Quantification of collateral aortopulmonary flow in patients subsequent to construction of bidirectional cavopulmonary shunts

Ryo Inuzuka, Hiroyuki Aotsuka, Hiromichi Nakajima, Hirokuni Yamazawa, Kenji Sugamoto, Shunsuke Tatebe, Mitsuru Aoki, Tadashi Fujiwara

研究成果: Article査読

13 被引用数 (Scopus)

抄録

Objectives: We sought to provide a new method for quantifying collateral aortopulmonary flow in patients subsequent to construction of a bidirectional cavopulmonary shunt, and to clarify the clinical advantages of the new method. Methods: We performed lung perfusion scintigraphy and cardiac catheterization in 10 patients subsequent to construction of a bidirectional cavopulmonary shunt. First, the ratio of collateral to systemic flow was determined by whole-body images of lung perfusion scintigraphy, dividing the total lung count by the total body count minus the total lung count. Second, we integrated lung perfusion scintigraphy and cardiac catheterization data using a formula derived from the Fick principle, taking the ratio of pulmonary to systemic flow to be 1 plus the ratio calculated above and multiplied by the systemic saturation minus the inferior caval venous saturation divided by the pulmonary venous saturation minus the inferior caval venous saturation. Finally, the amount of collateral flow was obtained from the ratio of pulmonary to systemic flow. We evaluated the impact of collateral flow on the calculation of pulmonary vascular resistance. Results: The median age at bidirectional cavopulmonary shunt was 1.41 years, and the median age at catheterization was 2.33 years. The mean amount of collateral flow was 1.75 ± 0.46 litres/min/ m2. The pulmonary vascular resistance calculated without considering the collateral flow was overestimated by an average of 57 ± 23%, compared to the resistance calculated with our new method. Conclusions: The use of scintigraphy combined with catheterization allows accurate determination of aortopulmonary collateral flow, and avoids overestimation of pulmonary vascular resistance in these candidates for the Fontan circulation.

本文言語English
ページ(範囲)485-493
ページ数9
ジャーナルCardiology in the Young
18
5
DOI
出版ステータスPublished - 2008
外部発表はい

ASJC Scopus subject areas

  • 小児科学、周産期医学および子どもの健康
  • 循環器および心血管医学

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