Energetic performance analysis of staged palliative surgery in tricuspid atresia using vector flow mapping

Abstract

BackgroundStaged palliative surgery markedly shifts the balance of volume load on a single ventricle and pulmonary vascular bed. Blalock-Taussig shunt necessitates a single ventricle eject blood to both the systemic and pulmonary circulation. On the contrary, bidirectional cavopulmonary shunt release the single ventricle from pulmonary circulation.Case presentationWe report a case of tricuspid atresia patient who underwent first palliative surgery and second palliative surgery. Volume loading condition was assessed by energetic parameters (energy loss, kinetic energy) intraoperatively using vector flow mapping. These energetic parameters can simply indicate the volume loading condition.ConclusionVector flow mapping was useful tool for monitoring volume loading condition in congenital heart disease surgery.Electronic supplementary materialThe online version of this article (10.1186/s12947-017-0118-3) contains supplementary material, which is available to authorized users.

Energetic performance index improvement after Glenn and Damus-Kaye-Stansel procedure using vector flow mapping analysis: a case report

“…After the DKS procedure, the KE would increase owing to the integrated systemic outflow; however, in this case, KE decreased, which was potentially explained by the fact that KE also depends on the left ventricular preload [14]. Interestingly, EL and KE were reported to decrease in an 11-month-old patient who underwent the Glenn procedure, which may be consistent with our findings [4]. Together, evaluation of EL and KE is difficult because the left ventricular preload changes dramatically during pediatric congenital heart surgery.…”

“…This flow visualization technique can assess dynamic flow to treat congenital heart diseases [2,3]. However, there have been few reports evaluating EL during congenital heart surgery [4,5]. In this case, we evaluated intracardiac flow, EL, and left ventricular output kinetic energy (KE) using VFM during the Glenn and Damus-Kaye-Stansel (DKS) procedures in order to assess the efficacy of the surgery.…”

Vector flow mapping: A review from theory to practice

“…57 In addition, EL seems to be a valid parameter to assess diastolic function in children after arterial switch operation. 58 Lastly, some authors examined flow parameters in patients with double-outlet right ventricle 59 double inlet-left ventricle 60 and tricuspid atresia 61 suggesting the suitability of VFM technique even in complex patients; however, these are anecdotical cases.…”