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. 1985 Aug;54(2):209–214. doi: 10.1136/hrt.54.2.209

Non-invasive assessment of pulmonary blood supply after staged repair of pulmonary atresia.

S Del Torso, M J Kelly, V Kalff, G Stellin, R B Mee, A W Venables
PMCID: PMC481879  PMID: 2990511

Abstract

Radionuclide studies were performed to determine pulmonary blood flow in six children who had undergone surgery for pulmonary atresia, ventricular septal defect, and hypoplastic pulmonary arteries with or without major aortopulmonary collateral arteries. Lung blood flow was assessed from both particle perfusion lung scans and the pulmonary and systemic phase of a radionuclide dynamic flow study. Five patients had perfusion defects identified on the particle perfusion lung scan. In three of these, abnormal areas were perfused only during the systemic phase of the flow study, a combination of findings that indicate the presence of perfusion by collateral arteries. In one patient no systemic perfusion was noted and in one an initial particle perfusion study indicated the presence of a lung segment perfused by a collateral artery. In this last patient the particle perfusion scan after total correction showed a reduction in the size of the lung perfusion defect and no evidence of lung perfusion during the systemic phase of the flow study. The particle perfusion lung scan in the sixth patient showed pronounced asymmetry in blood flow to the lungs with no segmental perfusion defect on the particle perfusion scan and no abnormalities on the systemic flow study. It is concluded that radionuclide lung perfusion and flow studies provide useful information on lung perfusion and merit further evaluation to define their role in the management of these patients.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Alderson P. O., Boonvisut S., McKnight R. C., Hartman A. F., Jr Pulmonary perfusion abnormalities and ventilation-perfusion imbalance in children after total repair of tetralogy of Fallot. Circulation. 1976 Feb;53(2):332–337. doi: 10.1161/01.cir.53.2.332. [DOI] [PubMed] [Google Scholar]
  2. Alfieri O., Blackstone E. H., Kirklin J. W., Pacifico A. D., Bargeron L. M., Jr Surgical treatment of tetralogy of Fallot with pulmonary atresia. J Thorac Cardiovasc Surg. 1978 Sep;76(3):321–335. [PubMed] [Google Scholar]
  3. BUTLER A. M., RICHIE R. H. Simplification and improvement in estimating drug dosage and fluid and dietary allowances for patients of varying sizes. N Engl J Med. 1960 May 5;262:903–908. doi: 10.1056/NEJM196005052621802. [DOI] [PubMed] [Google Scholar]
  4. Baker E. J., Malamitsi J., Jones O. D., Maisey M. N., Tynan M. J. Use of radionuclide labelled microspheres to show the distribution of the pulmonary perfusion with multifocal pulmonary blood supply. Br Heart J. 1984 Jul;52(1):72–76. doi: 10.1136/hrt.52.1.72. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Freedom R. M., Pongiglione G., Williams W. G., Trusler G. A., Rowe R. D. Palliative right ventricular outflow tract construction for patients with pulmonary atresia, ventricular septal defect, and hypoplastic pulmonary arteries. J Thorac Cardiovasc Surg. 1983 Jul;86(1):24–36. [PubMed] [Google Scholar]
  6. Friedman W. F., Braunwald E., Morrow A. G. Alterations in regional pulmonary blood flow in patients with congenital heart disease studied by radioisotope scanning. Circulation. 1968 May;37(5):747–758. doi: 10.1161/01.cir.37.5.747. [DOI] [PubMed] [Google Scholar]
  7. Gill C. C., Moodie D. S., McGoon D. C. Staged surgical management of pulmonary atresia with diminutive pulmonary arteries. J Thorac Cardiovasc Surg. 1977 Mar;73(3):436–442. [PubMed] [Google Scholar]
  8. Gooneratne N., Conway J. J. Radionuclide angiographic diagnosis of bronchopulmonary sequestration. J Nucl Med. 1976 Dec;17(12):1035–1037. [PubMed] [Google Scholar]
  9. Haworth S. G., Macartney F. J. Growth and development of pulmonary circulation in pulmonary atresia with ventricular septal defect and major aortopulmonary collateral arteries. Br Heart J. 1980 Jul;44(1):14–24. doi: 10.1136/hrt.44.1.14. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Haworth S. G., Rees P. G., Taylor J. F., Macartney F. J., de Leval M., Stark J. Pulmonary atresia with ventricular septal defect and major aortopulmonary collateral arteries. Effect of systemic pulmonary anastomosis. Br Heart J. 1981 Feb;45(2):133–141. doi: 10.1136/hrt.45.2.133. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Janos G. G., Gelfand M. J., Schwartz D. C., Kaplan S. Postoperative evaluation of the Fontan procedure by radionuclide angiography. Am Heart J. 1982 Oct;104(4 Pt 1):785–793. doi: 10.1016/0002-8703(82)90012-6. [DOI] [PubMed] [Google Scholar]
  12. Lane I., Treasure T., Leijala M., Shinebourne E., Lincoln C. Diminutive pulmonary artery growth following right ventricular outflow tract enlargement. Int J Cardiol. 1983 May;3(2):175–185. doi: 10.1016/0167-5273(83)90034-7. [DOI] [PubMed] [Google Scholar]
  13. Piehler J. M., Danielson G. K., McGoon D. C., Wallace R. B., Fulton R. E., Mair D. D. Management of pulmonary atresia with ventricular septal defect and hypoplastic pulmonary arteries by right ventricular outflow construction. J Thorac Cardiovasc Surg. 1980 Oct;80(4):552–567. [PubMed] [Google Scholar]
  14. Prosin M. A., Mishkin F. S. Radionuclide diagnosis of pulmonary sequestration. J Nucl Med. 1974 Jul;15(7):636–638. [PubMed] [Google Scholar]
  15. Puyau F. A., Meckstroth G. R. Evaluation of pulmonary perfusion patterns in children with tetralogy of Fallot. Am J Roentgenol Radium Ther Nucl Med. 1974 Sep;122(1):119–124. doi: 10.2214/ajr.122.1.119. [DOI] [PubMed] [Google Scholar]
  16. Rabinovitch M., Herrera-deLeon V., Castaneda A. R., Reid L. Growth and development of the pulmonary vascular bed in patients with tetralogy of Fallot with or without pulmonary atresia. Circulation. 1981 Dec;64(6):1234–1249. doi: 10.1161/01.cir.64.6.1234. [DOI] [PubMed] [Google Scholar]
  17. Sondheimer H. M., Oliphant M., Schneider B., Kavey R. E., Blackman M. S., Parker F. B., Jr Computerized axial tomography of the chest for visualization of "absent" pulmonary arteries. Circulation. 1982 May;65(5):1020–1025. doi: 10.1161/01.cir.65.5.1020. [DOI] [PubMed] [Google Scholar]
  18. Thiene G., Frescura C., Bortolotti U., Del Maschio A., Valente M. The systemic pulmonary circulation in pulmonary atresia with ventricular septal defect: concept of reciprocal development of the fourth and sixth aortic arches. Am Heart J. 1981 Mar;101(3):339–344. doi: 10.1016/0002-8703(81)90199-x. [DOI] [PubMed] [Google Scholar]

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