Experimental study for the bypass of the right heart (Fontan procedure) Evaluation of the bidirectional cavopulmonary connection for Fontan Procedure

点击翻译按钮获取中文摘要

A hepatomegaly and arrhythmias are often induced by high light atrial pressure after right atrium-pulmonary artery bypass (so-called Fontan procedure).Clinically, long-term benefit that these complications are reduced by the bidirectional cavopulmonary shunt in conjunction with Fontan procedure has been demonstrated. However, the mechanism of reducing right atrial load by the bidirectional cavopulmonary shunt is unknown.Therefore, the effects of this operation on hemodynamics and light atrium were studied.Four anesthetized dogs were underwent both a Fontan procedure with closure of tricuspid valve and a bidirectional cavopulmonary shunt. All dogs kept normal sinus rhythm.There were no statistical differences between only a Fontan procedure (bidirectional cavopulmonary shunt closed) and a Fontan procedure with bidirectional cavopulmonary shunt in heart rate (137<plus-minus>22 versus 136<plus-minus>23 bpm), cardiac output (O. 95<plus-minus>0.20 versus 0.91<plus-minus>0.26 l/min), mean blood pressure (37.0<plus-minus>9.0 versus 34.8<plus-minus>7.6 mmHg), Ieft atrial pressure (5.7<plus-minus>4.3 versus 4.9<plus-minus>4.1 mmHg) superior vena caval pressure (14.9<plus-minus>2.7 versus 15.1<plus-minus>2.9 mmHg) and right atrial pressure (16.6<plus-minus>4.0 versus 16There was a significant difference in right atrial myocardial length(100 versus 97.0<plus-minus>1.8%) (p<0.05This result shows that a bidirectional cavopuhnonary shunt in conjunction with a Fontan procedure decreases a right atrial muscle stress. This may improve postoperative hepatomegaly and arrliythmias.