There was reasonable agreement between MR phase velocity-derived PR fraction and that obtained from right ventricular pressure-volume loops generated by use of conductance and pressure-microtip catheters. Exacerbation of PR by increased airway pressure and branch pulmonary stenosis may be relevant to the acute postoperative and long-term management, respectively, of patients after repair of tetralogy of Fallot.
This study details the effects of changes in right ventricular (RV) volume on the conductance catheter gain factor both over a broad volume range and within the cardiac cycle. In seven closed-chest anesthetized pigs, a conductance catheter was introduced transvenously and positioned to span the RV long axis, including the outflow tract. Parallel conductance was determined using a saline dilution technique. Conductance volume gain factor (alpha) was computed using stroke volume obtained by thermodilution over a range of volumes obtained by volume loading or sustained partial occlusion of the inferior caval vein. The chest was then opened, an ultrasonic flow probe was placed around the pulmonary artery, and the conductance-derived RV volume was compared with the pulmonary flow integral over the course of ejection. When volume was varied over a broad range, an inverse relation between RV volume and alpha was observed (P < 0.001). This did not cause significant nonlinearity of the conductance-volume relation. The relation was also relatively linear during the course of ejection within the cardiac cycle. These results indicate that the conductance catheter may be employed, using the described technique, to assess RV volume under steady-state conditions.
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