Assist effect of stimulated right latissimus dorsi muscle flap on right atrial function and preventive effect of regurgitation from right atrium to SVC,IVC in atrial systole using synchronously stimulated latissimus dorsi muscle flap wrapped around SVC an

同步刺激背阔肌皮瓣包裹SVC和同步刺激右背阔肌皮瓣对右心房功能的辅助作用及心房收缩期右心房向SVC、IVC反流的预防作用

• 批准号: 07671447
• 负责人: SHOJI Yoshimi
• 金额: $ 1.22万
• 依托单位: Tohoku University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1995
• 资助国家: 日本
• 起止时间: 1995 至 1996
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-07671447/
• 关键词: Dynamic Cardiomyoplasty; pedicled latissimus dorsi muscle; right atrial function; Fontan operation; Dynamic Cardiomyoplasty; 右心機能; Fontan手術; Dynamic cardiomyoplasty

The purpose of this experiment is to investigate whether the right functioning latissimus dorsi muscle flap has not only the assist effect on right atrial function but also the preventive effect on bicaval regurgitant flow in atrial systole. The latissimus dorsi muscle flap is divided into three segments which are over the rt. atrium (RA) and wrapped round SVC and IVC,respectively. Cariomyostimulator (Myostim Model 7220, Telektronics Inc. Austrlia) is used as a burst stimulator that makes 5 pulse trains (pulse width 0.4 msec, interval 30 ns, 5V). Aortic flow velocity is measured with Doppler flow probe (Dimension system VF-1) and mean aortic pressure (AoP), right atrial pressure (RAP) are measured with Statham P23b transducer (Gould Inc. Cardiovascular Products, Oxnard, Calif.). Steady-state data and data during burst stimulation were obtained under muscle wrapping around SVC and IVC and without wrapping. Burst stimulation under muscle wrapping significantly increased maximal RAP but decreased mean RAP,mean AoP and mean aortic flow velocity in comparison with these parameters under no stimulation. Burst stimulation without wrapping significantly increased maximal RAP and mean RAP but decreased AoP compared with these parameters under no stimulation. Mean aortic flow velocity on stimulation was greater than that without muscle contraction (no significance). These data indicates stimulated muscle wrapping has mainly the effect of inflow obstruction but only right functioning latissmus dorsi muscle flap over RA improves right atrial function may increase aortic flow velocity.

本实验旨在探讨右功能性背阔肌瓣是否既有辅助右心房功能的作用，又有预防心房收缩期双腔静脉返流的作用。将背阔肌肌瓣分成三段，分别包裹上腔静脉和下腔静脉，置于右心房上方。Cariomoystimulator（Myostim 7220型，Telektronics Inc. Austria）用作产生5个脉冲串（脉冲宽度0.4 msec，间隔30 ns，5V）的爆发刺激器。用多普勒血流探头（Dimension system VF-1）测量主动脉血流速度，用斯坦森P23 b传感器（Gould Inc.）测量平均主动脉压（AoP）、右心房压（RAP）。Cardiovascular Products，奥克斯纳德，加利福尼亚州）。在SVC和IVC周围肌肉包裹和不包裹的情况下获得稳态数据和爆发刺激期间的数据。与无刺激下的这些参数相比，肌肉包裹下的爆发刺激显著增加了最大RAP，但降低了平均RAP，平均AoP和平均主动脉血流速度。与无刺激条件下相比，无包裹的爆发刺激显著增加了最大RAP和平均RAP，但降低了AoP。刺激时的平均主动脉血流速度大于无肌肉收缩时的平均主动脉血流速度（无显著性）。这些数据表明，刺激肌肉包裹主要有流入道阻塞的效果，但只有右功能背阔肌瓣在RA改善右心房功能可能会增加主动脉血流速度。