Dai Une
   Department   Kawasaki Medical School  Kawasaki Medical School, Department of Cardiovascular Surgery,
   Position   Professor
Article types 原著
Language English
Peer review Peer reviewed
Title Hybrid stage I palliation for hypoplastic left heart syndrome has no advantage on ventricular energetics: a theoretical analysis.
Journal Formal name:Heart and vessels
Abbreviation:Heart Vessels
ISSN code:16152573/09108327
Domestic / ForeginDomestic
Volume, Issue, Page 31(1),pp.105-13
Author and coauthor Shuji Shimizu, Toru Kawada, Dai Une, Toshiaki Shishido, Atsunori Kamiya, Shunji Sano, Masaru Sugimachi
Publication date 2016/01
Summary A hybrid procedure combining bilateral pulmonary artery banding with ductal stenting has recently been used as stage I palliation for hypoplastic left heart syndrome. However, the advantage of the hybrid procedure over the Norwood procedure on ventricular energetics remains unclear. To clarify this, we performed a computational analysis with a combination of time-varying elastance chamber model and modified three-element Windkessel vascular model. Although mean pulmonary artery (PA) pressure, pulmonary flow, and oxygen saturation were almost equivalent with the Norwood procedure, the hybrid procedure delivered higher systolic and lower diastolic systemic arterial pressures compared to the Norwood procedure with right ventricle (RV) to PA shunt. As a result, the hybrid procedure yielded increased systolic pressure-volume area and impaired mechanical efficiency. Therefore, the hybrid procedure has probably no advantage on ventricular energetics compared to the Norwood procedure with a RV-PA shunt.
DOI 10.1007/s00380-014-0604-6
PMID 25432766