Pediatric Cardiology

, Volume 12, Issue 3, pp 135–142 | Cite as

Cross-sectional echocardiographic measurements of right ventricular size and growth in patients with pulmonary atresia and intact ventricular septum

  • Katarina Hanséus
  • Gudrun Björkhem
  • Nils-Rune Lundström
  • Sven Laurin
Original Articles

Summary

Fifteen patients with pulmonary atresia or critical pulmonary stenosis and intact ventricular septum were studied. All were operated on in the neonatal period, with valvotomy or a systemic to pulmonary arterial shunt, or both. In 12 patients, right ventricular to pulmonary arterial communication was established in the neonatal period. In three patients, only systemic to pulmonary arterial shunts were constructed. Six patients died. The median follow-up period for the surviving patients was 65 months (range, 12–87 months).

Right and left atrial and ventricular dimensions and areas, the tricuspid annular diameter, and the cross-sectional area of the aortic root were measured in cross-sectional echocardiograms from the neonatal period, at the age of 1 year, and at the latest clinical follow-up. A classification of right ventricular morphology was made, based on identification of the inlet, the trabecular, and the outlet parts.

Most of the patients had hypoplastic right ventricles at birth but at the latest follow-up, seven of nine surviving patients had right ventricles in the normal range. Right ventricular growth was better in patients who were given a right ventricular to pulmonary arterial communication in the neonatal period and those with complete right ventricular anatomy. The patients who died had severely hypoplastic right ventricles and small tricuspid valves.

Key Words

Pulmonary atresia Cross-sectional echocardiography Right ventricular size Right ventricular growth 

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References

  1. 1.
    Bull C, de Leval M, Mercanti C, MaCartney F, Anderson R (1982) Pulmonary atresia and intact ventricular septum: A revised classification.Circulation 66:266–271.PubMedGoogle Scholar
  2. 2.
    Cobanoglu A, Metzdorff M, Pinson W, Grunkemeier G, Sunderland C, Starr A (1985) Valvotomy for pulmonary atresia with intact ventricular septum. A disciplined approach to achieve a functioning right ventricle.J Thorac Cardiovasc Surg 89:482–490.PubMedGoogle Scholar
  3. 3.
    de Leval M, Bull C, Stark J, Anderson R, Taylor J, MaCartney F (1982) Pulmonary atresia and intact ventricular septum: Surgical management based on a revised classification.Circulation 66:272–280PubMedGoogle Scholar
  4. 4.
    Dobell A, Grignon A (1977) Early and late results in pulmonary atresia.Ann Thorac Surg 24:264–274PubMedGoogle Scholar
  5. 5.
    Freedom R, Culham J, Moes C (1984) Pulmonary atresia and intact ventricular septum. In: Freedom R, Culham J, Moes C (eds)Angiocardiography of congenital heart disease 1984. Macmillan, New York, pp 231–253Google Scholar
  6. 6.
    Freedom R, Wilson G, Trusler G, Williams W, Rowe R (1983) Pulmonary atresia and intact ventricular septum.Scand J Thorac Cardiovasc Surg 17:1–28PubMedGoogle Scholar
  7. 7.
    Freedom R, Dische R, Rowe R (1978) The tricuspid valve in pulmonary atresia and intact ventricular septum.Arch Pathol Lab Med 102:28–29PubMedGoogle Scholar
  8. 8.
    Fricker F, Zuberbuhler J (1987) Pulmonary atresia and intact ventricular septum. In: Anderson R, MaCartney F, Shinebourne E, Tynand M (eds)Paediatric cardiology 1987. Churchill Livingstone, London, pp 711–720Google Scholar
  9. 9.
    Gutgesell H, Bricker T, Colvin E, Latson L, Hawkins E (1984) Atrioventricular annular diameter: two-dimensional echocardiographic-autopsy correlation.Am J Cardiol 53:1652–1655CrossRefPubMedGoogle Scholar
  10. 10.
    Hanséus K, Björkhem G, Lundström NR (1988) Dimensions of cardiac chambers and great vessels by cross-sectional echocardiography in infants and children.Pediatr Cardiol 9:7–15CrossRefPubMedGoogle Scholar
  11. 11.
    Joshi S, Brawn W, Mee R (1986) Pulmonary atresia with intact ventricular septum.J Thorac Cardiovasc Surg 91:192–199PubMedGoogle Scholar
  12. 12.
    King D, Smith O, Huhta J, Gutgesell H (1985) Mitral and tricuspid valve annular diameter in normal children determined by two-dimensional echocardiography.Am J Cardiol 55:787–789CrossRefPubMedGoogle Scholar
  13. 13.
    Leung M, Mok CK, Hui PW (1988) Echocardiographic assessment of neonates with pulmonary atresia and intact ventricular septum.J Am Coll Cardiol 12:719–725PubMedGoogle Scholar
  14. 14.
    Lewis A, Wells W, Lindesmith G (1983) Evaluation and surgical treatment of pulmonary atresia and intact ventricular septum in infancy.Circulation 67:1318–1323PubMedGoogle Scholar
  15. 15.
    Miller G, Restifo M, Shinebourne E, Paneth M, Joseph M, Lennox S, Kerr I (1973) Pulmonary atresia with intact ventricular settum and critical pulmonary stenosis presenting in first month of life.Br Heart J 35:9–16PubMedGoogle Scholar
  16. 16.
    Moulton A, Bowman F, Edie R, Hayes C, Ellis K, Gersony W, Malm J (1979) Pulmonary atresia with intact ventricular septum.J. Thorac Cardiovasc Surg 78:527–536PubMedGoogle Scholar
  17. 17.
    Patel R, Freedom R, Moes C, Bloom K, Olley P, Williams W, Trusler G, Rowe R (1980) Right ventricular volume determinations in 18 patients with pulmonary atresia and intact ventricular septum. Analysis of factors influencing right ventricular growth.Circulation 61:428–440PubMedGoogle Scholar
  18. 18.
    Scognamiglio R, Daliento L, Razzolini R, Boffa G, Pellegrino P, Chioin R, Volta S (1986) Pulmonary atresia with intact ventricualr septum: A quantitative cineventriculographic study of the right and left ventricular function.Pediatr Cardiol 7:183–187CrossRefPubMedGoogle Scholar
  19. 19.
    Silove E, de Giovanni J, Shiu M, Myint M (1983) Diagnosis of right ventricular outflow obstruction in infants by crosssectional echocardiography.Br Heart J 50:516–520Google Scholar
  20. 20.
    Trowitzsch E, Colan S, Sanders S (1985) Two-dimensional echocardiographic evaluation of right ventricular size and function in newborns with severe right ventricular outflow obstruction.J Am Coll Cardiol 6:388–393PubMedGoogle Scholar
  21. 21.
    Zuberbuhler J, Anderson R (1979) Morphological variations in pulmonary atresia with intact ventricular septum.Br Heart J 41:281–288PubMedGoogle Scholar

Copyright information

© Springer-Verlag New York Inc. 1991

Authors and Affiliations

  • Katarina Hanséus
    • 1
  • Gudrun Björkhem
    • 1
  • Nils-Rune Lundström
    • 1
  • Sven Laurin
    • 2
  1. 1.Department of PaediatricsUniversity HospitalLundSweden
  2. 2.Department of RadiologyUniversity HospitalLundSweden

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