山梨医科大学雑誌　第3巻2号　057-063(1988)

Qualitative Evaluation of Diminished Pulmonary Blood Flow of
Congenital Cyanotic Heart Disease by the Pulmonary
Venous Wedge Pressure Measurement
and Its Surgical Consideration

Tetsunosuke MATSUKAWA, Ryoichi HASHIMOTO, Shinpei YOSHII,
Shoji EGUCHI and Akira UENO

Abstract: In 27 cyanotic heart patients with complication of stenosis or atresia involving ventricular septal defect or single ventricle, we evaluated the diminished pulmonary blood flow by the pulmonary venous wedge pressure (PVWP) measurement.
There were significant correlations between mean PVWP and arterial oxygen saturation (r=0.71, P<.01) and right pulmonary arterial/ascending aortic diameter ratio (r=0.65, P<.01). Of the 27 patients, 14 (except one with mean PVWP above 13 mmHg) survived, but seven of 12 with mean PVWP below 12 mmHg died from sudden hypoxic attack or postoperative low cardiac output syndrome/late congcstive heart failure.
Mean PVWP value is useful as an indirect parameter affected by diminished pulmonary blood flow. In patients with mean PVWP below 12 mmHg, the urgent and/or initial shunt operation is recommended, in view of the threatened hypoxic state and/or unadequate size of pulmonary arteries vis a vis surgical reconstruction of the right ventricular outflow tract.

Key words: Pulmonary venous wedge pressure, Cyanotic heart disease, Dimnished pulmonary blood flow, Surgical indication




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