大動脈主肺動脈間短絡術における体血流量からみた適正流量の検討

概要

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Aorta-main pulmonary artery shunt with expanded polytetrafluoroethylene tube graft, Goretex^[○!R], (3-6mm in diameter) was undergone in consecutive 21 patients with complex cyanotic congenital heart disease aged 14 days to 12 years during the period of 1978 to 1981. There were three early deaths (mortality rate 14%). In 16 patients of them the shunt flow was measured with an electromagnetic flow meter of which probe was attached around the graft (QB) or around the proximal aorta (QS) to the graft and the distal portion (QD). (QB=QS-QD)There were five patients with severe cardiac failure including one early death and two late deaths, whose shtmt flows showed extremely high (QB/QS>40%, QB index>3l/min/m^2). The means of QB/QS and QB index of the patients without cardiac failure were 26±12%(n=10) and 1.65±0.70l/min/m^2 (n=12). In conelusion, the optimal shunt flow, QB/QS or QB index should be controlled in the range of 20 to 40% or not exceed 3l/min/m^2, and the optimal size of tube graft diameter (D) was calculated by the formula; D(mm) = 1.22ln BW(kg)+1.9 or D(mm)=1.57 ln BSA(m^2)+5.9, where BW and BSA were body weight and body surface area.
1981-12-20