A pulsed Doppler echocardiographic method for calculating pulmonary and systemic blood flow in atrial level shunts: validation studies in animals and initial human experience.

Valdes‐Cruz, Lilliam M.; Horowitz, S; Mesel, Emmanuel; Sahn, David J.; Fisher, Daniel C.; Larson, Douglas F.

doi:10.1161/01.cir.69.1.80

Cited by 76 publications

(24 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Dopplerestimated stroke volume was determined using the velocity time integral of flow through the left or right ventricular outflow tract · aortic or pulmonary annular cross-sectional area, respectively. Both annuli were measured immediately proximal to the point of insertion of valve leaflets at maximal systolic leaflet separation (inner diameter) [13].…”

Section: Methodsmentioning

confidence: 99%

Pre‐operative sildenafil and pulmonary endothelial‐related complications following cardiopulmonary bypass: a randomised trial in children undergoing cardiac surgery*

et al. 2011

View full text Add to dashboard Cite

SummaryIn a randomised trial, we compared the effects of oral sildenafil (0.5 mg.kg )1 ) and placebo, , respectively; p = 0.002; right ventricle 6.93 (1.47) vs 8.09 (2.25) cm.s )1 , respectively; p < 0.001) were significantly reduced in the sildenafil group. In this trial, pre-operative sildenafil did not affect postoperative pulmonary vascular resistance. There was, however, a negative impact on ventricular function and oxygenation.

show abstract

Section: Methodsmentioning

confidence: 99%

Pre‐operative sildenafil and pulmonary endothelial‐related complications following cardiopulmonary bypass: a randomised trial in children undergoing cardiac surgery*

et al. 2011

View full text Add to dashboard Cite

show abstract

“…For these reasons, we measured simple indices in this study, focusing on alterations of the left ventricular pump function and the systemic and pulmonary blood flow, that is, heart rate, left of ventricular dimensions, flow velocities, and compared to the serum concentration of denopamine. Many investigators have confirmed that cardiac output estimated by Doppler echocardiography well correlates to that measured by Fick or thermodilution method (Alverson et al 1982;Valdes-Cruz et al 1984). There are certainly some potential sources of error to assess the cardiac output using Doppler echocardiographies, such as the angle between the ultrasound beam and blood flow, and the measurement of the vessel diameter (DiSessa and Friedman 1984; Gardin et al 1985).…”

Section: Discussionmentioning

confidence: 86%

Denopamine Augments the Left Ventricular Pump Function in Infants with Ventricular Septal Defect and Pulmonary Hypertension: Doppler Echocardiographic Analysis.

Tomita

Ikeda

Chiba

1994

Tohoku J. Exp. Med.

View full text Add to dashboard Cite

The purpose of this study is to evaluate hemodynamic effects and clinical benefit of oral denopamine in infants with left to right shunt disease. We measured heart rates, left ventricular end-diastolic and end-systolic dimensions, shortening fractions, peak and mean flow velocities of the main pulmonary artery and ascending aorta at 30, 60 and 90 min after oral denopamine using Doppler echocardiography. Seventeen infants with ventricular septal defect and pulmonary hypertension (mean pulmonary artery pressures higher than 25 mmHg) were divided into two groups depending upon the doses of denopamine; group 1 received 1 mg/kg, and group 2 was given 0.5 mg/kg. Serum concentrations of denopamine were measured with high performance liquid chromatography after completion of these evaluations. In both groups, heart rates and left ventricular shortening fractions increased, and left ventricular end-systolic dimensions decreased significantly. Although peak and mean velocities of aortic and pulmonary flows increased significantly, there were no significant alterations in peak and mean velocity ratios of pulmonary to aortic flow. There was no significant difference in the serum concentration of denopamine between the two groups. However, percentage changes of some indices, such as heart rates, left ventricular end-systolic dimensions, peak aortic and pulmonary flow velocities, and mean aortic flow velocities exponentially correlated to serum concentrations of denopamine. In conclusion, denopamine is supposed to have beneficial actions to augment the systemic output by enhancing the left ventricular pump function in patients of ventricular septal defect. However, we should be careful for denopamine not to produce excessive increases in heart rate and pulmonary blood flow.denopamine; ventricular septal defect; pulmonary hypertension; infant

show abstract

“…The systemic blood flow (Q s ) can be calculated from the left ventricular outflow tract and that of the pulmonary blood flow (Q p ) from the right ventricular outflow tract. The assumption that both tracts are circles allows the velocity time integrals for each to be calculated with each heart beat to obtain values for Q p ⁄ Q s [13,14]. A left to right shunt will be considered severe when the Q p ⁄ Q s ratio is more than 1.8 : 1.0 [15].…”

Section: Discussionmentioning

confidence: 99%

Peri‐operative trans‐oesophageal echocardiography and nitric oxide during general anaesthesia in a patient with Eisenmenger's syndrome

Bouch¹,

Allsager

Moore

2006

Anaesthesia

View full text Add to dashboard Cite

SummaryWe describe the peri-operative care of a patient with Eisenmenger's syndrome presenting for laparotomy. These patients require techniques to prevent the potential increase in intracardiac shunt caused by anaesthesia, by minimising increases in pulmonary artery pressure and reductions in systemic vascular resistance. The successful use of combined epidural and general anaesthesia with elective use of inhaled nitric oxide as a pulmonary vasodilator, and intra-operative trans-oesophageal echocardiography is described. In 1897, Eisenmenger described pulmonary vascular pathology related to a ventricular septal defect with right ventricular hypertrophy [1]. In 1958, the term Eisenmenger complex was used to describe pulmonary hypertension as a consequence of raised pulmonary vascular resistance (over 800 dyne.s )1 .cm) with reversed or bidirectional shunting through a large ventricular septal defect [2]. The term Eisenmenger's syndrome is applied where communication exists between the pulmonary and systemic circulations, with resultant pulmonary vascular pathology and cyanosis as a consequence of a reversed or bidirectional shunt [2,3], the shunt position being immaterial [2].With advances in medical care, patients with Eisenmenger's syndrome are surviving well into adulthood and are more likely to require non-cardiac surgery [4]. In this group of patients, the leading cause of peri-operative death relates to cardiac morbidity associated with alteration of the ratio of pulmonary to systemic pressures secondary to surgery and anaesthesia. Mortality rates of up to 30% are frequently quoted for this group of patients undergoing non-cardiac surgery [4]. Case reportA 43-year-old woman with Crohn's disease presented with repeated progressive episodes of bowel obstruction, secondary to a terminal ileal stricture. At 27 years of age, following the birth of her fourth child, a diagnosis of pulmonary hypertension secondary to an atrial septal defect was made, which progressed to Eisenmenger's syndrome over the next 5 years.History revealed a patient with only mild symptoms of dyspnoea on reaching the top of a flight of stairs, but who continued to smoke cigarettes, with a 20 pack year history. Daily medications were warfarin, inhaled steroid and b 2 agonist, with nicardipine for treatment of pulmonary hypertension. She was taking no medications for Crohn's disease.On examination, she weighed 45 kg, had finger clubbing, a loud second heart sound and raised jugular venous pulse but no peripheral oedema or hepatomegaly. Arterial pressure measured non-invasively was 85 ⁄ 40 mmHg, and heart rate was 90 beats.min )1 . Electrocardiogram showed sinus rhythm with right axis deviation and right ventricular hypertrophy. Results of a recent cardiac catheterisation (performed for pulmonary assessment) revealed pulmonary artery pressures of 98 ⁄ 27 mmHg (mean 53 mmHg), mean right atrial pressure of 4 mmHg, mean pulmonary capillary wedge pressure 6 mmHg, with systemic arterial pressures of 95 ⁄ 42 mmHg and pulmonary-systemic flow ratio ...

show abstract

A pulsed Doppler echocardiographic method for calculating pulmonary and systemic blood flow in atrial level shunts: validation studies in animals and initial human experience.

Cited by 76 publications

References 10 publications

Pre‐operative sildenafil and pulmonary endothelial‐related complications following cardiopulmonary bypass: a randomised trial in children undergoing cardiac surgery*

Pre‐operative sildenafil and pulmonary endothelial‐related complications following cardiopulmonary bypass: a randomised trial in children undergoing cardiac surgery*

Denopamine Augments the Left Ventricular Pump Function in Infants with Ventricular Septal Defect and Pulmonary Hypertension: Doppler Echocardiographic Analysis.

Peri‐operative trans‐oesophageal echocardiography and nitric oxide during general anaesthesia in a patient with Eisenmenger's syndrome

Contact Info

Product

Resources

About