窗户封闭的Fontan.关闭前后的血液动力学评估. 对氧气输送变化的急性研究
Z M Hijazi1, J T Fahey, C S Kleinman
1Department of Pediatrics, Yale University School of Medicine, New Haven, Conn. 06510.
Circulation
|July 1, 1992
概括
在Fontan手术后关闭心房缺陷改善了动脉氧化,但降低了全身血流和氧气输送. 这可能导致运动能力降低,长期益处尚未确定.
科学领域:
- 心脏病学 心脏病学
- 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.
背景情况:
- 丰坦手术为复杂的先天性心脏缺陷创造了一个单体的修复,通常需要化为缓解.
- 与Fontan相关的Fenestrated心房缺陷可能需要关闭以优化血液动力学和氧气输送.
- 评估闭塞后的急性血液动力学变化对于确定永久关闭候选人至关重要.
研究的目的:
- 在Fontan手术的患者中,评估心房缺陷暂时封闭后急性血液动力学和氧气输送变化.
- 为了确定适合永久通过导管关闭他们的心房缺陷的患者.
主要方法:
- 血液动力学参数和氧和在14名患者的心房缺陷暂时封闭之前和之后被测量.
- 计算了全身血流 (Qs),全身氧运输 (SOT) 和氧提取.
- 患者在Fontan手术后的32天中位数经历了封闭.
主要成果:
- 暂时性闭塞显著增加了大动脉氧和度 (SaO2) 并降低了左心房 (LA) 压力.
- 系统血流 (Qs) 和系统氧气运输 (SOT) 在闭塞后显著下降.
- 氧气提取增加,而混合静脉氧和度 (SmvO2) 和右心房 (RA) 压力在大多数患者中保持不变.
结论:
- 在Fontan患者中,心房缺陷的延迟关闭改善了动脉氧化,但减少了全身血流和氧气输送.
- 较高的静止氧抽取表明运动能力降低的可能性.
- 关闭窗户的长期结果和好处需要进一步调查.
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