Summary
Quantitative cineventriculographic measurements (ventricular volumes, ejection fraction, and myocardial mass) were obtained in 15 neonates with pulmonary atresia and intact ventricular septum. There was a wide dimensional range for the right ventricle, from a reduced through normal to enlarged. A restrictive tricuspid valve (less than 12 mm) was associated with a small or diminutive right ventricle. A normal function of the right ventricle was present only in those cases with normal-sized chambers. The left ventricular end-diastolic volume was always greater than normal. The ejection fraction was normal only if a normal myocardial mass was present. Additional abnormalities were frequent in the myocardium of both ventricles, such as extreme thinning of the wall of the right ventricle and hypoplasia or fibroelastosis of the left ventricle. All these factors can lead to a poor surgical prognosis despite good anatomical correction.
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Arcilla RA, Gasul BM (1961) Congenital asplasia or marked hypoplasia of the myocardium of the right ventricle (Uhl's anomaly).J Pediatr 58:381
Bharati S, McAllister HA, Tatooles CJ, Miller RA, Weinberg MJ, Bucheleres HC, Lev M (1977) Anatomic variations in underdeveloped right ventricle related to tricuspid atresia and stenosis.J Thorac Cardiovasc Surg 77:383
Bharati S, McAllister HA, Chiemmongkeltip P, Lev M (1977) Congenital pulmonary atresia with tricuspid insufficiency: morphologic study.Am J Cardiol 40:70
Bowman F, Malm J, Hayes C, Gersony W, Ellis K (1971) Pulmonary atresia with intact ventricular septum.J Thorac Cardiovasc Surg 61:85
Braunlin EA, Formanek AG, Moller JH, Edwards JE (1982) Angiopathological appearances of pulmonary valve in pulmonary atresia with intact ventricular septum: interpretation of nature of right ventricle from pulmonary angiography.Br Heart J 47:281
Celermajar JM, Bowdler JD, Gengos DE, Cohen D, Stuckey D (1968) Pulmonary valve fusion with intact ventricular septum.Am Heart J 76:452
Cole RB, Muster AJ, Lev M, Paul M (1968) Pulmonary atresia with intact ventricular septum.Am J Cardiol 21:23
Davignon AL, Greenwold WE, Du-Shane JW, Edwards JE (1961) Congenital pulmonary atresia with intact ventricular septum: clinicopathologic correlation of two anatomic types.Am Heart J 62:591
Davignon AL, Du-Shane JW, Kincaid OW, Swan HJC (1961) Pulmonary atresia with intact ventricular septum: report of two cases studied by selective angiocardiography and right heart catheterization.Am Heart J 62:690
Dodge HT, Sandler H, Ballew DW, Lord JD Jr (1960) Use of biplane angiocardiography for measurement of left ventricular volume in man.Am Heart J 60:762
Edwards JE, Carey LS, Neufeld HN, Lester RG (1965)Congenital heart disease: correlation of pathologic anatomy and angiocardiography. WB Saunders, Philadelphia, p 575
Fontan F, Baudet E (1971) Surgical repair of tricuspid atresia.Thorax 26:240
Freedom RM, Harrington DP (1974) Contributions of intramyocardial sinusoids in pulmonary atresia and intact ventricular septum to a right-sided circular shunt.Br Heart J 36:1061
Freedom RM, White RT Jr, Ho CS, Gingell RL, Hawker RE, Rowe RD (1974) Evaluation of patients with pulmonary atresia and intact ventricular septum by double catheter technique.Am J Cardiol 33:892
Freedom RM, Dische MR, Rowe D (1978) The tricuspid valve in pulmonary atresia and intact ventricular septum: morphological study of 60 cases.Arch Pathol Lab Med 102:28
Freedom RM, Culham G, Moes CAF, Olley PM, Rowe RD (1978) Differentiation of functional and structural pulmonary atresia: role of aortography.Am J Cardiol 41:914
Goor DA, Lillehei CW (1975)Congenital malformations of the heart. Grune and Stratton, New York, p 325
Graham TP Jr, Jarmakani JM, Canent RV Jr, Morrow MN (1971) Left heart volume estimation in infancy and childhood: reevaluation of methodology and normal values.Circulation 43:895
Graham TP Jr, Jarmakani JM, Atwood GF, Canent RV (1973) Right ventricular volume determination in children.Circulation 47:144
Graham TP Jr, Bender HW, Atwood GF, Page DL, Sell CGR (1974) Increase in right ventricular volume following valvulotomy for pulmonary atresia or stenosis with intact ventricular septum.Circulation [Suppl II]50:II-69
Haworth SG, Shinebourne EA, Miller GAH (1975) Right to left interarterial shunting with normal right ventricular pressure.Br Heart J 37:386
Kreutzer G, Galindez E, Bonow H, De Palma C, Laura JP (1973) An operation for the correction of tricuspid atresia.J Thorac Cardiovasc Surg 66:613
Luckstead E, Mattioli L, Crosby I, Reed W, Diehl A (1972) Two stage palliative surgical approach for pulmonary atresia with intact ventricular septum.Am J Cardiol 29:490
Malm JR, Bowman FO, Hayes OJ, Gersony WM, Ellis K (1974) Results of surgical treatment of pulmonary atresia with intact ventricular septum.Adv Cardiol 11:18
Moller JH, Girod D, Amplatz K, Varco RL (1970) Pulmonary valvulotomy in pulmonary atresia with hypoplastic right ventricle.Surgery 68:630
Murphy DA, Murphy DR, Gibbons JE, Dobell ARC (1971) Surgical treatment of pulmonary atresia with intact ventricular septum.J Thorac Cardiovasc Surg 62:213
Oakley CM, Braimbridge MV, Bentall HH (1964) Reversed interatrial shunt following complete relief of pulmonary valve stenosis.Br Heart J 26:662
Patel RG, Freedom RM, Moes CAF, Bloom KR, Olley PM, Williams WG, Trusler GA, Rowe RD (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
Perrin EV, Mehrizi A (1965) Isolated free-wall hypoplasia of the right ventricle.Am J Dis Child 109:558
Rackley CE, Dodge HT, Coble YD Jr, Hay RE (1962) Method for determining ventricular mass in man.Circulation 29:666
Rigby ML, Silove ED, Astley R, Abrams LD (1977) Pulmonary atresia with intact ventricular septum: open heart surgical correction at 32 hours.Br Heart J 39:573
Trusler GA, Yamamoto N, Williams WG, Izukawa T, Rowe R, Mustard WT (1976) Surgical treatment of pulmonary atresia with intact ventricular septum.Br Heart J 38:957
Uhl HSM (1952) A previously undescribed congenital malformation of the heart: almost total absence of the myocardium of the right ventricle.Bull Johns Hopkins Hosp 91:197
Van Praagh R, Ando M, Van Praagh S, Senno A, Hougen TJ, Novak GI, Hastreiter AR (1976) Pulmonary atresia: anatomic considerations. In: Kidd BSL, Rowe RD (eds)The child with congenital heart disease after surgery. Futura, Mount Kisco NY, p 103
Zuberbuhler JE, Anderson RH (1979) Morphological variations in pulmonary atresia with intact ventricular septum.Br Heart J 41:281
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Scognamiglio, R., Daliento, L., Razzolini, R. et al. Pulmonary atresia with intact ventricular septum: A quantitative cineventriculographic study of the right and left ventricular function. Pediatr Cardiol 7, 183–187 (1986). https://doi.org/10.1007/BF02093176
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DOI: https://doi.org/10.1007/BF02093176