A new bridging technique to heart transplantation (Tx)-Feasibility of monoventricularization (Monovent) of bilateral ventricles with LVAD

心脏移植（Tx）的新桥接技术——双侧心室左心室单心室化（Monovent）的可行性

基本信息

批准号：
63480322
负责人：
YOZU Ryohei
金额：
$ 2.75万
依托单位：
Keio 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：
1988
资助国家：
日本
起止时间：
1988 至 1989
项目状态：
已结题

项目摘要

Since the prognosis of VSP and MR after acute MI was remarkably poor, heart transplantation would be necessary for many of those patients. A new bridging technique was examined in canine modles. The bilateral ventricles communicating through VSP were monoventricularized with mitral valve closure and maintained the pulmonary circulation which had low vascular resistance. The systemic circulation was maintained by a LVAD placed between the left atriumand the aorta.VSP and MR were made in eight mongrel dogs (pulmonary to systemic flow ratio=2.24<plus-minus>0.90). Then they were monoventricularized and equipped with LVAD. The hemodynamic state was evaluated A) in intact hearts, B) after VSP and MR were made and C) after monoventricularization and assisted circulation by LVACardiac output was A) 90.60<plus-minus>23.16, B) 42.23<plus-minus>15.76 and C) 73.43<plus-minus>15.14 ml/kg/min(A vs C:NS, A vs B and B vs C:p<0.01); mean aortic pressure was A) 96.75([SY.+-.[)24.69, B) 30.25([SY.+-.[)11.08 and C) 66.50<plus-minus>18.40 mm Hg (A vs B:p<0.01, A vs C and B vs C:p<0.05); central venous pressure was A)4.76<plus-minus>1.68, B) 8.94<plus-minus>2.17 and C) 10.68<plus-minus>2.43 mm Hg (A vs c:p<0.01, A vs B:p<0.05, aMean pulmonary arterial pressure and mean left atrial pressure did not show any significant difference among the three groups.This study supports the feasibility of maintenance of hemodynamics by monoventricularization and LVAD in patients with acute MI complicating VSP and MR.

由于急性MI后VSP和MR的预后非常差，因此许多患者需要心脏移植。在犬模块中检查了一种新的桥接技术。通过VSP通信的双侧心室用二尖瓣闭合进行单脑检查，并保持血管耐药性低的肺循环。通过放置在左心房之间的LVAD来维持全身循环，并在八只杂种犬中进行主动脉和MR（肺流量比= 2.24 <plus-minus> 0.90）。然后它们进行单文化并配备了LVAD。对血液动力学状态进行评估a）在完整的心脏中，b）进行VSP和MR，c）单室化和lvacardiac out量进行单次培养和辅助循环后，a）90.60 <plus-minus> 23.16，b）42.23 <plus-minus> 15.76和c 15.76 and c）73.43 <plus）73.43 <plus-minus> 15.14 a（a） B和B vs c：p <0.01）;平均主动脉压力为a）96.75（[SY。+ - 。[）24.69，b）30.25（[SY。+ - 。[）11.08和c）66.50 <plus-minus> 18.40 mm Hg（A VS B：vs vs b：p <0.01，a vs vs vs vs vs vs c and b vs c：p vs c：p <0.05）;中心静脉压力为a）4.76 <plus-minus> 1.68，b）8.94 <plus-minus> 2.17和c）10.68 <plus-minus> 2.43 mm hg（a vs vs vs c：p <0.01，a vs vs vs vs vs vs vs b：p <0.05，amean肺动脉压力和左肺动脉压力均不显着。急性MI复杂VSP和MR的患者单脑室和LVAD的血液动力学。