Assesment of mew oprative method using sutologous right atriun in order to improve the QOL in comlex heart defects.

评估自体右心房手术方法以改善复杂心脏缺陷的生活质量。

• 批准号: 08671547
• 负责人: SUZUKI Kazuhiko
• 金额: $ 0.64万
• 依托单位: Jikei university School of medicine
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1996
• 资助国家: 日本
• 起止时间: 1996 至 1997
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-08671547/
• 关键词: Fontan operation; intrapulmonary Doppler; ANP; BNP; TCPC; Autologous right atriuw flap; 自己石房壁フラップ; ナトリウム利尿ペプチド

The adventages of total cavopulmonary connection (TCPC) have been acknowledged at this present. With regard to atrial pulsatile force, however, the original Fontan procedure is superior to TCPC.So, we have extended the application of using autologous right atrial flap to TCPC,and pulmonary flow was assessed by intrapulmonary doppler echo cardiography (Flow wire) and measured ANP,BNP so called cardiac hormone in ten patients who underwent TCPC procedure.Pulmonary flow pattern was obtained by pulse doppler, using 15Mhz transducer of 0.014inch guide wire type (Flow wire).Group I(N=6) showed pulsatile flow signal and group II(N=4) was not pulsatile. Three of six in group I were tricuspid atresia and the other three were univentricular heart. Three of four in group II were univentricular heart and one was pure pulmonary atresia. Age was 8.8(]SY.+-。[)5.7 years in group I and 16.0(]SY.+-。[)9.1 years in group II.On the procedure of rerouting from inferior venae cavae to the pulmonary artery, the autologous right atrial wall was used in all cases of group I and two cases of group II.Right atrial volume index (ml/m<@D12@>D1) was 30(]SY.+-。[)5 in group I and 20(]SY.+-。[)8 in group II.The ejection fraction (%) of right atrium was 33(]SY.+-。[)11 in group I and 9(]SY.+-。[)2 in group II.ANP and BNP were recognized no tendency among two groups.Conclusion : 1) Using autologous right atrial wall in TCPC could provide pulsatile flow in pulmonary circulation. 2) Accelerating factors of this effect are tricuspid atresia and yonger age. 3) ANP and BNP so called cardiac hormone were recognized no tendency in this assesment.

全空腔连接（TCPC）的优越性目前已得到公认。在心房搏动力方面，Fontan手术上级TCPC，因此，我们将自体右心房瓣应用于TCPC，并采用肺内多普勒超声心动图评估肺血流方法：对10例TCPC手术患者应用血流导丝（Flow Wire）测定心钠素（ANP）、脑钠素（BNP），脉冲多普勒（Pulse Doppler）测定肺血流频谱，使用15 MHz的0.014英寸导丝型探头（Flow wire），I组（N=6）显示搏动性血流信号，II组（N=4）无搏动性血流信号。I组6例中3例为三尖瓣闭锁，3例为单心室。II组4例中3例为单心室，1例为单纯肺动脉闭锁。年龄8.8 ± 1.5岁。[)5.7Ⅰ组16.0（±）SY. [)9.1右房容积指数（ml/mD 12）D1 = 30（] SY. ±），右房容积指数（ml/mD 12）D1 = 30（]SY. ±）。[)5 I组和20（±）SY. [)8右房射血分数（%）为33 ± 0.05。[)11 I组和9组（]SY. ±. [)2结论：1）自体右心房壁TCPC可提供肺循环搏动性血流; 2)三尖瓣闭锁和年龄的增长是其加速因素。3)心钠素（ANP）和脑钠素（BNP）在本实验中无明显变化趋势.