Improving Flow Dynamics in Fontan Surgeries

描述(申请人提供)：先天性心脏缺陷的发生率 是1%，其中20%的事件对应于复杂 只有一个有效泵室的先天性病变；后者是 称为单心室性心脏缺陷。这些统计数据显示，有两个婴儿出生了 每1000名新生儿中，将有一个脑室出生。外科治疗 因为这些缺陷包括绕过心脏的右侧和 将体循环和肺循环串联起来 单室泵。在手术中幸存下来的患者需要终身的、密集的 医疗救治。心脏病专家报告称，他们工作量的20% 由这样的病人组成需要他们50%以上的时间；这 强调了患者问题的严重性以及需要 改进现有的治疗方法。目前的外科手术程序 单脑室患者的选择是全腔肺 连接(TCPC)。这一多机构BRP的中心假设 该项目是开发术前基于计算机外科设计 方法将促进临床治疗的最新水平 改善单心室患者的生活质量。的发展。 这些方法将以六个具体目标为指导：(1)制定基线 基于不同TCPC流体动力学评价的TCPC手术模板 构型；(Ii)研究移植材料对局部体液的影响 TCPC之后的动力学；(Iii)编制解剖学和材料数据库 验证基于计算机的手术规划和设计方案；(4)改进 基于计算机模拟技术的手术规划与设计 有助于预测手术后潜在血流状况的工具 任何给定的患者；(V)调查TCPC术后血流动力学的改善 通过治疗与上升相关的先天性异常而实现的 (Vi)确定TCPC术后中心静脉缩窄的可行性 使用压力调节器/泵施加压力。

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.