German Pediatric Heart Center, Sankt Augustin, Germany.
Ann Thorac Surg. 2013 Aug;96(2):709-11. doi: 10.1016/j.athoracsur.2013.02.046.
In failing Fontan circulation, the elevated central venous pressure increases lymphatic production and simultaneously retards lymphatic return to the central venous system, thus unbalancing lymphatic homoeostasis. To improve lymphatic drainage, a new concept based on decompression of the thoracic duct to the lower pressure levels of the common atrium, with concomitant increase of preload, has been developed. The thoracic duct, which in the majority of patients enters the circulation at the left subclavia-jugular junction, is decompressed by diverting the innominate vein directly to the common atrium.
在 Fontan 循环衰竭中，升高的中心静脉压增加了淋巴液的产生，同时阻碍了淋巴液向中心静脉系统的回流，从而打破了淋巴液的动态平衡。为了改善淋巴引流，已经开发出一种基于将胸导管减压至更低的腔静脉水平的新概念，同时增加前负荷。大多数患者的胸导管在左锁骨下颈静脉交界处进入循环，通过将无名静脉直接引流至腔静脉来减压。
