Document Detail

Changes in pulmonary venous Doppler parameters in fetal cardiac defects.
MedLine Citation:
PMID:  16795123     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: Recent observations in pediatric cardiological studies have prompted discussion on the possible role of intrauterine pulmonary venous changes in neonatal and postoperative outcome of infants with congenital heart defects. This study analyzes changes of Doppler blood flow velocity waveforms in the pulmonary veins of fetuses with different cardiac defects. METHODS: Eighty fetuses (mean gestational age, 27 weeks) with prenatally diagnosed cardiac defects were classified into one of five groups: obstructed left atrium, other left ventricular outflow tract obstruction, right ventricular outflow tract obstruction, miscellaneous cardiac defects and total anomalous pulmonary venous drainage. Doppler examination of the pulmonary veins was performed and the time velocity integral (TVI), end-diastolic (A) velocity, and pulsatility index for veins (PIV) were compared with reference ranges. RESULTS: Fetuses with infradiaphragmatic total anomalous pulmonary venous drainage showed a continuous Doppler flow pattern instead of the typical pulsatile waveform pattern. In fetuses with obstructed left atrium and restrictive foramen ovale, a reversed A-velocity and increased PIV were found. In five of the eight fetuses with left outflow tract obstruction but patent mitral valve, PIV was increased. In the other groups there were no obvious changes in Doppler parameters. CONCLUSIONS: We suggest routine examination of the pulmonary veins with pulsed Doppler ultrasound in every fetus with a prenatally diagnosed heart defect. Such Doppler parameters could be used in future as cut-offs for the recently reported in-utero atrial septostomy to decompress an obstructed left atrium.
F Lenz; R Chaoui
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology     Volume:  28     ISSN:  0960-7692     ISO Abbreviation:  Ultrasound Obstet Gynecol     Publication Date:  2006 Jul 
Date Detail:
Created Date:  2006-06-29     Completed Date:  2007-12-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  England    
Other Details:
Languages:  eng     Pagination:  63-70     Citation Subset:  IM    
Copyright Information:
2006 ISUOG. Published by John Wiley & Sons, Ltd.
Unit of Prenatal Diagnosis and Therapy, Charité University Hospital CCM, Berlin, Germany.
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MeSH Terms
Blood Flow Velocity
Echocardiography, Doppler, Color*
Gestational Age
Heart Defects, Congenital / physiopathology,  ultrasonography*
Pulmonary Veins / abnormalities*,  physiopathology,  ultrasonography*
Pulsatile Flow
Ultrasonography, Prenatal*

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