右心耳-肺動脈直接吻合によるFontan型手術の遠隔期右房特性

概要

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To evaluate the right atrial pulsatility after Fontan type operation, postoperative right atrial maximal volume (RAVmax) and right atrial ejection fraction (RAEF) were measured in 15 patients with biplane cineangiograms in long term period (10 years and 7 months ± 4 years and 2 months, average ± SD). Oblique partition method with direct right atrium-pulmonary artery (RA-PA) anastomosis was performed in 8 patients (oblique group). Atrial septal defect (ASD) closure with direct RA-PA anastomosis was performed in the other 7 patients with tricuspid atresia (ASD group). RAVmax in the long term period was 63 ± 14% of normal in the oblique group, 116 ± 36% of normal in the ASD group. RAEF in long term period was 24 ± 7% in the oblique group, 24 ± 8% in the ASD group. All 15 patients showed normal sinus rhythm. Another data acquired in the same time period regarding RAVmax and RAEF in the early period (about 5 weeks after operation) kept almost the same values of these RAVmax and RAEF in the long term period. Forward flow synchronized P wave was detected at the pulmonary artery by echocardiogram in the both groups. These data suggest that direct RA-PA anastomosis preserves good RA pulsatility and better hemodynamics after operation in the long term period.
東京女子医科大学の論文
2000-08-25