Document Detail


Site of coronary sinus drainage does not significantly affect coronary flow reserve in patients long term after Fontan operation.
MedLine Citation:
PMID:  16261275     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This study was designed to investigate the impact of postoperative coronary sinus drainage pressure on coronary flow reserve (CFR) assessed by Doppler guidewire in patients long term after Fontan operation. Twenty-nine patients (median age, 17.4 years female, 11) at a median of 10.6 years after Fontan operation were examined with intracoronary Doppler guidewire during cardiac catheterization. Fourteen patients had coronary sinus (CS) drainage to the systemic venous atrium and 15 patients had CS drainage to the pulmonary venous atrium after Fontan operation. Median CS drainage pressure was significantly higher in systemic venous CS drainage compared to pulmonary venous CS drainage (11 vs 5 mmHg, p < 0.0001). Median CFR values for the right and left coronary artery did not differ significantly with respect to CS drainage. There was a positive correlation between coronary flow reserve and pulmonary arteriolar resistance (p < 0.05) in multivariate regression analysis. The site of coronary drainage into the systemic atrium or the pulmonary venous atrium did not significantly affect CFR. Our data do not support a surgical strategy of elective redirection of coronary sinus blood to a low-pressure compartment but support an early staged approach. The positive correlation between CFR and pulmonary resistance demands further evaluation.
Authors:
A Eicken; W Sebening; T Genz; H Kaemmerer; R Lange; R Busch; J Hess
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Pediatric cardiology     Volume:  27     ISSN:  0172-0643     ISO Abbreviation:  Pediatr Cardiol     Publication Date:    2006 Jan-Feb
Date Detail:
Created Date:  2006-02-27     Completed Date:  2006-09-25     Revised Date:  2008-02-20    
Medline Journal Info:
Nlm Unique ID:  8003849     Medline TA:  Pediatr Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  102-9     Citation Subset:  IM    
Affiliation:
Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum, Technische Universität München, Lazarettstrasse 36, D-80636 Munich, Germany. eicken@dhm.mhn.de
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Blood Flow Velocity / physiology
Blood Pressure / physiology*
Child
Child, Preschool
Coronary Circulation / physiology*
Echocardiography, Doppler*
Female
Follow-Up Studies
Fontan Procedure*
Heart Atria / physiopathology,  surgery
Heart Catheterization
Heart Defects, Congenital / physiopathology,  surgery*,  ultrasonography
Heart Ventricles / abnormalities,  physiopathology,  surgery
Humans
Male
Multivariate Analysis
Postoperative Complications / physiopathology,  ultrasonography*
Pulmonary Circulation / physiology
Pulmonary Veins / physiopathology,  ultrasonography
Pulmonary Wedge Pressure / physiology*
Regression Analysis
Statistics as Topic
Vascular Resistance / physiology*
Venous Pressure / physiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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