Congenital Stenosis of the Pulmonary Artery Branches

Baum, David; Khoury, George H.; Ongley, Patrick A.; Swan, H. J. C.; Kincaid, Owings W.

doi:10.1161/01.cir.29.5.680

Cited by 60 publications

(29 citation statements)

References 1 publication

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“…The murmur usually disappears by 3-6 months of age. If a murmur persists beyond this age with the same Doppler characteris tics, a structural narrowing of the pulmonary artery tree (peripheral pulmonary artery ste nosis) should be suspected [9][10][11].…”

Section: Functional Murmur and Echocardiographymentioning

confidence: 99%

Doppler Assessment of Physiological Stenosis at the Bifurcation of the Main Pulmonary Artery: A Cause of Functional Murmur in Neonates

So¹,

Watanabe²,

Shimizu³

et al. 1996

Neonatology

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A systolic heart murmur is not infrequently recognized in healthy newborn infants, especially those with a low birth weight. This study aimed at assessing the hemodynamics at the bifurcation of the main pulmonary artery using Doppler echocardiography and to correlate the results with this murmur. The peak velocities of main pulmonary artery (MPAV) and right pulmonary artery (RPAV) were studied in 25 low-birth-weight infants who had recovered from acute stage and presented with a systolic murmur, and the ratio of RPAV/MPAV was calculated. Another compatible 25 healthy low-birth-weight infants without a murmur were enrolled as the control group. The initial MPAV values were 79.8 ± 20.7 (range 51–152) cm/s and 80.7 ± 14.2 (range 60–111) cm/s in the heart murmur group and in the control group, respectively (p > 0.05). The initial RPAV values were 193.4 ± 60.2 (range 118–388) cm/s and 99.8 ± 15.5 (range 76–132) cm/s in the heart murmur group and in the control group, respectively (p < 0.0001). The initial RPAV/MPAV ratios were 2.46 ± 0.61 (1.59–3.92) and 1.25 ± 0.14 (0.94–1.47) in the heart murmur group and in the control group, respectively (p < 0.0001). When the murmur disappeared after a period of 2–5 months, no significant differences in the last RPAV and RPAV/MPAV ratios between both groups could be found. The RPAV in the heart murmur group faded significantly to 118.7 ± 16.9 cm/s, and so did the RPAV/MPAV ratio to 1.24 ± 0.12 (p < 0.0001). A transient functional murmur recognized in healthy premature infants at about 1 month of age is caused by the pressure gradient that implies a physiological stenosis at the bifurcation of the main pulmonary artery. The RPAV is higher than the MPAV, and the RPAV/MPAV ratio is usually over 1.5. The RPAV became slower, and the RPAV/MPAV ratio fell as the murmur faded with age.

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Section: Functional Murmur and Echocardiographymentioning

confidence: 99%

Doppler Assessment of Physiological Stenosis at the Bifurcation of the Main Pulmonary Artery: A Cause of Functional Murmur in Neonates

So¹,

Watanabe²,

Shimizu³

et al. 1996

Neonatology

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“…The azygous vein group was privileged be cause of special interest in this autologous material, and provided 3 animals. 4 5-7 months postoperatively, but 1 already had a rather severe stenosis. It must be em phasized that there was no significant aggra vation during a further 9-month (average) follow-up (table V).…”

Section: Resultsmentioning

confidence: 95%

Experimental Evaluation of Three Biomaterials for Replacement of the Pulmonary Artery Branches

Planche¹,

Onursal²,

Weiss³

1983

Eur Surg Res

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24 adult dogs were randomly divided into 4 groups and submitted to angioplastic replacement of a 2- to 3-cm segment of the right or left pulmonary artery by three kinds of autogenous biomaterials; azygous vein, jugular vein and pericardium, and by a synthetic arterial prosthesis in a control group. In vivo evaluation was carried out by catheterization with a balloon catheter allowing successive intraluminal occlusion of the pulmonary branches, and by cineangiopneumography. There was a good correlation between evaluation techniques. Final evaluation after a follow-up of 5–20 months was based on postmortem measurement of the anastomosis diameter and histologic examination. In each group, the results were classified into four grades, numbered 0–3, and compared statistically. The results show that in this experimental model: (a) none of the autogenous tissues (selected for their potential ability to grow) proved better than the control Dacron arterial prosthesis, and (b) of the three biomaterials, the azygous vein was superior to the jugular vein and pericardium.

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“…Momma et al [23], in an angiographic study, found nine cases of juxtaductal LPA stenosis and five cases of juxtaductal LPA atresia. Baum et al [1], in a clinicoradiologic study, reported 26 cases of pulmonary arterial branch stenoses. However, the exact sites of the pulmonary stenoses were not described.…”

Section: Discussionmentioning

confidence: 99%

Coarctation of the Left Pulmonary Artery: Effects on the Pulmonary Vasculature of Infants

1997

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At autopsy, two infants had unsuspected coarctation of the left pulmonary artery (CoLPA), which was produced by an extension of ductal tissue into the wall of the left pulmonary artery. The first case, a 4-month-old girl, also had a ventricular septal defect and an anomalous branching pattern of the innominate arterial trunk. Pulmonary arterial hypertensive changes were noted in the right lung. In contrast, the left lung showed thin-walled pulmonary arteries. The second case, a term female newborn, had exhibited severe unexplained respiratory distress since birth. Histologic sections of the right lung showed dilated pulmonary arteries with thinned media, whereas the left lung showed a persistent fetal arterial pattern. It is believed that the peripheral pulmonary arterial changes are age-dependent and associated with asymmetric blood flow between the right and left pulmonary arteries. CoLPA is a rare pulmonary artery defect, and early diagnosis of this abnormality is important.

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Congenital Stenosis of the Pulmonary Artery Branches

Cited by 60 publications

References 1 publication

Doppler Assessment of Physiological Stenosis at the Bifurcation of the Main Pulmonary Artery: A Cause of Functional Murmur in Neonates

Doppler Assessment of Physiological Stenosis at the Bifurcation of the Main Pulmonary Artery: A Cause of Functional Murmur in Neonates

Experimental Evaluation of Three Biomaterials for Replacement of the Pulmonary Artery Branches

Coarctation of the Left Pulmonary Artery: Effects on the Pulmonary Vasculature of Infants

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