| Japanese |
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| Title | 右室を主心室とする低肺血流疾患に対するBlalock-Taussig短絡手術に関する検討 |
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| Subtitle | 原著 |
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| Authors | 石山雅邦 |
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| Organization | 東京女子医科大学附属日本心臓血圧研究所循環器小児外科 |
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| Journal | 循環制御 |
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| Volume | 21 |
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| Number | 4 |
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| Page | 440-444 |
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| Year/Month | 2000/ |
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| Article | 原著 |
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| Publisher | 日本循環制御医学会 |
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| Abstract | 右室を主心室とする低肺血流疾患に対し施行したBlalock-Taussig短絡手術(BTS)症例で術前後のカテーテルデータを有する63例を検討した. 全体としては術後良好な肺動脈の発育と心室機能の保持が得られ機能的根治手術に向けたBTSの有用性が示されたが, 肺動脈発育への影響には種々の因子によってばらつきが見られた. すなわち, 手術時年齢については1歳未満の群で肺動脈は良好に発達し, 房室弁が1つ(共通房室弁, 一側房室弁閉鎖)の場合は2つに比べ房室弁逆流を生じ易く, 肺動脈径の変化率も低めで術後肺血管抵抗が高値をとった. これはECD型房室弁で顕著であり, 臓器錯位の有無とも関連していた. 以上より右室を主心室とする低肺血流疾患に対しては早期の適切な短絡手術が重要であるが, 房室弁異常や臓器錯位合併症例においては根治手術に対する危険因子が複合化し慎重な経過観察が必要と考えられた. |
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| Practice | 基礎医学・関連科学 |
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| Keywords | Blalock-Taussig shunt, Single right ventricle, Common AV valve, Heterotaxia |
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| English |
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| Title | The effects of Blalock-Taussig shunt on the pulmonary artery growth and ventricular function in patients with single right ventricle. |
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| Subtitle | |
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| Authors | Masakuni Ishiyama |
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| Authors(kana) | |
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| Organization | Department of Pediatric Cardiovascular Surgery,The Heart Institute of Japan,Tokyo Women's Medical University |
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| Journal | Circulation Control |
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| Volume | 21 |
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| Number | 4 |
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| Page | 440-444 |
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| Year/Month | 2000/ |
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| Article | Original article |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | Sixty-three patiens with functionally univentricular heart of right ventricular type who underwent a Blalock-Taussig shunt (BTS) operation were reviewed. After BTS, satisfactory growth of the pulmonary artery and preservation of ventricular function were recognized in most patients. However, there were several preoperative risk factors that significantly influenced the pulmonary artery growth. The growth of the pulmonary artery was greater in younger age group (<1 year old) when the development ratio (DR) was calculated as the ratio of postoperative to preoperative pulmonary artery index (post PAI/pre PAI) (%) (<1 year old:184.9±13.0% vs >=1 year old:142.2±0.2%, p=0.002). Patients with common AV valve (CAVV) or heterotaxia had significantly higher incidence of AV valve regurgitation after BTS (p<0.01). Postoperative pulmonary vascular resistance was higher in the group (CAVV:2.2±0.2vs others:1.7±0.1, p=0.05), and highest in asplenia (asplenia:2.4±0.3 vs others:1.8±0.1, p=0.02). Our results suggest that BTS in early infancy is recommended in patients with single right ventricle for later Fontan-type operation. However, there should be undetermined factors that influence the development of pulmonary artery and AV valve regurgitation in patients with CAVV and/or heterotaxia. |
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| Practice | Basic medicine |
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| Keywords | Blalock-Taussig shunt, Single right ventricle, Common AV valve, Heterotaxia |
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