Doppler flow profiles in the right and left pulmonary artery in children with congenital heart disease and a bidirectional cavopulmonary shunt.
The systolic and diastolic Doppler tracings in the right and left pulmonary artery were analyzed in 10 patients with complex cyanotic congenital heart disease, aged 6 months to 12 years (median 3 years), after employment of a bidirectional cavopulmonary shunt. The postoperative interval ranged from 2 weeks to 1.7 years (median 1.3 years). In children with pulmonary atresia or severe pulmonary stenosis with minimal antegrade pulsatile pulmonary blood flow Doppler echocardiography confirmed a systolic and diastolic bidirectional shunt from the vena cava superior to both pulmonary arteries. In children with pulmonary stenosis, Doppler echocardiography confirmed a systolic shunt only to the right pulmonary artery and a diastolic bidirectional shunt into both pulmonary arteries. As the left pulmonary artery was perfused by the pulsatile transvalvular flow it was difficult to detect a concomitant systolic Glenn-related flow in those patients. Quantitative analysis of the diastolic Doppler tracings revealed a significant difference in the velocity time integral in the right and left pulmonary artery indicating a dominant right lung perfusion in diastole.
Salzer-Muhar
U
U
Department of Pediatric Cardiology, University of Vienna, Austria.
Marx
M
M
Ties
M
M
Proll
E
E
Wimmer
M
M
D001166:Arteriovenous Shunt, Surgical / Q000379:methods*; D001783:Blood Flow Velocity; D002648:Child; D002675:Child, Preschool; D003971:Diastole; D015150:Echocardiography, Doppler; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D010166:Palliative Care; D011651:Pulmonary Artery / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery*; D018633:Pulmonary Atresia / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D011666:Pulmonary Valve Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D011673:Pulsatile Flow; D012039:Regional Blood Flow; D013599:Systole; D016896:Treatment Outcome; D014683:Vena Cava, Superior / Q000000981:diagnostic imaging* / Q000601:surgery*