在Fontan手术后,单左心室的收缩功能恢复的自然史和模式
T Sluysmans1, S P Sanders, M van der Velde
1Department of Cardiology, Children's Hospital, Boston, MA 02115.
Circulation
|December 11, 1992
概括
在单心室患者的Fontan型修复改善左心室 (LV) 功能,如果早期进行. 然而,随着手术年龄的增加,恢复能力显著下降.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 遗传性心脏病是一种先天性心脏病.
- 心脏外科手术 心脏外科手术
背景情况:
- 单心室生理学在历史上导致心力衰竭和早期死亡在Fontan手术之前.
- 尽管有缓解疗法,心室功能障碍仍然是这些患者的重大临床挑战.
研究的目的:
- 为了调查单心室患者心室功能障碍的原因.
- 确定Fontan型修复是否可以逆转左心室 (LV) 功能恶化.
主要方法:
- 声心成像用于评估84名患者 (0.2-35岁) 的心室尺寸,体积,形状,壁应力和缩功能.
- 测量是在息手术 (冲刺,带带) 之前和之后,以及在格伦或方丹手术后进行的.
- 分析相关的年龄,大动脉氧和和手术时间与LV功能.
主要成果:
- 在Fontan之前,心室体积是正常的2-3倍,并且在2岁后出现异常的壁应力.
- LV 形状的逐渐变化 (球形) 和增加的壁面应力与缩功能和收缩能力的下降相关.
- 早期的Fontan/Glenn修复 (<10年) 改善了LV功能和收缩性;晚期的修复显示出有限的恢复.
结论:
- 早期的Fontan型修复可逆转单心室患者与年龄和体积负载相关的异常收缩力学.
- 在Fontan型修复手术后,LV功能恢复的潜力随着手术时年龄的增加而下降.
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