Improving Flow Dynamics in Fontan Surgeries

描述（申请人提供）：先天性心脏病的发病率 是1%，其中20%的发生率对应于复杂的 只有一个有效泵室的先天性病变;后者是 称为单心室心脏缺陷。这些统计数据显示， 每1,000个新生儿中就有1个只有一个心室。外科治疗 因为这些缺陷包括绕过心脏的右侧， 将体循环和肺循环串联起来， 单心室泵手术后存活的患者需要终身的，密集的 医疗护理。心脏病专家报告说， 这类患者需要超过50%的时间， 强调了患者问题的严重性以及 改善现有的治疗方法。目前的外科手术 单心室患者的选择是全腔静脉 连接（TCPC）。本多机构BRP的中心假设 该项目是开发术前基于计算机的手术设计 方法将推进最先进的临床治疗， 单心室患者，改善他们的生活质量。的发展 这些方法将以六个具体目标为指导：（一）制定基线 基于各种TCPC流体动力学评估的TCPC手术模板 （ii）研究移植物材料对局部流体的影响 TCPC后的动力学;（iii）编制解剖和材料数据库， 验证基于计算机的手术规划和设计协议;（iv）提高 通过计算机模拟开发外科规划和设计 有助于预测潜在术后流动状况的工具， 任何给定患者;（v）研究TCPC后血流动力学的改善 通过治疗先天性异常来实现 主动脉;（vi）确定减少TCPC后中心静脉的可行性 使用压力调节器/泵进行加压。

Description (provided by applicant): The incidence of congenital heart defects is 1 percent with 20 percent of these incidences corresponding to complex congenital lesions with only one effective pumping chamber; the latter are termed single ventricle heart defects. These statistics show that 2 babies out of every 1,000 births will be born with a single ventricle. Surgical treatment for these defects consists of bypassing the right side of the heart and connecting the systemic and pulmonary circulations in series with the univentricular pump. Patients who survive surgery require lifelong, intensive medical attention. Cardiologists report that the 20 percent of their caseload consisting of such patients requires over 50 percent of their time; this underscores the gravity of problems in patients as well as the need for improvements in existing treatment methods. The current surgical procedure of choice for patients with a single ventricle is the total cavopulmonary connection (TCPC). The central hypothesis for this Multi-Institutional BRP Project is that development of pre-operative computer-based surgical design methods will advance the state-of-the-art in clinical treatment of single-ventricle patients and improve their quality of life. The development of these methods will be guided by six specific aims: (i) development of baseline TCPC surgical templates based on fluid dynamic assessments of various TCPC configurations; (ii) study the impact of graft materials on local fluid dynamics following TCPC; (iii) compile anatomic and materials databases for validating computer-based surgical planning and design protocols; (iv) improve surgical planning and design through development of computer-based simulation tools facilitating prediction of potential post-operative flow conditions in any given patient; (v) investigate improvements in post-TCPC hemodynamics achieved by treating congenital abnormalities associated with the ascending aorta; (vi) determine the feasibility of reducing post-TCPC central venous pressure using a pressure regulator/pump.