Kurokawa Satoshi, Doi Kenji, Iwata Shihoko, Sato Keita, Seino Yusuke, Nomura Minoru, Ozaki Makoto
Faculty of Medicine, Department of Anesthesiology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, ZIP 162-8666 Japan.
JA Clin Rep. 2016;2(1):27. doi: 10.1186/s40981-016-0054-5. Epub 2016 Oct 4.
Very few studies have investigated the blood flow velocity from the inferior vena cava (IVC) to the pulmonary artery following the Fontan operation using an extra-cardiac conduit (ECC). No studies at all have investigated the velocity immediately after the circulation is established. The purpose of this retrospective study was to find an acceptable flow velocity at the ECC following the completion of a total cavo-pulmonary connection (TCPC) via transesophageal echocardiography.
We measured the mean velocity (m-V) of the blood flow proximal to the anastomosis between the IVC and ECC in eight patients and compared the results with theoretically predicted values based on assumptions regarding the cardiac output, the ratio of the IVC flow to the superior vena cava flow, and the cross-sectional form of the ECC. Mean velocities ranging from about 15 to 60 cm/s were detected in the absence of any observable stenosis. The measured m-V was significantly faster than the predicted value in our study, both collectively and in every patient individually. The shrinking and compression of the ECC might account for the faster velocities measured in our cases.
The observed range of m-V at the ECC, about 15-60cm/s, may be acceptable for the establishment of TCPC circulation.
极少有研究使用心外管道（ECC）对Fontan手术之后从下腔静脉（IVC）到肺动脉的血流速度进行调查。根本没有研究对循环建立后即刻的血流速度进行调查。这项回顾性研究的目的是通过经食管超声心动图检查，找出在完成全腔静脉-肺动脉连接（TCPC）后ECC处可接受的血流速度。
我们测量了8例患者IVC与ECC吻合口近端的血流平均速度（m-V），并将结果与基于心输出量、IVC血流与上腔静脉血流之比以及ECC横截面形态的假设所预测的理论值进行比较。在未观察到任何狭窄的情况下，检测到平均速度约为15至60厘米/秒。我们的研究中，总体及每位患者个体的测量m-V均显著快于预测值。ECC的收缩和受压可能是我们所测速度较快的原因。
ECC处观察到的m-V范围约为15 - 60厘米/秒，对于建立TCPC循环可能是可接受的。
