基于文丘里效应的自身动力性Fontan循环的数值模拟和验证

右心室旷置（Fontan）手术是功能性单心室的唯一治疗方案，但并发症和死亡率仍居先心病首位，根本原因在于Fontan循环缺少右心室动力供应。前期工作和国外研究显示如何在腔肺连接水平供给动力源，保持腔静脉低压状态(5∽15 mmHg)同时提升2∽5mmHg动力是关键。文丘里效应和喷射泵的本质是高能量流体驱动低能量流体，同时降低上游压力。假设：借助高能量体循环，管道连接升主动脉和腔肺连接水平的右肺动脉，近右肺动脉端部分钳闭造成高速喷嘴，以提升Fontan动力和保持腔静脉低压。围绕假设，展开研究：（1）构建和数值模拟心外管道Fontan手术三维模型；（2）三维模型上数值模拟探讨喷嘴最佳设计：口径和角度；（3）犬自身动力性Fontan循环模型上验证喷嘴最佳设计；（4）犬自身动力性双向腔肺吻合术（Glenn）模型上验证喷嘴的中期通畅性。为形成自身动力性、双心室Fontan生理提供理论基础和应用前景。

Right ventricle bypass (Fontan) operation is the sole treatment strategy for functional single ventricle, however, its mortality and morbidity still remains the highest among congenital heart disease surgery. The underlying cause lies in lack of right ventricular power source. Results of our previous researches and foreign studies indicate that the key is to provide a pumping power resource at the level of the cavopulmonary connection by boosting a pressure of about 2-5 mmHg with maintaining low CVP pressure(5-<15 mmHg) stat simultaneously. The essence of Venturi effect and ejector pump is a high-energy flow stream driving a low-energy flow with reduction of upstream flow pressure. A hypothesis based on it ,a Gore-Tex conduit is connected between the ascending aortic artery and the right pulmonary artery(RPA) at the level of the cavopulmonary connection with the help of high-energy systemic circulation. A clip is applied to the RPA end of the conduit to produce a high-velocity nozzle and boost Fontan power with low CVP . According to the hypothesis, following researches will be carried out: （1）Construction and numerical simulation of 3-dimensional model of extracardiac Fontan operation; 2) Numerical simulation of the best design of nozzle in.3-dimensional model,including diameter and angle; 3) To verify the best design of nozzle on a canine Fontan circulation ; 4) To verify the middle term patency of the nozzle on a Glenn animal model . These researches will provide theories foundation and application perspective for a self-powering Fontan and bi-ventricular Fontan physiology.