Pulmonary artery growth in univentricular physiology patients

Kansy, Andrzej; Brzezińska‐Rajszys, Grażyna; Zubrzycka, Maria; Mirkowicz-Małek, Małgorzata; Maruszewski, Przemysław; Manowska, Małgorzata; Maruszewski, Bohdan

doi:10.5603/kp.2013.0121

Cited by 17 publications

(13 citation statements)

References 21 publications

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“…Tricuspid atresia and left side dominant single-ventricle anatomy were the most common diagnosis in our study population similar to other studies on single ventricle [1,[11][12][13].…”

Section: Discussionsupporting

confidence: 87%

“…Recommendation for routine catheterization is policy dependent rather than a specific widely accepted guideline [4,5,12,14,15]. But because of the high PAP in our study and a good correlation between IVC-CI and peripheral vein pressure with level of mean PAP, noninvasive estimation of mean PAP prior to proceeding to cardiac catheterization, taking its risks into consideration, as already mentioned may be recommended [16].…”

Section: Discussionmentioning

confidence: 68%

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Noninvasive Assessment of Pulmonary Artery Pressure in Patients with Extracardiac Conduit Total Cavopulmonary Connection

et al. 2016

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To assess quantitative measurement of mean pulmonary artery pressure (PAP) in extracardiac total cavopulmonary connection (TCPC) patients by noninvasive echocardiographic inferior vena cava collapsibility index (IVC-CI) and also correlation between the peripheral vein pressure and mean PAP. In 19 TCPC patients with at least 1-year follow-up after completion of TCPC, complete echocardiography including IVC-CI was recorded. All patients underwent cardiac catheterization for mean PAP pressure, peripheral vein pressure (PVP) and contrast study. Different cutoff points of mean PAP were analyzed, and based on the highest cutoff point, patients were categorized into two groups: mean PAP < 17 mmHg (acceptable) and > = 17 mmHg (high) for comparison analysis. Between 2006 and 2015, from 43 patients who had undergone TCPC, nineteen patients with a mean age 12.9 ± 6.6 years and mean follow-up time of 3.4 ± 1.9 years were included in this study. Mean PAP was 14.6 ± 3.97 (range 8-22 mmHg). Thirteen (68 %) patients had PAP < 17 mmHg. No significant statistical difference was detected with respect to age, sex, type of congenital heart disease and fenestration between these two groups. But, right ventricular dominancy was more prevalent in the high PAP group (50 % vs. 7.7 % P value 0.03). IVC-CI had a correlation with mean PAP (r 0.67, P < 0.001). IVC-CI < 21.8 % can predict PAP > = 17 mmHg with 83 % sensitivity and 100 % specificity. Regression analysis proposed an equation for PAP measurement: PAP (mmHg) = 20.2097-0.1796 × (IVC-CI), (r2 = 0.56). Peripheral vein pressure measurement also showed a good correlation with mean PAP and may be used to estimate PAP with the following equation: PAP (mmHg) = 0. 8675 × PVP, (r 0.90, P < 0.0001). In conclusion, IVC-CI as noninvasive and peripheral vein pressure measurement as a minimal invasive method may be useful for quantitative estimation of PAP in patients with extracardiac TCPC.

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“…Tricuspid atresia and left side dominant single-ventricle anatomy were the most common diagnosis in our study population similar to other studies on single ventricle [1,[11][12][13].…”

Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 68%

Noninvasive Assessment of Pulmonary Artery Pressure in Patients with Extracardiac Conduit Total Cavopulmonary Connection

et al. 2016

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“…The first palliative procedure to optimize pulmonary blood flow is therefore critical to the development of the pulmonary vasculature in patients with single ventricle physiology . The initial shunting procedure may cause asymmetric flow, and hypoplasia or mild pulmonary vascular disease of the pulmonary vascular bed.…”

Section: The Ventriclementioning

confidence: 99%

Cardiovascular adaptation to the Fontan circulation

Veldtman

Opotowsky

Wittekind

et al. 2017

Congenital Heart Disease

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Although medium-term survival following Fontan operations in the modern era has improved dramatically, late cardiovascular and extracardiac morbidity are common and are associated with impaired quality of life and premature late mortality. This serves as a reminder of the extraordinary adaptations required of the cardiovascular system when the systemic arterial, systemic venous and pulmonary circulations are placed in series coupled to a single ventricular pump. This article reviews the key features and principles that govern interactions between the ventricle, systemic arterial circulation, the systemic venous and pulmonary circulatory compartments, the microcirculation, and lymphatic circulations. The overarching aim is to provide insight into the integrative pathophysiology that governs the Fontan circulation and stimulate thoughtful approaches to advance research.

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“…Therefore, the dilemma is quite clear: without proper development of pulmonary arteries, the patient with HLHS will not be a good candidate for a Fontan completion (Figure 1). Pulmonary arterial growth in patients with univentricular physiology is greater in patients with increased pulmonary blood flow prior to Glenn anastomosis but thereafter the Nakata index and McGoon ratio decreased significantly (13). …”

Section: The Pulmonary Circulation In Patients With Hlhsmentioning

confidence: 99%

Hypoplastic Left Heart Syndrome â€“ Unresolved Issues

2014

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Hypoplastic left heart syndrome (HLHS) is one of the most challenging congenital heart defects. At present, it is expected that – at best – 70% of newborns with HLHS will reach adulthood. This review addresses the problems of right ventricular (RV) failure and insufficient growth of pulmonary vasculature in these patients. In order to further improve long-term prognosis translational research to control RV function, growth of pulmonary arteries and progress in chronic circulatory support are clearly needed to provide a further improvement for adults with HLHS.

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Pulmonary artery growth in univentricular physiology patients

Cited by 17 publications

References 21 publications

Noninvasive Assessment of Pulmonary Artery Pressure in Patients with Extracardiac Conduit Total Cavopulmonary Connection

Noninvasive Assessment of Pulmonary Artery Pressure in Patients with Extracardiac Conduit Total Cavopulmonary Connection

Cardiovascular adaptation to the Fontan circulation

Hypoplastic Left Heart Syndrome â€“ Unresolved Issues

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