Doppler evaluation of superior caval venous pathways after Mustard and Senning operations.
Doppler waveforms from the superior caval vein were analysed to evaluate the patency of superior caval venous pathways following venous redirection (Mustard and Senning) operations for complete transposition. The group consisted of 26 unselected survivors of Mustard (9 patients) and Senning operations (17 patients). Patients were examined a mean of 5.9 (range 0.1-15.3) years following operation and their age at study ranged from 0.4-25.3 years, mean 7.3 years. Doppler waveforms were correlated with digital subtraction angiograms, which were performed in every patient within 24 hours of the Doppler study. Totally occluded superior caval venous pathways were identified in 3 patients with digital subtraction angiography. The remaining patients had angiographically patent pathways. In the 23 patients with patent pathways, Doppler waveforms demonstrated an initial systolic peak smaller than a second diastolic peak. In the 3 patients with totally occluded pathways, the pattern of the waveform was reversed, with the systolic larger than the diastolic peak. Doppler examination of the superior caval vein is a quick and simple bedside method of accurately determining patency of superior caval venous pathways after atrial redirection procedures for complete transposition.
Department of Paediatric Cardiology, Guy's Hospital, London, U.K.
J M
JM
Parsons
S A
SA
Qureshi
E J
EJ
Ladusans
R
R
Anjos
E J
EJ
Baker
A K
AK
Yates
P B
PB
Deverall
M
M
Tynan
D000293:Adolescent; D000328:Adult; D015901:Angiography, Digital Subtraction; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D011183:Postoperative Complications / Q000175:diagnosis*; D013479:Superior Vena Cava Syndrome / Q000175:diagnosis*; D014188:Transposition of Great Vessels / Q000601:surgery*; D014463:Ultrasonography; D014654:Vascular Patency