Partial cavopulmonary assist from the inferior vena cava to the pulmonary artery improves hemodynamics in failing Fontan circulation: a theoretical analysis.
Partial cavopulmonary assist from the inferior vena cava to the pulmonary artery improves hemodynamics in failing Fontan circulation: a theoretical analysis.
复制标题
从下腔静脉到肺动脉的部分腔肺辅助可改善 Fontan 循环失败的血流动力学：理论分析。
DOI：
10.1007/s12576-015-0422-3
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发表时间：
2016
期刊：
影响因子：
--
通讯作者：
Sugimachi M.
中科院分区：
文献类型：
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作者：
Shimizu S;Kawada T;Une D;Fukumitsu M;Turner MJ;Kamiya A;Shishido T;Sugimachi M.
失败Fontan患者的腔静脉辅助（CPA）在临床环境中仍然是一个具有挑战性的问题。为了评估从下腔静脉（IVC）到肺动脉（PA）的部分CPA的有效性，我们使用Fontan循环的计算模型进行了理论分析。心腔和血管系统分别用时变弹性模型和修正的三元件Windkessel模型描述。将描述为非线性函数的旋转泵插入IVC和PA之间。当肺血管阻力指数在2.1 ~ 5.9Wood单位m ~ 2范围内变化时，部分CPA与全CPA一样有效地维持心脏指数，并与全CPA相比显著降低IVC压力。然而，部分CPA显著增加了上级腔静脉压力。从全CPA到部分CPA的修改可能是患有高IVC压力的Fontan失败患者的有效替代方案。
Cavopulmonary assist (CPA) for failing Fontan patients remains a challenging issue in the clinical setting. To evaluate the effectiveness of a partial CPA from the inferior vena cava (IVC) to the pulmonary artery (PA), we performed a theoretical analysis using a computational model of the Fontan circulation. Cardiac chambers and vascular systems were described as the time-varying elastance model and the modified three-element Windkessel model, respectively. A rotational pump described as a non-linear function was inserted between the IVC and the PA. When pulmonary vascular resistance index varied from 2.1 to 5.9 Wood units m2, the partial CPA maintained cardiac index as efficiently as total CPA and markedly reduced the IVC pressure compared with total CPA. However, the partial CPA increased the superior vena cava pressure substantially. The modification from total to partial CPA is potentially an effective alternative in failing Fontan patients suffering from high IVC pressure.