23 research outputs found
Off-pump direct hepatic veins-to-hemiazygos vein anastomosis after primary Kawashima operation: long-term result
Proximal origin and hypoplasia of the left pulmonary artery in association with chromosome 22q11 deletion, right aortic arch, and persistently patent right-sided arterial duct
Intrauterine rupture of anterior tricuspid valve papillary muscle: Tricuspid valve chordae replacement on the first day of life
Transcatheter closure of various types of defects within the oval fossa using the double umbrella device (CardioSEAL) – feasibility and echocardiographic follow-up
The potential value of transoesophageal evaluation of individual pulmonary venous flow after an atrial baffle procedure
Following a Mustard's procedure, transoesophageal echocardiography allowed the visualization of all 4 pulmonary veins in 7/12 patients (mean age 14.8 years) and of three veins in a further 2 patients. Both upper pulmonary veins could be visualized consistently. No patient had an isolated pulmonary venous stenosis. In 9 patients in sinus rhythm, computer analysis of Doppler tracings from the left upper pulmonary vein showed significantly lower systolic peak velocities (mean 0.39 +/- 0.10 m/s) and time velocity integrals (mean 6.9 +/- 1.66 cm) than in normal subjects (mean 0.6 +/- 0.09 m/s and 14.4 +/- 2.97 cm respectively; P less than 0.001). We postulate that this is due to compromised atrial relaxation and compliance. In contrast, patients in junctional rhythm (mean 10.7 vs. 7.7 cm in normal subjects). Flow reversal during early ventricular systole (due to tricuspid regurgitation or atrial contraction after retrograde conduction during junctional rhythm) was detected in 6/12 patients. These results confirm that the transoesophageal approach should allow the identification of isolated pulmonary venous obstruction after a Mustard procedure. In addition. detailed analysis of tracings of flow in the pulmonary veins can document the presence of compromised atrial relaxation and help to evaluate the severity of tricuspid regurgitation. It may provide a new index with which to assess impaired systemic ventricular function