Skip to main content
Erschienen in: Pediatric Cardiology 6/2017

19.06.2017 | Original Article

Pulmonary Vein Doppler Patterns in Infants with Single Right Ventricle Anomalies After Initial Staged Palliations

verfasst von: Edward C. Kirkpatrick, Jessica Steltzer, Pippa Simpson, Amy Pan, Andrea Dragulescu, Christine B. Falkensammer, Sarah Gelehrter, Wyman W. Lai, Jami Levine, Stephen Miller, Thomas A. Miller, Jay Pruetz, Ritu Sachdeva, Deepika Thacker, Peter Frommelt

Erschienen in: Pediatric Cardiology | Ausgabe 6/2017

Einloggen, um Zugang zu erhalten

Abstract

The aim of this study was to describe serial changes in echocardiographic Doppler pulmonary vein flow (PVF) patterns in infants with single right ventricle (RV) anomalies enrolled in the Single Ventricle Reconstruction trial. Measurement of PVF peak systolic (S) and diastolic (D) velocities, velocity time integrals (VTI), S/D peak velocity and VTI ratios, and frequency of atrial reversal (Ar) waves were made at three postoperative time points in 261 infants: early post-Norwood, pre-stage II surgery, and 14 months. Indices were compared over time, between initial shunt type [modified Blalock–Taussig shunt (MBTS) and right ventricle-to-pulmonary artery shunt (RVPAS)] and in relation to clinical outcomes. S velocities and VTI increased over time while D wave was stable, resulting in increasing S/D peak velocity and VTI ratios, with a median post-Norwood S/D VTI ratio of 1.14 versus 1.38 at pre-stage II and 1.89 at 14 months (P < 0.0001 between intervals). MBTS subjects had significantly higher S/D peak velocity and VTI ratios compared to RVPAS at the post-Norwood and pre-stage II time points (P < 0.0001) but not by 14 months. PVF patterns did not correlate with survival or hospitalization course at 1 year. PVF patterns after Norwood palliation differ from normal infants by having a dominant systolic pattern throughout infancy. PVF differences based upon shunt type resolve by 14 months and did not correlate with clinical outcomes. This study describes normative values and variations in PVF for infants with a single RV from shunt-dependent pulmonary blood flow to cavopulmonary blood flow.
Literatur
1.
Zurück zum Zitat Frommelt P, Guey L, Minich L et al (2012) Does initial shunt type for the Norwood procedure affect echocardiographic measures of cardiac size and function during infancy?: the Single Ventricle Reconstruction trial. Circulation 125:2630–2638CrossRefPubMedPubMedCentral Frommelt P, Guey L, Minich L et al (2012) Does initial shunt type for the Norwood procedure affect echocardiographic measures of cardiac size and function during infancy?: the Single Ventricle Reconstruction trial. Circulation 125:2630–2638CrossRefPubMedPubMedCentral
3.
Zurück zum Zitat Ohye R, Sleeper L, Mahony L et al (2010) Comparison of shunt types in the Norwood procedure for single-ventricle lesions. N Engl J Med 362:1980–1992CrossRefPubMedPubMedCentral Ohye R, Sleeper L, Mahony L et al (2010) Comparison of shunt types in the Norwood procedure for single-ventricle lesions. N Engl J Med 362:1980–1992CrossRefPubMedPubMedCentral
4.
Zurück zum Zitat O’Leary P, Durongpisitkul K, Cordes T et al (1998) Diastolic ventricular function in children: a Doppler echocardiographic study establishing normal values and predictors of increased ventricular end-diastolic pressure. Mayo Clin Proc 73:616–628CrossRefPubMed O’Leary P, Durongpisitkul K, Cordes T et al (1998) Diastolic ventricular function in children: a Doppler echocardiographic study establishing normal values and predictors of increased ventricular end-diastolic pressure. Mayo Clin Proc 73:616–628CrossRefPubMed
5.
Zurück zum Zitat Cantinotti M, Lopez L (2015) Nomograms for blood flow and tissue Doppler velocities to evaluate diastolic function in children: a critical review. J Am Soc Echocardiogr 26:126–141CrossRef Cantinotti M, Lopez L (2015) Nomograms for blood flow and tissue Doppler velocities to evaluate diastolic function in children: a critical review. J Am Soc Echocardiogr 26:126–141CrossRef
6.
Zurück zum Zitat Harada K, Suzuki T, Tamura M et al (2015) Effect of aging from infancy to childhood on flow velocity patterns of pulmonary vein by Doppler echocardiography. Am J Cardiol 77:221–224CrossRef Harada K, Suzuki T, Tamura M et al (2015) Effect of aging from infancy to childhood on flow velocity patterns of pulmonary vein by Doppler echocardiography. Am J Cardiol 77:221–224CrossRef
7.
Zurück zum Zitat Eidem BW, McMahon CJ, Cohen RR et al (2015) Impact of cardiac growth on doppler tissue imaging velocities: a study in healthy children. J Am Soc Echocardiogr 17:212–221CrossRef Eidem BW, McMahon CJ, Cohen RR et al (2015) Impact of cardiac growth on doppler tissue imaging velocities: a study in healthy children. J Am Soc Echocardiogr 17:212–221CrossRef
10.
12.
Zurück zum Zitat Rychik JMD, Fogel MAMD, Donofrio MTMD et al (2015) Comparison of patterns of pulmonary venous blood flow in the functional single ventricle heart after operative aortopulmonary shunt versus superior cavopulmonary shunt. Am J Cardiol 80:922–926CrossRef Rychik JMD, Fogel MAMD, Donofrio MTMD et al (2015) Comparison of patterns of pulmonary venous blood flow in the functional single ventricle heart after operative aortopulmonary shunt versus superior cavopulmonary shunt. Am J Cardiol 80:922–926CrossRef
13.
Zurück zum Zitat Malec E, Januszewska K, Kolcz J, Mroczek T (2003) Right ventricle-to-pulmonary artery shunt versus modified Blalock–Taussig shunt in the Norwood procedure for hypoplastic left heart syndrome—influence on early and late haemodynamic status. Eur J Cardio-Thorac Surg 23:728–734CrossRef Malec E, Januszewska K, Kolcz J, Mroczek T (2003) Right ventricle-to-pulmonary artery shunt versus modified Blalock–Taussig shunt in the Norwood procedure for hypoplastic left heart syndrome—influence on early and late haemodynamic status. Eur J Cardio-Thorac Surg 23:728–734CrossRef
15.
Zurück zum Zitat Oh J, Appleton C, Hatle L et al (1997) The noninvasive assessment of left ventricular diastolic function with two-dimensional and Doppler echocardiography. J Am Soc Echocardiogr 10:246–270CrossRefPubMed Oh J, Appleton C, Hatle L et al (1997) The noninvasive assessment of left ventricular diastolic function with two-dimensional and Doppler echocardiography. J Am Soc Echocardiogr 10:246–270CrossRefPubMed
16.
Zurück zum Zitat Menon S, Gray R, Tani L (2011) Evaluation of ventricular filling pressures and ventricular function by Doppler echocardiography in patients with functional single ventricle: correlation with simultaneous cardiac catheterization. J Am Soc Echocardiogr 24:1220–1225CrossRefPubMed Menon S, Gray R, Tani L (2011) Evaluation of ventricular filling pressures and ventricular function by Doppler echocardiography in patients with functional single ventricle: correlation with simultaneous cardiac catheterization. J Am Soc Echocardiogr 24:1220–1225CrossRefPubMed
17.
Metadaten
Titel
Pulmonary Vein Doppler Patterns in Infants with Single Right Ventricle Anomalies After Initial Staged Palliations
verfasst von
Edward C. Kirkpatrick
Jessica Steltzer
Pippa Simpson
Amy Pan
Andrea Dragulescu
Christine B. Falkensammer
Sarah Gelehrter
Wyman W. Lai
Jami Levine
Stephen Miller
Thomas A. Miller
Jay Pruetz
Ritu Sachdeva
Deepika Thacker
Peter Frommelt
Publikationsdatum
19.06.2017
Verlag
Springer US
Erschienen in
Pediatric Cardiology / Ausgabe 6/2017
Print ISSN: 0172-0643
Elektronische ISSN: 1432-1971
DOI
https://doi.org/10.1007/s00246-017-1660-3

Weitere Artikel der Ausgabe 6/2017

Pediatric Cardiology 6/2017 Zur Ausgabe

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.