Echocardiographic Assessment of Pulmonary Arteries Pulsatility Index in Fontan Circulation
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Background: Late complications after Fontan procedure may be due to the absence of pump and pulsatile pulmonary blood flowin this type of palliation. Our aim was to quantify the degree of pulsation by echocardiographic method in patients with extracardiactotal cavopulmonary connection (ECTCPC) in comparison with biventricular circulation and few cases of pulsatile Fontan. Methods: In a case series study, pulsatility index (PI) derived by echocardiographic method were compared between 20 patientswith ECTCPC, 6 patients with pulsatile Fontan and 18 normal individual aged 4 to 20 years old. All patients were in New YorkHeart Association class of I and there was no report of complication. Results: In patients with ECTCPC pulmonary artery branches Doppler flow study showed lower peak and mean velocitiescompared to the pulsatile Fontan and normal groups. ECTCPC patients had PI of 0.59 ± 0.14 and 0.59 ± 0.09 for right and leftpulmonary arteries (RPA and LPA) respectively. PI was higher in patients with preserved antegrade flow (RPA PI = 0.94 ± 0.26,LPA PI = 0.98 ± 0.27) and in normal individuals (RPA PI = 1.59 ± 0.12, LPA PI = 1.64 ± 0.17) for both branches (p = 0.000). Conclusion: Using a Doppler derived index for pulsatility, patients with ECTCPC had the least pulsation. The pulmonary arteryflow pattern in patients with preserved antegrade flow showed higher pulsatility indices in both branches. Normal individualshad the greatest pulsatility index.
Abstract
Background: Late complications after Fontan procedure may be due to the absence of pump and pulsatile pulmonary blood flowin this type of palliation. Our aim was to quantify the degree of pulsation by echocardiographic method in patients with extracardiactotal cavopulmonary connection (ECTCPC) in comparison with biventricular circulation and few cases of pulsatile Fontan. Methods: In a case series study, pulsatility index (PI) derived by echocardiographic method were compared between 20 patientswith ECTCPC, 6 patients with pulsatile Fontan and 18 normal individual aged 4 to 20 years old. All patients were in New YorkHeart Association class of I and there was no report of complication. Results: In patients with ECTCPC pulmonary artery branches Doppler flow study showed lower peak and mean velocitiescompared to the pulsatile Fontan and normal groups. ECTCPC patients had PI of 0.59 ± 0.14 and 0.59 ± 0.09 for right and leftpulmonary arteries (RPA and LPA) respectively. PI was higher in patients with preserved antegrade flow (RPA PI = 0.94 ± 0.26,LPA PI = 0.98 ± 0.27) and in normal individuals (RPA PI = 1.59 ± 0.12, LPA PI = 1.64 ± 0.17) for both branches (p = 0.000). Conclusion: Using a Doppler derived index for pulsatility, patients with ECTCPC had the least pulsation. The pulmonary arteryflow pattern in patients with preserved antegrade flow showed higher pulsatility indices in both branches. Normal individualshad the greatest pulsatility index.
참고문헌 (16)
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