徳島大学 教育・研究者情報データベース(EDB)

1. 徳島大学.医学部.医学科.病態情報医学講座
2. 徳島大学.医学部.附属病院(〜2003年9月30日/->組織[徳島大学.病院.医科診療部門])

1. 川人 伸次([徳島大学.大学院医歯薬学研究部.歯学域.口腔科学部門.臨床歯学系.歯科麻酔科学])

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2. 北畑 洋

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3. 田中 克哉([徳島大学.大学院医歯薬学研究部.医学域.医科学部門.外科系.麻酔・疼痛治療医学]/[徳島大学.病院.診療科.脳·神経·精神科])

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4. 野﨑 淳平

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5. 大下 修造

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(英) Intraoperative evaluation of pulmonary artery flow during the Fontan procedure by transesophageal Doppler echocardiography.

(英) After the Fontan procedure, pulmonary artery (PA) flow is maintained without right ventricular pump function. We evaluated intraoperative PA flow velocity patterns using transesophageal Doppler echocardiography (TEE) immediately after cardiopulmonary bypass (CPB) in patients during Fontan or hemi-Fontan procedures. We studied 10 patients with single-ventricle physiology (age range, 5 mo to 3 yr 1 mo). Anesthesia was induced and maintained with fentanyl. After induction of anesthesia, a pediatric TEE probe was inserted into the esophagus. All patients had surgical repair involving direct anastomosis of the right atrium to the PA. Immediately after completion of CPB, adequacy of the atriopulmonary anastomosis was assessed and PA flow velocity was recorded. In all patients, the atriopulmonary anastomosis was clearly defined using a single-plane TEE probe, and PA flow recording was completed successfully. Intraoperative PA flow velocities showed two distinct patterns. Biphasic forward flows with peak velocities during systole and diastole were observed in six patients. The remaining four patients showed forward flows with flow reversals. The four patients demonstrating flow reversals showed significantly reduced fractional shortening (26.5+/-2.1% vs. 35.5+/-6.3%) and larger pressure gradient between the right atrium and left atrium (10.8+/-1.3 mm Hg vs 8.0+/-0.9 mm Hg) when compared to those without reverse flow. Two patients with reverse flow required reoperation because of hypotension. Because PA flow is influenced by pulmonary vascular resistance and left ventricular function, TEE assessed intraoperative PA flow should be further evaluated as a useful predictor of surgical outcome after a Fontan procedure.

1. (英) Blood Pressure
2. (英) Child, Preschool
3. (英) Echocardiography, Transesophageal
4. (英) Female
5. (英) Fontan Procedure
6. (英) Humans
7. (英) Infant
8. (英) Male
9. (英) Monitoring, Intraoperative
10. (英) Pulmonary Artery

1. (英) Article.PublicationTypeList.PublicationType: Clinical Trial

2. (英) Article.PublicationTypeList.PublicationType: Journal Article