Changes in pulmonary artery size before and after total cavopulmonary connection.
OBJECTIVE
To assess changes in size of the central pulmonary arteries following a total cavopulmonary connection (TCPC).


METHODS
A retrospective analysis of the angiographic diameters of the central pulmonary arteries, expressed as z scores, in infancy before the TCPC and 3.5 (0.9) years (mean (SD)) later. Analysis of the relation between the pulmonary arteriolar resistance and the z scores at follow up.


METHODS
Tertiary referral centre.


METHODS
32 patients who had TCPC from February 1990 to July 1993.


RESULTS
The patients were divided into two groups (n = 16) depending on their preoperative flow ratio: group I, Qp/Qs < or = 1; group II, Qp/Qs > 1. At the initial study in infancy the mean z scores in group I were -6.0 for the right pulmonary artery (RPA) and -9.6 for the left pulmonary artery (LPA); in group II the respective values were -2.7 and -3.0. Before the TCPC the values increased to 0.5 (RPA) and -0.5 (LPA) in group I, and to 8.8 (RPA) and 8.2 (LPA) in group II. At follow up the z scores decreased to -2.4 (RPA) and -4.9 (LPA) in group I, and to 2.2 (RPA) and -0.7 (LPA) in group II. The changes in pulmonary artery diameters were significant for both groups (p < 0.02). Following the TCPC, no significant difference in pulmonary arteriolar resistance index was found between patients with relatively small pulmonary arteries (z score RPA + LPA < or = 0) and those with relatively large pulmonary arteries (z score RPA + LPA > 0).


CONCLUSIONS
Creation of a TCPC results in a significant reduction in size of the central pulmonary arteries. At a mean interval of 3.5 years following the TCPC, however, there was no significant difference in pulmonary arteriolar resistance index between patients with smaller and larger central pulmonary arteries.
Buheitel
G
G
Department of Paediatric Cardiology, University Children's Hospital Erlangen, Germany.
Hofbeck
M
M
Tenbrink
U
U
Leipold
G
G
von der Emde
J
J
Singer
H
H
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D018610:Heart Bypass, Right; D006330:Heart Defects, Congenital / Q000473:pathology / Q000601:surgery*; D006801:Humans; D011651:Pulmonary Artery / Q000254:growth & development / Q000473:pathology* / Q000503:physiopathology; D012039:Regional Blood Flow; D013997:Time Factors; D014655:Vascular Resistance