P-412 Doppler Evaluation of Left to Right Shunt (Qp/Qs) in Patients with Isolated Ventricular Septal Defect (VSD)

Can intraoperative TEE correctly measure residual shunt after surgical repair of ventricular septal defects?

“…To our knowledge, however, this echocardiographic modality has not been used intraoperatively to determine the indications for revision after correction for intracardiac shunt lesions. Several studies have previously indicated that Qp/Qs evaluated by the conventional method (the same method we employed in this study) was excellently correlated with the Qp/Qs in cardiac catheterization, with a correlation coefficient of greater than 0.90 and a standard error of the estimate of about 0.20 [7,10]. In addition, the method could accurately estimate Qp/Qs even in subjects without shunt lesion [8].…”

“…Previous studies have suggested that Doppler echocardiography accurately estimates Qp/Qs in various cardiac shunt lesions [6][7][8][9][10][11]. To our knowledge, however, this echocardiographic modality has not been used intraoperatively to determine the indications for revision after correction for intracardiac shunt lesions.…”

“…In addition, the method could accurately estimate Qp/Qs even in subjects without shunt lesion [8]. The transesophageal approach has never been applied for the estimation of Qp/Qs in previous studies [6][7][8][9][10][11]. Several studies, however, have demonstrated that intraoperative TEE can accurately determine cardiac output either at the PA, right ventricular outflow tract, LVOT, or aortic valve by measuring VTI and the luminal area in patients undergoing cardiac or noncardiac surgery [12][13][14][15][16][17].…”

“…Doppler echocardiography techniques have been used to accurately estimate the ratio of pulmonary blood flow to systemic blood flow (Qp/Qs) in various cardiac shunt lesions in non-operating room settings [6][7][8][9][10][11]. One conventional method applicable either before or after the repair of a shunt lesion is to calculate the relative amounts of flow passing through the pulmonary artery (PA) and left ventricular outflow tract (LVOT) by measuring the velocitytime integrals and luminal areas of the PA and LVOT.…”

Hybrid Approach to Post–Myocardial Infarction Ventricular Septal Rupture Repair and Its Early Complications

“…One method was using bedside TTE to access the velocity-time integral of the right ventricular outflow tract and left ventricular outflow tract. 13,14 The second method was using a pulmonary artery catheter that allowed for the collection of oxygen saturation from the central venous pressure and pulmonary artery ports. The Qp/Qs was calculated and monitored by using the equation (SaO 2 À SvO 2 )/(SpvO 2 À SpaO 2 ), where SpvO 2 is the pulmonary vein O 2 saturation and SpaO 2 is the pulmonary artery O 2 saturation, which was assumed to be the same as SaO 2 .…”