Format

Send to

Choose Destination
Pediatr Cardiol. 2017 Oct;38(7):1434-1440. doi: 10.1007/s00246-017-1681-y. Epub 2017 Jul 12.

Can the Pulmonary Artery Wedge Pressure be Used Reliably as a Surrogate for the Left Atrial Mean Pressure in Pre-Fontan Evaluation?

Author information

1
Rush Center for Congenital Heart Disease, Rush University Children's Hospital, 1625 W. Harrison St, Kellogg Building, Suite 608, Chicago, IL, 60612, USA. Bassel_MohammadNijres@rush.edu.
2
Rush Center for Congenital Heart Disease, Rush University Children's Hospital, 1625 W. Harrison St, Kellogg Building, Suite 608, Chicago, IL, 60612, USA.

Abstract

The correlation between mean pulmonary artery wedge pressure (PAWP) and left atrial mean pressure (LAMP) has been poorly studied in patients with single ventricle (SV) physiology (Bernstein et al. in Pediatr Cardiol 33: 15-20 2012). The aim of this study is to determine if the PAWP can be used safely as a surrogate to the LAMP to calculate the pulmonary vascular resistance (PVR) during the pre-Fontan evaluation. Also, we aimed to understand if the presence of significant systemic-to-pulmonary collaterals (SPCs) is a confounding factor for accurate estimation of the LAMP. From February 2007 to February 2017, forty-one patients were eligible for inclusion in the study. These patients were varied in terms of underlying cardiac malformation. Sex distribution was equal with 20 males and 21 females. Median weight was 11.8 kg, median body surface area was 0.51 m2, median age at catheterization was 2 years, and the median age at Glenn surgery was 5 months. We found the left and right PAWP and LAMP correlated strongly and the differences in the measurements were negligible. Similar findings were observed when calculating PVRs using PAWP and LAMP. These findings were more pronounced in the absence of significant SPCs. PAWP and LAMP correlation was still valid in the presence of significant SPCs; however, the correlation among the calculated PVRs was more attenuated.

KEYWORDS:

Left atrial mean pressure; Pre-Fontan evaluation; Pulmonary artery wedge pressure; Pulmonary vascular resistance; Single ventricle; Systemic-to-pulmonary collaterals

PMID:
28702716
DOI:
10.1007/s00246-017-1681-y
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Springer
Loading ...
Support Center