Faculty Collaboration Database

Doppler assessment of pulmonary artery flow patterns and ventricular function after the Fontan operation. Am J Cardiol 1991 Nov 01;68(11):1211-5

Date

11/01/1991

Pubmed ID

1951081

DOI

10.1016/0002-9149(91)90195-q

Scopus ID

2-s2.0-0026066879 (requires institutional sign-in at Scopus site)   61 Citations

Abstract

To assess the relation between ventricular systolic and diastolic function and pulmonary artery (PA) flow patterns after the Fontan operation, 15 postoperative patients were prospectively evaluated with echocardiography. Blood flow velocities in the PA were recorded with pulsed Doppler echocardiography. Ejection fraction was measured by 2-dimensional echocardiography using Simpson's rule. Indexes of diastolic function were measured from the systemic atrioventricular valve inflow Doppler and included peak E and A velocities, peak filling rate normalized for stroke volume, the fractions of filling in early and late diastole (E and A area fractions), and the E/A velocity and area ratios. Compared with 15 age-matched control subjects, the 15 patients who had undergone the Fontan procedure had decreased peak E velocity (0.65 +/- 0.20 vs 0.87 +/- 0.10 m/s), decreased E/A velocity ratio (1.29 +/- 0.23 vs 1.98 +/- 0.46), decreased normalized peak filling rate (6.09 +/- 0.90 vs 6.81 +/- 0.83 s-1), decreased E area fraction (0.63 +/- 0.09 vs 0.72 +/- 0.07), increased A area fraction (0.37 +/- 0.07 vs 0.24 +/- 0.06), and decreased E/A area ratio (1.77 +/- 0.45 vs 3.33 +/- 1.15) (p less than 0.05). These diastolic filling abnormalities are consistent with impaired ventricular relaxation and decreased early diastolic transvalvular pressure gradient. PA Doppler recordings showed 2 distinct patterns of flow. Pattern I, observed in 9 patients, showed biphasic forward flow with peak velocities in mid to late systole and mid-diastole. Pattern II, observed in the remaining 6 patients, showed decreased systolic forward flow, a late systolic to early diastolic flow reversal, and delayed onset of diastolic forward flow.(ABSTRACT TRUNCATED AT 250 WORDS)

Author List

Frommelt PC, Snider AR, Meliones JN, Vermilion RP

Author

Peter C. Frommelt MD Adjunct Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Blood Flow Velocity
Cardiac Surgical Procedures
Child
Child, Preschool
Echocardiography, Doppler
Female
Heart Defects, Congenital
Heart Valves
Humans
Male
Pulmonary Artery
Ventricular Function