Pediatric Cardiology

, Volume 4, Issue 3, pp 189–196 | Cite as

Dimensions of the great arteries, semilunar valve roots, and right ventricular outflow tract during growth: Normative angiocardiographic data

  • Hans-H. Sievers
  • Dietrich G. W. Onnasch
  • Peter E. Lange
  • Alexander Bernhard
  • Paul H. Heintzen


Systolic and diastolic diameters of the right and left pulmonary arteries (RPAD, LPAD), descending thoracic aorta (DTAD), right ventricular infundibulum (RVID), and pulmonary and aortic valve roots at the proximal, commissural and distal levels were estimated from angiocardiograms in 24 infants, children, and adolescents without heart disease, and correlated with body surface area (BSA), stroke volume (SV), cardiac output (CO), and ventricular volumes.

The relationships between cardiovascular diameters and BSA were better expressed by a power function than by the other functions tried. We obtained different exponents for pulmonary and aortic valve annuli and the more distally measured great arteries (RPAD, LPAD, and DTAD), suggesting different growth patterns. The right ventricular infundibular shortening fraction (RVISF) was weakly correlated with BSA (r=-0.328), and the values obtained indicated constancy during normal growth. There was a direct proportional relationship between the pulmonary valve annulus diameter and the cube root of the right ventricular volume (r=0.952), as well as between SV and cross-sections of the right pulmonary artery (RPAC;r=0.916), left pulmonary artery (LPAC;r=0.878) and descending thoracic aorta (r=0.962). RPAC and LPAC were strongly correlated (r=0.940), the RPAC being significantly larger than the LPAC.

Key words

Cardiovascular dimensions Normal growth Angiocardiography 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Arvidsson H (1963) Angiocardiographic measurements in congenital heart disease in infancy and childhood.Acta Radiol (Diagn) 1:981–994Google Scholar
  2. 2.
    Blackstone EH, Kirklin JW, Bertranou EG, Labrosse CJ, Soto B, Bargeron LM (1979) Preoperative prediction from cineangiograms of postrepair right ventricular pressure in tetralogy of Fallot.J Thorac Cardiovasc Surg 78:542–552Google Scholar
  3. 3.
    Blackstone EH, Kirklin JW, Pacifico AD (1979) Decision-making in repair of tetralogy of Fallot based on intraoperative measurements of pulmonary arterial outflow tract.J Thorac Cardiovasc Surg 77:526–532Google Scholar
  4. 4.
    Calder LA, Barrat-Boyes BG, Brandt PWT, Neutze JM (1979) Postoperative evaluation of patients with tetralogy of Fallot repaired in infancy.J Thorac Cardiovasc Surg 77:704–720Google Scholar
  5. 5.
    Castellanos A, Hernandez FA, Mercado H (1966) Angiocardiographic measurement of the right main pulmonary artery in congenital heart disease.Angiology 17:743–755Google Scholar
  6. 6.
    De la Cruz MV, Anselmi G, Romero A, Monroy G (1960) A qualitative and quantitative study of the ventricles and great vessels of normal children.Am Heart J 60:675–690Google Scholar
  7. 7.
    Dotter CT, Steinberg J (1949) The angiocardiographic measurement of the normal great vessels.Radiology 52:353–358Google Scholar
  8. 8.
    Eckner FAO, Brown BW, Davidson DL, Glagov S (1969) Dimensions of normal human hearts.Arch Pathol 88:497–507Google Scholar
  9. 9.
    Epstein ML, Goldberg SJ, Allen HD, Konecke L, Wood J (1975) Great vessel, cardiac chamber and wall growth patterns in normal children.Circulation 51:1124–1129Google Scholar
  10. 10.
    Fischer EA, Eckner FAO, DuBrow JW, Hastreiter AR (1978) Correlation of angiographic and autopsy left ventricular dimensions in children.Circulation 58:739–746Google Scholar
  11. 11.
    Henry WL, Ware J, Gardin JM, Hepner SJ, McKay J, Weiner M (1978) Echocardiographic measurements in normal subjects.Circulation 57:278–285Google Scholar
  12. 12.
    Hernandez FA, Castellanos A (1966) The size of the main pulmonary artery in congenital heart disease. Angiocardiographic measurement.Acta Cardiol 21:1–19Google Scholar
  13. 13.
    Hurwitt E (1947) The size of the pulmonary valve.Bull Int Assoc Med Museums (Balt) 27:170–172Google Scholar
  14. 14.
    Jarmakani JMM, Graham TP, Benson DW, Canent RV, Greenfield JC (1971) In vivo pressure-radius relationships of the pulmonary artery in children with congenital heart disease.Circulation 43:585–592Google Scholar
  15. 15.
    Lange PE, Onnasch D, Farr FL, Heintzen PH (1978) Angiocardiographic left ventricular volume determination. Accuracy, as determined from human casts, and clinical application.Eur J Cardiol 814–5:449–476Google Scholar
  16. 16.
    Lange PE, Onnasch DGW, Schaupp GH, Zill C, Heintzen PH (1982) Size and function of the human left and right ventricles during growth. Normative angiographic data.Ped Cardiol 3:205–211Google Scholar
  17. 17.
    Leech GJ, Guiney TE, Davies MJ, Parker DJ (1981) Echocardiography of the aortic valve. In: Rijsterborgh H (ed)Echocardiology. Martinus Nijhoff, The Hague, p 39Google Scholar
  18. 18.
    Lundström NR (1974) Clinical applications of echocardiography in infants and children.Acta Paediat Scand 63:23–32Google Scholar
  19. 19.
    Lundström NR, Mortensson W (1974) Clinical applications of echocardiography in infants and children.Acta Paediat Scand 63:33–41Google Scholar
  20. 20.
    McAlpine WA (1975)Heart and Coronary Arteries, 1st ed. Springer-Verlag, Berlin Heidelberg New YorkGoogle Scholar
  21. 21.
    Naito Y, Fugita T, Manabe H, Kawashima Y (1980) The criteria for reconstruction of right ventricular outflow tract in total correction of tetralogy of Fallot.J Thorac Cardiovasc Surg 80:574–581Google Scholar
  22. 22.
    Oku H, Shirotani H, Yokoyama T, Yokota Y, Kaway J, Mori A, Kanzaki Y, Makino S, Ando F, Setsine N (1978) Postoperative size of the right ventricular outflow tract and optimal age in complete repair of tetralogy of Fallot.Ann Thorac Surg 25:322–328Google Scholar
  23. 23.
    Oku H, Shirotani H, Yokoyama T, Yokota Y, Kaway J, Makino S, Noguchi K, Setsine N, Nishioka T, Okamoto F, Shinohara T (1980) Right ventricular outflow tract prosthesis in total correction of tetralogy of Fallot.Circulation 62:604–609Google Scholar
  24. 24.
    Pacifico AD, Kirklin JW, Blackstone EH (1977) Surgical management of pulmonary stenosis in tetralogy of Fallot.J Thorac Cardiovasc Surg 74:382–395Google Scholar
  25. 25.
    Roge CLL, Silvermann NH, Hart PA, Ray RM (1978) Cardiac structure growth pattern determined by echocardiography.Circulation 57:285–290Google Scholar
  26. 26.
    Rowlatt UF, Rimoldi HJ, Lev M (1963) The quantitative anatomy of the normal child's heart.Pediatr Clin North Am 10:499–588Google Scholar
  27. 27.
    Tucker WY, Turley K, Ullyot DJ, Ebert PA (1979) Management of symptomatic tetralogy of Fallot in the first year of life.J Thorac Cardiovasc Surg 78:494–501A0946015 00004 CS-SPJRNPDF [HEADSUP]Google Scholar

Copyright information

© Springer-Verlag 1983

Authors and Affiliations

  • Hans-H. Sievers
    • 1
    • 2
  • Dietrich G. W. Onnasch
    • 1
    • 2
  • Peter E. Lange
    • 1
    • 2
  • Alexander Bernhard
    • 1
    • 2
  • Paul H. Heintzen
    • 1
    • 2
  1. 1.Department of Pediatric CardiologyUniversity of KielKielFRG
  2. 2.Department of Cardiovascular SurgeryUniversity of KielKielFRG

Personalised recommendations