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

右心搭桥术（Fontan 手术）的实验研究 Fontan 手术双向腔肺连接的评估

• 批准号: 01480345
• 负责人: NAITO Yasuaki
• 金额: $ 2.37万
• 依托单位: Wakayama Medical University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for General Scientific Research (B)
• 财政年份: 1989
• 资助国家: 日本
• 起止时间: 1989 至 1990
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-01480345/
• 关键词: Fontan procedure; Bidirectional cavopulmonary shunt; Arrhythmia; Biーdirectional Glenn shunt; 右房負荷の軽減; グレン手術

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.

右心房-肺动脉搭桥术（Fontan手术）后，心房内高压常引起肝肿大和心律失常，临床上已证实双向腔静脉分流术联合Fontan手术可减少这些并发症的发生。本实验观察了双向腔静脉分流术对血流动力学和心房光的影响。单纯Fontan手术（关闭双向腔静脉分流）与Fontan手术（关闭双向腔静脉分流）的心率（137 <plus-minus>22 vs 136 <plus-minus>23 bpm）、心输出量（O.平均<plus-minus><plus-minus>血压（37.0 ± <plus-minus>9.0 vs 34.8 <plus-minus>± 7.6 mmHg）、左房压（5.7 <plus-minus>± 4.3 vs 4.9 <plus-minus>± 4.1 mmHg）、上级腔静脉压（14.9 ± <plus-minus>2.7 vs 15.1 ± <plus-minus>2.9 mmHg）和右房压（16.6 ± <plus-minus>4.0 vs 16 mmHg）。右房心肌长度（100 vs 97.0 ± 1.8%）有显著差异<plus-minus>（p&lt;0.05）。这可能会改善术后肝肿大和心律失常。