加藤 智栄¹, 藤岡 顕太郎¹, 近江 三喜男¹, 森 文樹¹, 古川 昭一¹, 毛利 平¹, 松崎 益徳²

Tomoe KATOH¹, Kentaro FUJIOKA¹, Mikio OHMI¹, Fumiki MORI¹, Shoichi FURUKAWA¹, Hitoshi MOHRI¹, Masunori MATSUZAKI²

¹山口大学医学部第一外科, ²山口大学医学部第二内科

¹First Department of Surgery, Yamaguchi University School of Medicine, ²Second Department of Internal Medicine, Yamaguchi University School of Medicine

キーワード : Pulsed Doppler echo, Modified Fontan operation, Tricuspid atresia

　Pulsed Doppler echocardiograms detected from the second intercostal right sternal border was useful to analyse blood flow at the site of atriopulmonary anastomosis following modified Fontan procedure in a 5 year-old boy with tricuspid atresia type IIb. Right atrial contraction played an important role in the forward pulmonary circulation. A regurgitant flow from the pulmonary artery was extremely small despite the presence of a negative RA-PA pressure gradient. These findings suggest a possible existance of a "Physiological pulmonary valve" fuction. Fine pulmonary circulation after the Fontan type operation may also be attributed to suction effect by the left heart.