Hemodynamic of fenestration closure in Fontan circulation

2022 Fiscal Year Final Research Report

• Project/Area Number: 19K17605
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 53020:Cardiology-related
• Research Institution: Kyushu University
• Principal Investigator: Muraoka Mamoru 九州大学, 医学研究院, 共同研究員 (30747986)
• Project Period (FY): 2019-04-01 – 2023-03-31
• Keywords: フォンタン / 血行動態 / 心房中隔欠損症

Outline of Final Research Achievements

The fenestration to reduce central venous pressure in the Fontan circulation is generally attempted to be closed to prevent long-term cyanosis in the remote phase. However, some patients are found to have hemodynamics unsuitable for fenestration closure due to high central venous pressure after trial closure. The purpose of this study is to quantitatively predict hemodynamics after fenestration closure.
Prior to the prediction for fenestration closure, we have demonstrated that the predicted hemodynamics after closing an ASD, which is a defect between chambers of low pressure analogous to the Fontan fenestration, matched well with those experimentally measured. The model also showed that the risk of pulmonary edema after ASD closure depends on the balance of right and left cardiac functions. The model predictions in Fontan patients were not validated within the study period.

Free Research Field

小児循環器

Academic Significance and Societal Importance of the Research Achievements

Fontan循環におけるfenestrationに先立ち、世界で初めてASDが与える血行動態変化を予測できることを立証した。高齢者では左心機能低下に起因するASD閉鎖後の肺水腫増悪のリスクを考慮する必要があり、本研究は事前の治療適応の判断、治療後の安全な管理に貢献できる。また本研究の予測モデルは、同じ低圧系の孔であるfenestrationの治療適応を選定するFontan患者個別医療の基盤となることが期待される。