Assessment of the intrapulmonary ventilation-perfusion distribution after the Fontan procedure for complex cardiac anomalies: Relation to pulmonary hemodynamics

Journal Article · Wed Mar 14 23:00:00 EST 1990 · Journal of the American College of Cardiology; (USA)

DOI:https://doi.org/10.1016/0735-1097(90)90284-V· OSTI ID:6921034

Matsushita, T; Matsuda, H; Ogawa, M; Ohno, K; Sano, T; Nakano, S; Shimazaki, Y; Nakahara, K; Arisawa, J; Kozuka, T ^[1]

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1. Osaka Univ. Medical School (Japan)

In 12 patients who underwent the Fontan procedure for complex cardiac anomalies, lung scanning with xenon-133 was performed to assess the intrapulmonary ventilation-perfusion distribution, and comparison was made with a control group. All data were then analyzed in relation to either pre- or postoperative pulmonary hemodynamic data. In ventilation scans, the intrapulmonary distribution in the right lung was almost normal. In perfusion scans, an abnormal increased upper to lower lobe perfusion ratio greater than the normal value found in the control group was noted in seven patients (58.3%). There was a significant correlation (p less than 0.02) between the upper to lower lobe perfusion ratio and postoperative pulmonary vascular resistance. Furthermore, this perfusion ratio correlated inversely with the preoperative (p less than 0.005) and postoperative (p less than 0.02) right pulmonary artery area index, defined as the ratio of cross-sectional area to the normal value. Of five patients with less than 90% arterial oxygen saturation, four showed an abnormal distribution of pulmonary blood flow greater than the normal perfusion ratio. No patient had evidence of a pulmonary arteriovenous fistula by the echocardiographic contrast study. These results suggest that abnormal distribution of pulmonary blood flow to the upper lung segment may develop in patients after the Fontan procedure, and that insufficient size of the pulmonary artery before operation and the consequent postoperative elevation of pulmonary vascular resistance may be responsible for this perfusion abnormality.

• OSTI ID: 6921034
• Journal Information: Journal of the American College of Cardiology; (USA), Journal Name: Journal of the American College of Cardiology; (USA) Vol. 15:4; ISSN 0735-1097; ISSN JACCD
• Country of Publication: United States
• Language: English

Related Subjects

550601* -- Medicine-- Unsealed Radionuclides in Diagnostics
62 RADIOLOGY AND NUCLEAR MEDICINE
BETA DECAY RADIOISOTOPES
BETA-MINUS DECAY RADIOISOTOPES
BODY
CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
COUNTING TECHNIQUES
DAYS LIVING RADIOISOTOPES
DIAGNOSIS
DIAGRAMS
DISEASES
ELECTROCARDIOGRAMS
EVEN-ODD NUCLEI
HEART
INTERMEDIATE MASS NUCLEI
INTERNAL CONVERSION RADIOISOTOPES
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
LUNGS
NUCLEI
ORGANS
PATIENTS
PERFUSED ORGANS
RADIOISOTOPE SCANNING
RADIOISOTOPES
RESPIRATORY SYSTEM
XENON 133
XENON ISOTOPES