Alva Carlos, Gómez Felipe David, Ortegón Cardeña José, Yáñez Gutiérrez Lucelli, Lazcano Sonia
Servicio de Cardiopatías Congénitas, Hospital de Cardiología del Centro Médico Nacional Siglo XXI.
Arch Cardiol Mex. 2008 Jul-Sep;78(3):305-8.
In patients with Bidirectional Glenn who have undergone surgery, the superior caval venous flow provides the only pulmonary blood supply. This is the effective pulmonary flow and at the same time its volume is not enough to overflow the single ventricle. The unsaturated, inferior vena cava flow is not oxygenated, since it goes across the interatrial septal communication and gets mixed in the left ventricle with the pulmonary venous blood. In this work, a bidirectional Glenn case is analyzed. The hemodynamic data before and after the operation are shown. It was evident from this case that the use of the Fick method to measure pulmonary flow in patients with bidirectional Glenn operation is not appropriate. Alternative methods, such as Doppler echocardiography and Magnetic Resonance Imaging, are recommended. A literature review on this subject was carefully done.
在接受过手术的双向格林分流患者中,上腔静脉血流是唯一的肺供血来源。这是有效的肺血流量,同时其容量不足以使单心室发生血液充盈过度。未饱和的下腔静脉血流未得到氧合,因为它穿过房间隔交通口并在左心室内与肺静脉血混合。在本研究中,分析了一例双向格林分流病例。展示了手术前后的血流动力学数据。从该病例可以明显看出,使用菲克法测量双向格林分流手术患者的肺血流量并不合适。建议采用替代方法,如多普勒超声心动图和磁共振成像。对该主题进行了仔细的文献综述。