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Antegrade diastolic pulmonary arterial flow as a marker of right ventricular restriction after complete repair of pulmonary atresia with intact septum and critical pulmonary valvar stenosis

Published online by Cambridge University Press:  19 August 2008

Andrew N. Redington ,
Daniel Penny ,
Michael L. Rigby  and
Alison Hayes
Andrew N. Redington*
Affiliation:
From the Department of Paediatric Cardiology, Royal Brompton National Heart & Lung Hospitals, London
Daniel Penny
Affiliation:
From the Department of Paediatric Cardiology, Royal Brompton National Heart & Lung Hospitals, London
Michael L. Rigby
Affiliation:
From the Department of Paediatric Cardiology, Royal Brompton National Heart & Lung Hospitals, London
Alison Hayes
Affiliation:
From the Department of Paediatric Cardiology, Royal Brompton National Heart & Lung Hospitals, London
*
Dr Andrew N. Redington, Consultant Paediatric Cardiologist, Royal Brompton National Heart & Lung Hospital, Sydney Street, London SW3 6NP, U.K.
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Abstract

In order to examine right ventricular diastolic function after complete correction of pulmonary atresia with intact ventricular septum and critical pulmonary valvar stenosis, we undertook a prospective analysis of seven patients who had previously undergone successful repair. Comparison was with age and sex-matched controls. The relationship between antegrade pulmonary arterial diastolic flow and other indices of right ventricular dysfunction were compared. The ratio of the velocity of early rapid filling to that of atrial systolic flow was no different from normal, but the deceleration of early rapid filling showed significant shortening with inspiration in patients, but not in control subjects. All patients, but none of the controls, demonstrated significant antegrade diastolic pulmonary arterial flow during late diastole. Despite “normal” ratios ofvelocity of early rapid filling to systolic atrial flow, patients after complete correction of pulmonary atresia with intact ventricular septum and critical pulmonary stenosis have abnormal right ventricular diastolic function typical of a restrictive physiology. This presumably reflects incomplete adaptation due to the presence of endomyocardial fibrosis.

Keywords

Pulmonary atresiaintact septumpulmonary valvar stenosis
Type
World Forum for Pediatric Cardiology Symposium on Pulmonary Atresia
Information
Cardiology in the Young , Volume 2 , Issue 4 , October 1992 , pp. 382 - 386
Copyright
Copyright © Cambridge University Press 1992

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References

1.Coles, J, Williams, WG, Trusler, GA, Lightfoot, N, Freedom, RM. Surgical considerations and outcome. In: Freedom, RM (ed). Pulmonary Atresia with Intact Septum. Futura Publishing, New York, 1989, pp 249–257.Google Scholar
2.Quereshi, SA, Rosenthal, E, Tynan, M, Anjos, R, Baker, E. Transcatheter laser assisted pulmonic valve dilatation in pulmonary valve atresia. Am J Cardiol 1991; 67: 428–431.CrossRefGoogle Scholar
3.Hatle, L, Angelsen, B, Tromsdal, A. Noninvasive assessment of atrioventricular pressure half-time by Doppler ultrasound. Circulation 1979; 60: 1096–1104.CrossRefGoogle ScholarPubMed
4.Leung, MP, Lo, PTS, Lo, RNS, Cheung, H, Mok, C-K. The changes in right ventricular diastolic indices in babies with pulmonary atresia and intact septum undergoing corrective surgery: A pulsed Doppler echocardiographic study. Cardiol Young 1991; 1: 114–122.CrossRefGoogle Scholar
5.De Leval, M, Bull, C, Stark, J, Anderson, RH, Taylor, JFN, McCartney, FJ. Pulmonary atresia and intact ventricular septum: Surgical management based on a revised classification. Circulation 1982; 66: 272–280.CrossRefGoogle ScholarPubMed
6.Appleton, CP, Hatle, LK, Popp, RL. Demonstration of restrictive ventricular physiology by Doppler echocardiography. J Am Coll Cardiol 1988; 11: 757–768.CrossRefGoogle ScholarPubMed
7.Redington, AN, Oldershaw, PJ, Shinebourne, EA, Rigby, ML. A new technique for measuring pulmonary regurgitation: Application to the assessment of right ventricular function before and after repair of tetralogy of Fallot. Br Heart J 1988; 60: 57–65.CrossRefGoogle Scholar
8.Bryan, C, Oppenheimer, EH. Ventricular endocardial fibroelastosis: Basis for its presence or absence in cases of pulmonic and aortic atresia. Arch Pathol 1969; 87: 82–86.Google ScholarPubMed
9.Fyfe, DA, Edwards, WD, Driscoll, DJ. Myocardial ischaemia in patients with pulmonary atresia and intact ventricular septum. J Am Coll Cardiol 1986; 8: 402–406.CrossRefGoogle ScholarPubMed