Late-diastolic forward flow in the aorta induced by left atrial contraction.
Late-diastolic forward flow is a well-described phenomenon detectable by Doppler echocardiography in the pulmonary trunk. It is supported by a restrictive right ventricular diastolic function and by a low end-diastolic pulmonary artery pressure. A similar phenomenon for the left ventricle and the aorta has not been described. We report a case of a preterm infant with aortic stenosis and endocardial fibroelastosis, who underwent balloon valvuloplasty. Restrictive left ventricular diastolic filling led to high left atrial pressure (27 mm Hg) and a very pathologic ratio of early-to-late peak velocities (2.6) for an infant of 29 weeks' gestation. In combination with a low diastolic aortic pressure (24 mm Hg) caused by moderate aortic regurgitation after intervention, a late-diastolic forward flow was detectable in the aorta during left atrial contraction with pulsed Doppler echocardiography.
Ewert
P
P
Department of Congenital Heart Diseases, German Heart Institute, Berlin, Germany. ewert@dhzb.de
Nagdyman
N
N
Daehnert
I
I
Dittrich
S
S
Abdul-Khaliq
H
H
Berger
F
F
Lange
P E
PE
D001011:Aorta / Q000503:physiopathology*; D001024:Aortic Valve Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000628:therapy; D016275:Atrial Function; D002404:Catheterization; D003971:Diastole / Q000502:physiology*; D018619:Echocardiography, Doppler, Pulsed; D004695:Endocardial Fibroelastosis / Q000150:complications / Q000503:physiopathology; D017809:Fatal Outcome; D006439:Hemodynamics; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D012039:Regional Blood Flow