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首页> 外文期刊>Japanese circulation journal >Influence of age (body size) on the Fontan circulation--analysis by a theoretical model.
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Influence of age (body size) on the Fontan circulation--analysis by a theoretical model.

机译：年龄（体型）对Fontan循环的影响-理论模型分析。

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摘要

Among the original selection criteria for the Fontan operation, the recommended age at the time of surgery has been 4 years or older, but recent clinical data have indicated the feasibility of this procedure in younger patients. Because age may influence the properties of the systemic vascular bed, changes in systemic vascular resistance (Rs) and systemic vascular compliance (Cs) associated with physical development were quantified in 86 pediatric patients without known abnormalities of the systemic circulation, and the effects of age (body size) on Fontan circulation were then analyzed using an analytical model of the cardiovascular system. As the body surface area (BSA) of the patient decreased, Cs also decreased significantly (r=0.81, p<0.001). Based upon this relationship between BSA and Cs, the analytical model showed that the impedance (ventricular afterload) of the Fontan circulation significantly increased as Cs decreased with the decrease in BSA. Moreover, the increase in impedance in response to changes in heart rate or Rs was inversely proportional to the BSA. However, these findings were significant only when the BSA was below 0.3 m2. Small BSA, or a lower age, has minimal effects on the Fontan circulation until it comes close to the infant value, and thus the Fontan procedure may be feasible much earlier than formerly recommended when the hemodynamics are otherwise acceptable.
机译：在Fontan手术的最初选择标准中，手术时的推荐年龄为4岁或以上，但最近的临床数据表明该手术在年轻患者中的可行性。由于年龄可能影响全身血管床的特性，因此对86名没有已知体循环异常和年龄影响的儿科患者定量了与身体发育相关的全身血管阻力（Rs）和全身血管顺应性（Cs）的变化然后使用心血管系统分析模型分析Fontan循环中的（身体大小）。随着患者体表面积（BSA）的减少，Cs也显着降低（r = 0.81，p <0.001）。基于BSA和Cs之间的这种关系，分析模型表明，随着Cs随BSA的减少而降低，Fontan循环的阻抗（心室后负荷）显着增加。此外，响应心率或Rs变化的阻抗增加与BSA成反比。但是，只有当BSA低于0.3平方米时，这些发现才有意义。较小的BSA或年龄较小的人对Fontan循环的影响极小，直到接近婴儿价值为止，因此在血液动力学可接受的情况下，Fontan程序可能比以前建议的要早得多。

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