尽管存在舒张期反流，但是经肺动脉非瓣右心室到肺动脉分流的诺伍德手术改善了心室能量学：理论分析。
Norwood procedure with non-valved right ventricle to pulmonary artery shunt improves ventricular energetics despite the presence of diastolic regurgitation: a theoretical analysis.
机构信息
Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center Research Institute, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565, Japan.
出版信息
J Physiol Sci. 2011 Nov;61(6):457-65. doi: 10.1007/s12576-011-0166-7. Epub 2011 Aug 10.
Abstract
When the Norwood procedure is conducted for the hypoplastic left heart syndrome using a non-valved right ventricle (RV) to pulmonary artery (PA) shunt, diastolic regurgitation from PA to RV may have an adverse effect on postoperative hemodynamics. In this study, we examined the impact of the diastolic regurgitation on ventricular energetics by computational analysis using a combination of a time-varying elastance chamber model and a modified three-element Windkessel vascular model. This study revealed that use of the valved or non-valved RV-PA shunt eliminated pulmonary over-circulation which was observed when using the systemic to pulmonary artery shunt (modified Blalock-Taussig shunt). Although the valved RV-PA shunt improved pulmonary blood supply and consequently increased pulmonary artery flow and oxygen saturation compared to the non-valved RV-PA shunt, the non-valved RV-PA shunt improved ventricular energetics in spite of the presence of PA to RV regurgitation.
摘要
当使用无阀右心室（RV）至肺动脉（PA）分流进行左心发育不全综合征的 Norwood 手术时，PA 至 RV 的舒张反流可能对术后血流动力学产生不利影响。在这项研究中，我们通过使用时变顺应性室模型和改良三元素 Windkessel 血管模型的组合进行计算分析，检查了舒张反流对心室能量学的影响。这项研究表明，使用带瓣或无瓣 RV-PA 分流消除了肺过度循环，而使用体肺动脉分流（改良 Blalock-Taussig 分流）时则观察到了这种现象。虽然带瓣 RV-PA 分流改善了肺血供，从而增加了肺动脉流量和氧饱和度，与无瓣 RV-PA 分流相比，但无瓣 RV-PA 分流尽管存在 PA 至 RV 反流，仍改善了心室能量学。
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