the injection wells or saltwater disposal wells, in which water block is a formation damage type. Misconceptions and difficult situations resulting from these injuries can increase water saturation in borehole and affect the fluid transmissibility power in reaching far and near distances of the wellbore, which results in injection rate loss at the wellhead. Accordingly, for the equations of water block here, a set of variables, of a particular domain, for defining relationships between rock- and fluid-based parameters are required. For these equations, at first, the structural classifications of fracture and grain in the layers (d1, d2, and d3) are defined. Afterward, the equations of overburden pressure (Pob) for a definite sectional area surrounding the wellbore for any lithology (in the three categories relative to porosity) are obtained by these structural classifications and other characteristics of rock and fluid. Naturally, prior to equations of overburden pressure in a definite layer or a definite sectional area around the wellbore, the overburden pressure of a point in a layer in the first four equations is expressed. In the second, the estimated overburden pressure equations are applied in driving the equations of removed water block (Bk). The equations of removed water block, themselves, are divided into two groups of equations, i.e., equations of oil wells and equations of saltwater disposal wells, and each group of equations is again classified based on the wettability of reservoir rock (oil-wet or water-wet) in the two ranges of porosity. In the third, after describing these equations (i.e., equations of Bk), the other new variable included in the equations of removed water block, that is, the acid expanding ability (Ik) for a definite oil layer around the wellbore, is presented, which is extracted from (1) the full characteristics of reservoir (including experimental and empirical equations of overburden pressure), (2) the history of producing well, (3) core flooding displacement experiments at laboratory, and (4) the acidic and alkaline solvent properties. Finally, the rate of forming water block (q) is calculated using the value calculated for the removed water block, and, additionally, the trend of using solvents is determined for different rocks using these sets of equations. The acceptance criteria are the nature of rock and fluid in the reservoir circumstances. Equations as a quick and cost-efficient method are also introduced, providing computational methods to determine how much and how the blocked fluid in the reservoir layers is removed from the definite strata around the wellbore after injection operation of acids and solvents, with various degrees of acidity, to the types of lithology during acidizing operations. Moreover, these equations can calculate the removed water block (Bk) after injecting solvents to the different acidic properties in the acidizing, for two categories of porosity which cover all lithologies. The equations also ascertain in the current reservoir conditions how much solvent for a type of lithology is to be mixed with other base fluids.",book:{id:"8229",slug:"oil-and-gas-wells",title:"Oil and Gas Wells",fullTitle:"Oil and Gas Wells"},signatures:"Mohammad Karimi, Mohammad Reza Adelzadeh, Mojtaba Mosleh Tehrani, Maryam Mohammadipour, Ruhangiz Mohammadian and Abbas Helalizade",authors:[{id:"298820",title:"Mr.",name:"M.",middleName:null,surname:"Karimi",slug:"m.-karimi",fullName:"M. 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