Flow dynamics in the main pulmonary artery after the Fontan procedure in patients with tricuspid atresia or single ventricle.

Abstract

We analyzed the flow velocity pattern in the main pulmonary artery after Fontan operation in patients with tricuspid atresia (n = 10) or with single ventricle (n = 10) by means of a catheter-mounted velocity probe. The area underneath the velocity signal of the forward flow was integrated, and ratios of the portions during atrial systole and during the diastolic phase to the total area (Fa and Fd) were calculated. The Fa was 0.54 +/- 0.09 in patients with tricuspid atresia and 0.45 +/- 0.05 in those with single ventricle (p less than .01). Cardiac output, obtained by the thermodilution method, was 2.45 +/- 0.48 liters/min/m2 in patients with tricuspid atresia and 2.75 +/- 0.72 liters/min/m2 in those with single ventricle. The forward flow during atrial contraction, calculated by multiplying Fa by cardiac output, was 1.32 +/- 0.35 liters/min/m2 in patients with tricuspid atresia and 1.23 +/- 0.33 liters/min/m2 in those with single ventricle. The diastolic forward flow, calculated from Fd and cardiac output, was 0.99 +/- 0.25 liter/min/m2 in patients with tricuspid atresia and 1.52 +/- 0.45 liters/min/m2 in those with single ventricle (p less than 0.005). The sum of cross-sectional areas of the right and left pulmonary arteries normalized by body surface area (PA index) was 282 +/- 85 cm2/m2 in patients with tricuspid atresia and 462 +/- 65 cm2/m2 in those with single ventricle (p less than .005). The Fa was inversely correlated with the PA index in the whole group (r = -.69) and also in the tricuspid atresia group alone (r = -.87).(ABSTRACT TRUNCATED AT 250 WORDS)