| Project/Area Number |
63570660
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| Research Category |
Grant-in-Aid for General Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Research Field |
Thoracic surgery
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| Research Institution | Osaka University |
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Principal Investigator |
SHIMAZAKI Yasuhisa MD Osaka University Medical School, Assistant Professor, 医学部, 助手 (60116043)
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| Co-Investigator(Kenkyū-buntansha) |
TANIGUCHI Kazuhiro MD Osaka University Medical School, Assistant Professor, 医学部, 助手 (90171842)
MATSUDA Hikaru MD Osaka University Medical School, Associate Professor, 医学部, 講師 (00028614)
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| Project Period (FY) |
1988 – 1989
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| Project Status |
Completed (Fiscal Year 1989)
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| Budget Amount *help |
¥2,200,000 (Direct Cost: ¥2,200,000)
Fiscal Year 1989: ¥300,000 (Direct Cost: ¥300,000)
Fiscal Year 1988: ¥1,900,000 (Direct Cost: ¥1,900,000)
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| Keywords | Pulsed Doppler Catheter / Complex Congenital Heart Disease / Fontan Operation / Pulmonary Vascular Resistance / カテ先バルスドップラ-カテ-テル / Fontan手術 / カテ先パルス / ドップラーカテーテル |
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| Research Abstract |
Surgical results of Fontan type operation for complex heart disease are not satisfactory, and mainly dependent on the pulmonary vascular resistance. Therefore, accurate preoperative evaluation of pulmonary vascular resistance is indispensable to improve surgical results. Pulmonary vascular flow in cyanotic heart disease has been calculated from estimated or measured oxygen consumption and difference of pulmonary arterial and venous oxygen saturation according to the Fick method. However, this flow includes aortopulmonary collateral arteries which is not connected to the central pulmonary artery. After corrective surgery of Fontan type operation, effective pulmonary vascular bed is restricted to that connected to the central pulmonary artery. Postoperative pulmonary vascular resistance is often higher than preoperative one predicted from Fick principle. The difference is larger as the collateral pulmonary flow increases. The aim of this study is to establish the method of accurate preop
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erative measurement of vascular resistance of pulmonary artery in which total mixed venous blood is accepted after Fontan operation.
1.Basic Study
During cardiac catheterization 20 MHz pulsed Doppler flow catheter (Miller Instrument Model, DC 101) was inserted into the femoral artery and vein, and the velocities of these vessels were measured. The flow velocity was highly correlated with the flow measured with electromagnetic flow meter. The accuracy of this system was established.
2. Clinical Study Pulsed Doppler flow catheter was inserted into the pulmonary artery or Blalock-Taussig shunt during preoperative cardiac catheterization, and effective pulmonary flow was directly measured. Pulmonary vascular resistance was calculated from the effective flow and pulmonary arterial and venous pressure. Conventional measurement of pulmonary vascular resistance was also performed with Fick method. Pulmonary vascular resistance measured with Doppler catheter system was significantly higher than that measured with Fick method. Immediately or late after Fontan operation pulmonary vascular resistance was calculated from the pulmonary flow measured with electromagnetic flow meter and dye dilution method. These values were highly correlated with preoperatively measured pulmonary vascular resistance with pulsed Doppler system. Thus direct measurement of pulmonary flow with pulsed Doppler catheter system was valuable for preoperative prediction of pulmonary vascular resistance.
Pulsed Doppler flow catheter was inserted into the pulmonary artery or Blalock-Taussig shunt during preoperative cardiac catheterization, and effective pulmonary flow was directly measured. Pulmonary vascular resistance was calculated from the effective flow and pulmonary arterial and venous pressure. Conventional measurement of pulmonary vascular resistance was also performed with Fick method. Pulmonary vascular resistance measured with Doppler catheter system was significantly higher than that measured with Fick method. Immediately or late after Fontan operation pulmonary vascular resistance was calculated from the pulmonary flow measured with electromagnetic flow meter and dye dilution method. These values were highly correlated with preoperatively measured pulmonary vascular resistance with pulsed Doppler system. Thus direct measurement of pulmonary flow with pulsed Doppler catheter system was valuable for preoperative prediction of pulmonary vascular resistance. Less
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