2008, Number 3
<< Back Next >>
Arch Cardiol Mex 2008; 78 (3)
El método de Fick subestima el cálculo de flujo pulmonar en los enfermos operados de Glenn bidireccional
Alva C, David GF, Ortegón CJ, Yáñez GL, Lazcano S
Language: Spanish
References: 12
Page: 305-308
PDF size: 110.65 Kb.
ABSTRACT
In patients with Bidirectional Glenn who have undergone surgery, the superior caval venous flow provides the only pulmonary blood supply. This is the effective pulmonary flow and at the same time its volume is not enough to overflow the single ventricle. The unsaturated, inferior vena cava flow is not oxygenated, since it goes across the interatrial septal communication and gets mixed in the left ventricle with the pulmonary venous blood. In this work, a bidirectional Glenn case is analyzed. The hemodynamic data before and after the operation are shown. It was evident from this case that the use of the Fick method to measure pulmonary flow in patients with bidirectional Glenn operation is not appropriate. Alternative methods, such as Doppler echocardiography and Magnetic Resonance Imaging, are recommended. A literature review on this subject was carefully done.
REFERENCES
Aeba R, Katogi T, Kashima I: Factors influencing arterial oxygenation early after bidirectional cavopulmonary shunt without additional sources of pulmonary flow. J Thorac Cardiovasc Surg 2000; 120: 589-595.
Bradley SM, Mosca RS, Hennein HA: Bidirectional superior cavopulmonary connections in young infants. Circulation 1996; 94: 5-11.
Konstantinov IE, Alexei-Meskishvili: Letter. Ann Thorac Surg 2000; 69: 311-312.
Yeh T Jr, Williams WG, McCrindle BW: Equivalent survival following cavopulmonary shunt: with or without the Fontan procedure. Eur J Cardiothorac Surg 1999; 16: 111-116.
Salim MA, Case CL, Sade RM: Pulmonary/systemic flow ratio in children after cavopulmonary anastomosis. J Am Coll Cardiol 1995; 25: 735-738.
Azakie A, McCrindle BW, Van Arsd.ll G: Extracardiac conduit versus lateral tunnel cavopulmonary connections at a single institution: impact on outcomes. J Thorac Cardiovasc Surg 2001; 122: 1219-1228.
Calderon C, Ramirez S, Viesca R, Ramirez L, Casanova M, García Montes A, et al: Cirugía de Fontan. Factores de riesgo a corto y mediano plazo. Arch Cardiol Mex 2005; 75: 425-434.
Calderón-Colmenero J, Cervantes JL, Ramírez S, Attie F: Exclusión del ventrículo venoso. Evolución y retos. A propósito de los primeros cien casos del procedimiento de Fontan en el Instituto Nacional de Cardiología Ignacio Chávez. Arch Cardiol Mex 2006; 76(S4): 102-110.
Fernandez Pineda L, Cazzaniga M, Villagrá F, Díez Balda JI, Daghero F, Herraiz Sarachaga I, et al: La operación de Glenn bidireccional en 100 casos con cardiopatías congénitas complejas: factores determinantes del resultado quirúrgico. Rev Esp Cardiol 2001: 54: 1061-1074.
Salim MA, DiSessa G, Arheart KL, Alpert BS: Contribution of superior vena caval flow to total cardiac output in children. A Doppler echocardiographic study. Circulation 1995; 92: 1860-1865.
Mertens EB, Kuzo R, De Jaegere T, Lawrenson J, Dymarkowski S, Bogaert J, et al: The ratio of flow in the superior and inferior caval veins alter consturction of a bidirectional cavopulmonary anastomosis in children. Cardiol Young 2003; 13: 123-130.
Diller GP, Uebing A, Wilson K, Davies LC, Dimopoulos K, Thorne SA, et al: Analytical identification of ideal pulmonary-systemic flow balance in patients with bidirectional cavopulmonary shunt and univentricular circulation. Circulation 2007; 114: 1243-1250.