A Series Of Studies Of Bidirectional Cavopulmonary Anastomosis In Animal Experiments And Clinical Applications

The role of bidirectional cavopulmonary anastomosis for palliation of complex cyanotic congenital heart disease is widely recognized. A modification of the Glenn shunt,the bidirectional cavopulmonary anastomosis(BCPA), directs blood flow from the superior vena(e) cava(e) to both pulmonary arteries via an end-to-side anastomosis between the superior vena(e) cava(e) and ipsilateral pulmonary artery. BCPA can provide increased pulmonary blood flow in patients with cyanotic congenital heart disease and reduced pulmonary blood flow. Pulsatile BCPA is BCPA with additional source 'pulsatile' pulmonary blood from the stenotic pulmonary valve. The addition of a small amount of antegrade pulmonary blood flow has a beneficial effect on at oxygenation without a significant rise in the superior vena caval pressure. The studies investigated BCPA in respects of animal experimental model, clinical application, two dimensional Doppler examination, radionuclide lung perfusion imaging, angiography, etc.The studies consisted of two chapters, a part of animal experiments and rest of clinical applications.In chapter of animal experimental studies,discussion had been concerned about:â‘  Biventricular repair of hypoplastic right ventricle assisted by pulsatile bidirectional cavopulmonary anastomosis.Findings suggested that with application of BCPA, complex congenital heart lesions with a right ventricular size that was above 25% of normal did undergo biventricrlar repair.â‘¡ Doppler echocardiography confirmed a systolic and diastolic bidirectional shunt from the superior vena cava to both pulmonary arteries after BCPA, also confirmed a total phase of systolic arterial flow from stenotic pulmonary valve in both right and left pulmonary arteries and a diastolic bidirectional shunt into both pulmonary arteries after pulsatile BCPA.In chapter 2 of clinical part studies:â‘ Radionuclide lung perfusion imagings were studied to assess pulmonary flow in both lungs after BCPA. This noninvasive method might qualitatively and quantitatively analyse relative ratio of pulmonary flow in both lungs, distribution of blood flow perfusion and right-to-left shunt, which would be beneficial to clinics.