Abstract
The initial or continuing patency of systemic-to-pulmonary artery anastomoses is often difficult to establish clinically. A continuous murmur may or may not be present, especially immediately postoperatively, or it may be masked. Increase in PaO2 may be helpful, but occasionally aortography is necessary to confirm patency. The purpose of this study was to use RGPD to identify the flow characteristics of systemic-pulmonary artery shunts. RGPD is a noninvasive bedside technique which allows evaluation of flow by placing a Doppler sample beam within an echocardio-graphically defined cavity. With the transducer placed in the suprasternal notch, the sample Doppler beam was placed within the right pulmonary artery (RPA). Flow characteristics were described by both a time interval histogram (TIH) and by an audible signal (AS). Thirty-eight children were studied by RGPD. Ten normal children had neither systolic nor diastolic RPA turbulence. Nineteen subjects with valvar pulmonic stenosis had RPA systolic turbulence by TIH and AS. Nine children (age 1 day-10 years) had Blalock-Taussig (4) or Waterston-Cooley (5) shunts. Seven were evaluated within 1 week postoperation. Shunt patency was confirmed by autopsy (2), catheterization (2) or by Pa02 rise (5). Suprasternal RGPD showed RPA systolic and diastolic turbulent flow in 9 of 9 by TIH and AS; in 6, a shunt murmur was not audible at the time of RGPD. RGPD is a useful noninvasive bedside test which effectively confirms surgical shunt patency.
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Allen, H., Sahn, D. & Goldberg, S. 82 NONINVASIVE ASSESSMENT OF SURGICAL SYSTEMIC-TO-PULMON-ARY ARTERY SHUNTS BY RANGE-GATED PULSED DOPPLER ECHO-CARDIOGRAPHY (RGPD). Pediatr Res 12 (Suppl 4), 377 (1978). https://doi.org/10.1203/00006450-197804001-00087
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DOI: https://doi.org/10.1203/00006450-197804001-00087