右房右室连接与右房肺动脉连接的对比研究

Comparative study of atrioventricular versus atriopulmonary connections for modified fontan repair of tricuspid valve atresia in dogs

目的 通过动物实验模拟右房右室连接术和右房肺动脉连接术，对比研究两种术式的血流动力学效果。方法 选１０ 条成年杂种犬，随机分成右房右室连接和右房肺动脉连接两组，右房右室连接组分别利用５０ ％ 及２５ ％ 的右室容积参与 Ｆｏｎｔａｎ 循环，监测血流动力学参数，计算能量损耗，再与右房肺动脉连接组进行比较。结果 与右房肺动脉连接组相比，无论是５０ ％ 还是２５ ％ 的右室容积用于 Ｆｏｎｔａｎ 循环，其手术后右房压低（ Ｐ ＜ ０ ．０５） 、每搏功指数高（ Ｐ ＜ ０ ．０５） 、能量损耗小（ Ｐ ＜ ０ ．０１） 。结论 治疗三尖瓣闭锁，可利用发育不良的右心室参与 Ｆｏｎｔａｎ 循环。

Objective To compare the hemodynamic effect of atrioventricular versus atriopulmonary connections for modified Fontan in dogs. Methods Ten adult mongrel dogs were divided into two groups. Group I underwent right atrium to right ventricle (using 50% and 25% right ventricular chamber, respectively) connection with the flap of valved homopulmonary artery (modified Bjrk procedure). Group Ⅱ were subjected to the modified atriopulmonary connection. The right atrium pressure and pulmonary artery pressure were measured by a Swan Ganz catheter. The cardiac output were measured by thermodilution, and the fluid energy loss was calculated. rk procedure). Group Ⅱ were subjected to the modified atriopulmonary connection. The right atrium pressure and pulmonary artery pressure were measured by a Swan Ganz catheter. The cardiac output were measured by thermodilution, and the fluid energy loss was calculated. Results The postoperative right atrium pressure in group I was lower than in group Ⅱ (P<0.05). The postoperative stroke index in group I was higher than in group Ⅱ (P<0.05). The fluid energy loss was decreased when 50% or 25% right ventricle chamber were used (P<0.01). Conclusion Atrioventricular connection would be better than atriopulmonary connections from modified Fontan repair of tricuspid valve atresia.