The mid-term follow-up of pulmonary perfusion in patients after extracardiac total cavopulmonary connection

Abstract

Radionuclide scintigraphy is superior to the pulmonary angiography in the study of functional pulmonary perfusion. Fontan circulation may lead to gravity-dependent blood redistribution, and its weak pulsation can promote pulmonary vascular development. However, the reduced pulmonary arterial resistance at mid-term follow-up may not lead to an increased amount of pulmonary perfusion or oxygen supply, which is probably because of the massive opening of the arteriovenous shunt and increased futile circulation.

Pulmonary Artery Branch Stenosis in Patients with Congenital Heart Disease

“…The number of patients is limited and it is a very heterogeneous population. In addition, we are aware that lung scintigraphy, which has been routinely used in almost all our patients during the last few years, may provide false‐negative and false‐positive results . However, we still believe that lung scintigraphy plays an important role together with other diagnostic modalities, in the evaluation of mid‐ and long‐term outcome of these patients, helping us to plan further investigations in order to devise the most appropriate therapeutic strategy for these patients.…”

New insights into the aspects of pulmonary diffusing capacity in Fontan patients

“…Reduced pulmonary perfusion in Fontan patients compared with controls has previously been shown. 19 In a recent study by Wang et al, 20 pulmonary perfusion was reported in 43 Fontan patients palliated with an extracardiac conduit who were examined at 1 month and 5 years after the Fontan operation. The total pulmonary perfusion did not change significantly between the two examinations, whereas perfusion of the lower lung segment compared with the upper lung segment and that of the posterior segment of the lower lobe significantly increased in the latter examination.…”

Distribution of lung blood on modified bilateral Glenn shunt evaluated by Tc-99m-MAA lung perfusion scintigraphy

“…Notably, the lack of low pulsatile pulmonary blood flow after Glenn procedure would be increased by blood perfusion to the lower lung lobes. [ 13 , 14 ] In the modified bilateral Glenn connection, the maintaining additional pulmonary blood flow would result in pulsatile pulmonary blood flow in the lungs and reasonable blood oxygen saturation. Thus, we can speculate that possible blood flow redistribution due to low pulsatile flow would occur slowly after the operation.…”