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Abnormal pattern of flow in the superior caval vein in children after open heart surgery
K Ichihashi1, H Shiraishi, M Momoi
1Department of Pediatrics, Jichi Medical School, Kawachigun, Tochigi, Japan. koichiha@jichi.ac.jp
Insights
Children undergoing open heart surgery show altered superior caval vein blood flow patterns. Postoperative patients exhibit reversed systolic and diastolic flow velocities, indicating potential right atrial reserve capacity changes.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Surgery
- Medical Imaging
Background:
- Open heart surgery for septal defects can impact venous blood flow dynamics.
- Understanding superior caval vein (SCV) flow is crucial for assessing cardiac function post-surgery.
Purpose of the Study:
- To investigate SCV flow patterns in children after open heart surgery.
- To compare SCV flow velocity curves in postoperative patients with healthy controls.
Main Methods:
- Pulsed Doppler examinations were used to record SCV flow velocity curves.
- Measurements included peak systolic and diastolic flow velocities and their ratios.
- 37 children post-septal defect repair were compared to 64 age-matched controls.
Main Results:
- Postoperative patients displayed reversed systolic and diastolic flow velocity patterns compared to controls.
- Systolic velocity changes during inspiration were exaggerated in postoperative patients.
- Respiration-induced changes in flow velocity curves were diminished post-surgery.
Conclusions:
- Altered SCV flow patterns suggest potential changes in right atrial function after pediatric open heart surgery.
- Reduced respiratory variation in flow may indicate decreased right atrial reserve capacity.
Abstract:
To investigate the pattern of flow in the superior caval vein in children after open heart surgery, we examined the flow velocity curves in 37 patients who had undergone surgical correction of either ventricular or atrial septal defects. The control group consisted of 64 age-matched children. We used pulsed Doppler examinations to record the velocity curves. We measured the highest and lowest peak flow velocities during systole and diastole, and calculated ratios for the various measurements. We found that the velocity of the wave in systole is lower than that of the wave in diastole in the postoperative patients, which is contrary to the normal pattern. The velocity in systole increases more than that in diastole during inspiration, which is also different from the normal pattern. The change in pattern of flow velocity curve during respiration was smaller in patients after surgery than in normal subjects, which might indicate that there is less reserve ability in the right atrium in postoperative patients.