Improving Flow Dynamics in Fontan Surgeries

改善 Fontan 手术中的血流动力学

• 批准号: 6910005
• 负责人: AJIT P YOGANATHAN
• 金额: $ 104.3万
• 依托单位: GEORGIA INSTITUTE OF TECHNOLOGY
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-07-01 至 2007-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6910005
• 关键词: aorta disorder; cardiovascular shunt surgery; children; circulatory assist; clinical research; computer assisted patient care; computer simulation; computer system design /evaluation; congenital cardiovascular shunt; heart surgery; heart ventricle; hemodynamics; human subject; human therapy evaluation; image processing; informatics; intracardiac pressure; magnetic resonance imaging; patient care planning; patient oriented research; postoperative complications; postoperative state; sheep; technology /technique development

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.

描述（由申请人提供）：先天性心脏病的发生率 是 1%，其中 20% 的事件对应于复杂的情况 仅一个有效泵室的先天性病变；后者是 称为单心室心脏缺陷。这些统计数据表明，有 2 名婴儿外出 每 1,000 名新生儿中就有一个出生时就有单心室。手术治疗 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。手术幸存的患者需要终生强化治疗 医疗关注。心脏病专家报告称，他们 20% 的病例 包含此类患者需要花费超过 50% 的时间；这 强调了患者问题的严重性以及治疗的必要性 现有治疗方法的改进。目前的手术流程是 单心室患者的选择是全腔肺 连接（TCPC）。该多机构 BRP 的中心假设 项目是开发术前基于计算机的手术设计 方法将推进临床治疗的最先进水平 单心室患者并提高他们的生活质量。的发展 这些方法将以六个具体目标为指导： (i) 制定基线 基于各种 TCPC 流体动力学评估的 TCPC 手术模板 配置； (ii) 研究移植材料对局部液体的影响 TCPC 之后的动态； (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方案； (四) 改进 通过开发计算机模拟进行手术规划和设计 有助于预测潜在术后血流状况的工具 任何特定患者； (v) 研究 TCPC 后血流动力学的改善 通过治疗与上升相关的先天性异常来实现 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/泵施加压力。