The efficacy of using pulmonary vein wedge pressure for the estimation of pulmonary artery pressure in children with congenital heart disease
✍ Scribed by Manatomo Toyono; Kenji Harada; Masamichi Tamura; Kenji Yasuoka; Tomomi Oyama; Goro Takada
- Publisher
- John Wiley and Sons
- Year
- 2003
- Tongue
- English
- Weight
- 105 KB
- Volume
- 58
- Category
- Article
- ISSN
- 1522-1946
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✦ Synopsis
Abstract
The objectives of this study were to assess the accuracy of pulmonary vein wedge pressure (PVWP) in estimating pulmonary artery pressure (PAP) in various types of congenital heart disease, including single‐ventricle physiology. The systolic, diastolic, and mean values of both PAPs and PVWPs were measured in 30 patients (a total of 46 points). Pulmonary artery pressure ranged from 13 to 74 (34 ± 15) mm Hg in systole, 5 to 25 (13 ± 6) mm Hg in diastole, and 6 to 48 (18 ± 10) mm Hg in mean. As a whole, good correlations between PAPs and PVWPs were observed (systole, r = 0.70; diastole, r = 0.85; mean, r = 0.82; P < 0.0001). However, with an increase in PAP, the discrepancy between PAPs and PVWPs increased. When the mean PVWP was more than 18 mm Hg, the mean PVWP in 14 of 24 (58%) underestimated the mean PAP by up to 22 mm Hg (mean difference, −1.7 ± 5.8 mm Hg). On the other hand, all of the patients with mean PVWPs less than 18 mm Hg (n = 22) had mean PAPs less than 18 mm Hg (r = 0.86; PAP = 1.11 × PVWP − 1.41; P < 0.0001), and the mean difference was −0.2 ± 1.8 mm Hg. The mean PVWP can accurately estimate the mean PAP in children with congenital heart disease who have a mean PVWP less than 18 mm Hg. Cathet Cardiovasc Intervent 2003;58:232–237. © 2003 Wiley‐Liss, Inc.
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A 3 French (3F) coaxial polyurethane catheter was utilized for catheterization of the pulmonary artery in patients with complex congenital heart disease with concomitant stenosis or atresia of the pulmonary valve, with or without Blalock-Taussig shunts. Mean aortic and atrial pressures measured with