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선천성 심장질환에 대한 Fontan 순환의 유체역학적 분석
노형운(Hyung-Woon Roh),서상호(Sang-Ho Suh),이병권(Byung-Kwon Lee),권혁문(Hyukc-Moon Kwon) 대한기계학회 2009 대한기계학회 춘추학술대회 Vol.2009 No.5
In 1971 Fontan and Baudet reported on a palliative operation in patients with tricuspid atresia. The new idea was to direct venous blood flow into the pulmonary arteries without a pumping chamber in between. While there were many modification developed after initial suggestion and they made a advance for survival benefit. However, the complete pulmonary flow were not restored, and several complications, such as arrhythmia, pulmonary vascular insufficiency, abnormalities in hepatic function, and coagulopathy were still not resolved. We hypothesized that these complications were driven mainly by the deficit of driving force according as right heart bypass. It reported that there were no typical pulmonary blood flow patterns of cardiac origin in patients with Fontan circulation, except for slight late diastolic flow acceleration representing diastolic inflow. The aim of this study is to assess pulmonary blood flow patterns after Fontan surgery by using computational fluid dynamics analysis. It found that the flows from SVC and IVC were not well mixed in all 4 different phases, and IVC flows were not well advanced to pulmonary artery during inspiration. This phenomenon was remarkable especially during inspiration phase in upright position. Conclusively, it might be suggested that Fontan circulation is needed by a pumping structure for mixing blood from SVC and IVC and IVC blood flow advance.
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