Assessment of superior vena cava flow and cardiac output in different patterns of patent ductus arteriosus shunt

2021 ◽  
Author(s):  
Adrianne Rahde Bischoff ◽  
Regan E. Giesinger ◽  
Amy H. Stanford ◽  
Ravi Ashwath ◽  
Patrick J. McNamara
Keyword(s):  
Cardiac Output ◽  
Patent Ductus Arteriosus ◽  
Superior Vena Cava ◽  
Superior Vena ◽  
Ductus Arteriosus ◽  
Vena Cava ◽  
Patent Ductus

scholarly journals Manajemen Anestesi Prosedur Fontan

2017 ◽  
Vol 9 (3) ◽  
pp. 157
Author(s):  
Akhmad Ridconi ◽  
Budi Nugroho
Keyword(s):  
Cardiac Output ◽  
Septal Defect ◽  
Single Ventricle ◽  
Superior Vena ◽  
Ductus Arteriosus ◽  
Vena Cava ◽  
Double Outlet Right Ventricle ◽  
Low Cardiac Output ◽  
Bilateral Superior Vena Cava ◽  
Patent Ductus

PendahuluanSingle ventricle merupakan kelainan jantung kongenital kompleks, dan seseorang yang hidup dengan kelainan ini akan disertai dengan sejumlah keterbatasan. Tanpa terapi bedah, univentrikel akan menjadi malapetaka. Prosedur Fontan merupakan teknik pembedahan terpilih yang dapat diterapkan pada pasien dengan single ventricle. Hasil prosedur Fontan dipengaruhi oleh beberapa faktor termasuk faktor, prosedur, pengelolaan, dan tekanan vena sisi kanan berangsur-angsur akan meningkat. Seiring dengan berjalannya waktu gagal jantung kanan akan mengalami penurunan fungsi sistem, meliputi peningkatan resistensi pembuluh darah pulmoner (PVR), peningkatan tekanan vena sistemik (SVR), low-cardiac output kronis, disfungsi ventrikel kanan, dan kegagalan prosedur perbaikan single ventricle. Presentasi KasusWanita 19 tahun dengan Double Outlet Right Ventricle, Ventricular Septal Defect, Pulmonal Stenosis, Patent Ductus Arteriosus, Bilateral Superior Vena Cava yang akan menjalani prosedur Fontan. KesimpulanProsedur Fontan akan meningkatkan usia harapan hidup pasien. Keberhasilan jangka panjang ditentukan oleh banyaknya komplikasi. Dalam kondisi tidak adanya ketaatan.

scholarly journals Size of Patent Ductus Arteriosus and Echocardiographic Markers of Shunt Volume in Preterm Infants Based on Postnatal Age

2021 ◽  
Vol 9 ◽  
Author(s):  
Eui Kyung Choi ◽  
Kyu Hee Park ◽  
Byung Min Choi
Keyword(s):  
Patent Ductus Arteriosus ◽  
Preterm Infants ◽  
Superior Vena ◽  
Ductus Arteriosus ◽  
Vena Cava ◽  
Left Ventricular ◽  
Coefficient Of Determination ◽  
Flow Ratio ◽  
Shunt Volume ◽  
Patent Ductus

Objective: This study was conducted in order to compare the strength of correlation between echocardiographic markers of shunt volume and patent ductus arteriosus (PDA) diameter based on postnatal age.Methods: This retrospective study focused on preterm infants (aged <32 weeks of gestation) admitted to the Neonatal Intensive Care Unit of Korea University Ansan Hospital, between April 2014 and December 2017, who studied serial targeted neonatal echocardiography (TNE) for PDA during hospitalization. The association between echocardiographic characteristics and duct size was divided into the following days: within 3 days (very early, VE), 4–7 days after birth (early, E), and after 8 days of birth (late, L).Results: We found 113 assessments conducted on 57 infants in the VE period, 92 assessments on 40 infants in the E period, and 342 assessments on 37 infants in the L period. Median gestational age and birth weight were 28+2 weeks of gestation and 1,115 g, respectively. In the univariate regression analysis, we found a statistically significant correlation between PDA diameter and all TNE markers in the E and L days, but not in the VE period. Only ductal velocity [coefficient of determination (R2) = 0.224], antegrade left pulmonary artery diastolic flow velocity (R2 = 0.165), left ventricular output (LVO)/superior vena cava (SVC) flow ratio (R2 = 0.048), and E/A wave ratio (R2 = 0.092) showed weak correlations with PDA diameter in the VE period. The slopes of the regressions showed significant changes based on postnatal age in the maximum ductal velocity, left atrium/aorta ratio, LVO/SVC flow ratio, and LVO.Conclusions: It is difficult to predict the echocardiographic markers of shunt volume based on the PDA diameter in preterm infants younger than 4 days. A better understanding of the changes in the hemodynamic consequences of PDA based on postnatal age is needed when considering treatment.

scholarly journals Interatrial shunt for chronic pulmonary hypertension: differential impact of low-flow vs. high-flow shunting

2009 ◽  
Vol 296 (3) ◽  
pp. H639-H644 ◽  
Author(s):  
Andreas Zierer ◽  
Spencer J. Melby ◽  
Rochus K. Voeller ◽  
Marc R. Moon
Keyword(s):  
Pulmonary Hypertension ◽  
Cardiac Output ◽  
Superior Vena Cava ◽  
Diastolic Pressure ◽  
Superior Vena ◽  
Vena Cava ◽  
High Flow ◽  
Low Flow ◽  
Right Atrial ◽  
Chronic Pulmonary Hypertension

The purpose of the present study was to determine for the first time the qualitative and quantitative impact of varying degrees of interatrial shunting on right heart dynamics and systemic perfusion in subjects with chronic pulmonary hypertension (CPH). Eight dogs underwent 3 mo of progressive pulmonary artery banding, following which right atrial and ventricular end-systolic and end-diastolic pressure-volume relations were calculated using conductance catheters. An 8-mm shunt prosthesis was inserted between the superior vena cava and left atrium, yielding a controlled model of atrial septostomy. Data were obtained 1) preshunt or “CPH”; 2) “Low-Flow” shunt; and 3) “High-Flow” shunt (occluding superior vena cava forcing all flow through the shunt). With progressive shunting, right ventricular pressure fell from 72 ± 19 mmHg (CPH) to 54 ± 17 mmHg (Low-Flow) and 47 ± 17 mmHg (High-Flow) ( P < 0.001). Cardiac output increased from 1.5 ± 0.3 l/min at CPH to 1.8 ± 0.4 l/min at Low-Flow (286 ± 105 ml/min, 15% of cardiac output; P < 0.001), but returned to 1.6 ± 0.3 l/min at High-Flow (466 ± 172 ml/min, 29% of cardiac output; P = 0.008 vs. Low-Flow, P = 0.21 vs. CPH). There was a modest rise in systemic oxygen delivery from 252 ± 46 ml/min at CPH to 276 ± 50 ml/min at Low-Flow ( P = 0.07), but substantial fall to 222 ± 50 ml/min at High-Flow ( P = 0.005 vs. CPH, P < 0.001 vs. Low-Flow). With progressive shunting, bichamber contractility did not change ( P = 0.98), but the slope of the right atrial end-diastolic pressure volume relation decreased ( P < 0.04), consistent with improved compliance. This study demonstrated that Low-Flow interatrial shunting consistently improved right atrial mechanics and systemic perfusion in subjects with CPH, while High-Flow exceeded an “ideal shunt fraction”.

Sternal Cleft Associated with Cantrell's Pentalogy in a German Shepherd Dog

2015 ◽  
Vol 51 (4) ◽  
pp. 279-284 ◽  
Author(s):  
Manuel Benlloch-Gonzalez ◽  
Cyrill Poncet
Keyword(s):  
Patent Ductus Arteriosus ◽  
Abdominal Wall ◽  
Ductus Arteriosus ◽  
Vena Cava ◽  
Exercise Intolerance ◽  
German Shepherd ◽  
German Shepherd Dog ◽  
Sternal Cleft ◽  
Cantrell's Pentalogy ◽  
Patent Ductus

A 5 mo old male German shepherd dog weighing 15.5 kg was presented with an abdominal wall hernia and exercise intolerance. Physical examination showed a grade II/VI systolic heart murmur and an area of cutaneous atrophy overlying a midline supraumbilical wall defect. Thoracic radiography, computed tomography, and ultrasound examination revealed a congenital caudal sternal cleft, a supraumbilical diastasis rectus, and a patent ductus arteriosus. Exploratory surgery confirmed defects of the pars sternalis of the diaphragm and caudoventral pericardium and a persistent left cranial vena cava. Those findings were compatible with Cantrell's pentalogy. Surgical treatment included ligation of the patent ductus arteriosus through the sternal cleft, diaphragmatic reconstruction with paracostal extension of the diaphragmatic defect, pericardial and linea alba appositional reconstruction, and primary approximation of the sternal halves. Growth and exercise activity were normal 10 mo after surgery. The discovery of a midline cranial abdominal wall, pericardial, diaphragmatic, or sternal defect should prompt a thorough examination to rule out any possible associated syndrome. Cantrell's pentalogy presents various degrees of expression and is rare in dogs. Management involves early surgical repair of congenital anomalies to protect the visceral structures. The prognosis in dogs with mild forms of the syndrome is encouraging.

Sign in / Sign up

Export Citation Format

Share Document