Influence of Age (Body Size) on the Fontan Circulation : Analysis by a Theoretical Model
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概要
- 論文の詳細を見る
Among the original selection criteria for the Fontan operation, the recommended age at the time of surgery has been 4 years or older, but recent clinical data have indicated the feasibility of this procedure in younger patients. Because age may influence the properties of the systemic vascular bed, changes in systemic vascular resistance (Rs) and systemic vascular compliance (Cs) associated with physical development were quantifid in 86 pediatric patients without known abnormalities of the systemic circulation, and the effects of age (body size) on Fontan circulation were then analyzed using an analytical model of the cardiovascular system. As the body surface area (BSA) of the patient decreased, Cs also decreased significantiy (r=0.81, p<0.001). Based upon this relationship between BSA and Cs, the analytical model showed that the impedance (ventricular afterload) of the Fontan circulation significantly increased as Cs decreased with the decrease in BSA. Moreover, the increase in impedance in response to changes in heart rate or Rs was inversely proportional to the BSA. However, these findings were significant only when the BSA was below 0.3m^2. Small BSA, or a lower age, has minimal effects on the Fontan circulation until it comes close to the infant value, and thus the Fontan procedure may be feasible much earlier than formerly recommended when the hemodynamics are otherwise acceptable.
- 社団法人日本循環器学会の論文
- 2000-11-20
著者
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KYO Shunei
Department of Cardiothoracic Surgery, The University of Tokyo
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Kobayashi Toshiki
Department Of Pediatric Cardiology Saitama Medical University International Medical Center
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SASAKI NOZOMU
Department of Pediatrics, Saitama Medical University
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Kyo Shunei
Department Of Cardiovascular Surgery Saitama Medical University
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Kyo Shunei
Department Of Cardiac Surgery Saitama Medical School
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Sasaki Nozomu
Department Of Pediatrics Saitama Medical College
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Ishizawa Akira
Department of Cardiology, National Children's Hospital
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SENZAKI HIDEAKI
Department of Pediatric Cardiology and Cardiovascular Surgery, Saitama Heart Institute, Saitama Medi
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YOKOTE YUJI
Department of Pediatric Cardiology and Cardiovascular Surgery, Saitama Heart Institute, Saitama Medi
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Naito Chiharu
Department of Pediatrics and Pediatric Cardiology, and Cardiovascular Surgery, Saitama Medical Schoo
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Yokota Yuji
Saitama Medical School
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Kyo Shunei
Fujiyoshida Municipal hospital
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Ishizawa Akira
Department Of Pediatric Cardiology National Children's Hospital
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Naito Chiharu
Department Of Pediatrics And Pediatric Cardiology And Cardiovascular Surgery Saitama Medical School
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Yokote Yuji
The Department Of Surgery Saitama Medical School
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Kyo Shunei
Department Of Cardiovascular Surgery Saitama Medical School
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Koyanagi Toshiya
The Department Of Surgery Saitama Medical School
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Senzaki Hideaki
Department Of Pediatric Cardiology International Medical Center Saitama Medical University
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Kyo Shunei
The Department Of Surgery Saitama Medical School
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Kyo Shunei
Department Of Pediatrics And Pediatric Cardiology And Cardiovascular Surgery Saitama Medical School
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Sasaki Nozomu
Department of Pediatric Cardiology and Cardiovascular Surgery, Saitama Heart Institute, Saitama Medical School Hospital
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KOBAYASHI Toshiki
Department of JMTR Project, Oarai Research Establishment, Japan Atomic Energy Research Institute
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