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Contrast Echocardiogram for the Evaluation of Streaming in a Single-Ventricle Patient

  • Shinya Miura
  • Youichi Ookoshi
  • Kodai Momoki
  • Kenji Hoshino
  • Ikuya Ueta
Case Report
  • 20 Downloads

Abstract

In cases involving single ventricles, predicting streaming characteristics is difficult. Unfavorable streaming can cause decreased oxygen saturation. Judging whether desaturation results from decreased pulmonary flow or unfavorable streaming is critical. A 20-day-old infant with a single left ventricle underwent ductus arteriosus ligation and pulmonary artery banding to control high pulmonary flow. Severe desaturation presented postoperatively, which worsened to 68% despite pure-oxygen ventilation. A bedside contrast echocardiogram helped determine whether unfavorable streaming caused desaturation. It revealed systemic venous streaming predominantly directed to the aorta. Emergent balloon atrial septostomy facilitated mixing at the atrial level. Oxygen saturation promptly increased to 85%.

Keywords

Congenital cardiac disease Echocardiography Echocardiogram Admixture Unfavorable streaming Ultrasound 

Notes

Compliance with Ethical Standards

Conflict of interest

All authors disclose no conflict of interest with respect to the research, authorship, and publication of this article.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

Supplementary material 1 (AVI 73520 KB)

References

  1. 1.
    Tharakan JA (2011) Admixture lesions in congenital cyanotic heart disease. Ann Pediatr Cardiol 4(1):53–59CrossRefGoogle Scholar
  2. 2.
    Rahimtoola SH, Ongley PA, Swan HJ (1966) The hemodynamics of common (or single) ventricle. Circulation 34(1):14–23CrossRefGoogle Scholar
  3. 3.
    Macartney FJ et al (1976) Common or single ventricle. An angiocardiographic and hemodynamic study of 42 patients. Circulation 53(3):543–554CrossRefGoogle Scholar
  4. 4.
    Meyer SL et al (2017) Intracardiac anatomical relationships and potential for streaming in double inlet left ventricles. PLoS ONE 12(11):e0188048CrossRefGoogle Scholar
  5. 5.
    Van Hare GF, Silverman NH (1989) Contrast two-dimensional echocardiography in congenital heart disease: techniques, indications and clinical utility. J Am Coll Cardiol 13(3):673–686CrossRefGoogle Scholar
  6. 6.
    Rizzo M et al (2005) The feasibility and usefulness of contrast exercise echocardiography for the assessment of left ventricular function in master athletes. Eur J Echocardiogr 6(1):24–30CrossRefGoogle Scholar
  7. 7.
    Chiu AH, Haluszkiewicz E, McAuliffe W (2014) Micro-bubble transcranial Doppler ultrasound for exclusion of right-to-left circulatory shunts: why should we provide the service? J Med Imaging Radiat Oncol 58(4):464–468PubMedGoogle Scholar
  8. 8.
    Wong J et al (2014) Streaming in transposition of the great arteries by using cardiac magnetic resonance imaging. Circulation 129(10):1169–1170CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Pediatric Intensive CareSaitama Children’s Medical CenterSaitamaJapan
  2. 2.Department of Pediatric CardiologySaitama Children’s Medical CenterSaitamaJapan

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