The study of pulmonary arterial development in patients after 5 years of extracardiac tota cavopulmonary connection
10.3760/cma.j.issn.1001-4497.2012.01.006
- VernacularTitle:心外管道全腔静脉肺动脉连接术后5年的肺血管发育
- Author:
Huishan WANG
;
Zongtao YIN
;
Zengwei WANG
;
Hongyu ZHU
;
Minhua FANG
- Publication Type:Journal Article
- Keywords:
Heart defects,congenital;
Heart bypass,right;
Pulmonary artery;
Vascular resistance;
Radionuclide angiocardiography;
Angiography,digital subtruction
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2012;28(1):16-19
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo study the pulmonary arterial development over five years in patients underwent extracardiac total cavopulmonary connection (ETCPC).Methods43 survived patients,who had undergone ETCPC were examined with pulmonary perfusion at one month and five year following the operation.Central venous pressure (CVP) and arterial oxygenation saturation (SatO2 ％ ) were measured by right cardiac catheter,pulmonary arterial index (PAI) and pulmonary vascular resistance (PVR) were calculated.Pulmonary blood distribution were measured and calculated by 99m Tc-MAA perfusion imaging.ResultsThe PAI and PVR of the follow-up group reduced significantly ( t =2.41,P ＜ 0.05 ; t =2.08,P ＜ 0.05 ),CVP also reduced significantly ( t =2.69,P ＜ 0.05 ),but SatO2 ％ did not changed significantly.Total radionuclide counts and the ratio of rightorleft pulmonary perfusion did not change significantly.( t =0.38,P ＞ 0.05 ;t =1.12,P ＞ 0.05 ),but the ratio of the superior and inferior lobe decreased significantly( t =2.54,P ＜ 0.05 ).ConclusionThe weak pulsation and low dynamic of Fontan circulation also can promote pulmonary vascular development.However,the improvement of hemodynamic in pulmonary circulation at mid-term follow will not lead to an increased amount of pulmonary perfusion or oxygen supply,which is probably due to the massive opening of the arteriovenous shunt and increased futile circulation.
