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Updated: Jul 14, 2026
Three-Dimensional Echocardiographic Method for the Visualization and Assessment of Specific Parameters of the Pulmonary Veins
Published on: October 28, 2020
Echocardiograph pulmonary venous flow patterns in congenital heart defects with increased pulmonary flow
Ivan Romero Rivera1, Maria Alayde Mendonça da Silva, Valdir Ambrósio Moises
1Universidade Federal de São Paulo, São Paulo, SP, Brazil. irivera@cardiol.br
Insights
Children with congenital heart defects and increased pulmonary flow show continuous, high-velocity pulmonary venous flow. Alterations are primarily noted in the atrial contraction waveform patterns.
Area of Science:
- Pediatric Cardiology
- Echocardiography
- Congenital Heart Disease
Background:
- Increased pulmonary flow is a common finding in various congenital heart defects.
- Pulmonary venous flow patterns can provide insights into cardiac hemodynamics.
Purpose of the Study:
- To characterize pulmonary venous flow patterns in pediatric patients with congenital heart defects and elevated pulmonary blood flow.
- To correlate echocardiographic findings with specific congenital heart conditions.
Main Methods:
- Prospective study of 29 children with congenital heart defects and increased pulmonary flow.
- Transthoracic echocardiography utilizing the apical view and Doppler.
- Sample volume placed at the lower pulmonary vein, analyzing flow patterns and atrial contraction waveforms (Absent/Reversed).
Main Results:
- All patients exhibited continuous, high-velocity pulmonary venous flow.
- Dominant diastolic waveform observed in 62% of patients, dominant systolic in 31%.
- Absent atrial contraction waveform noted in 79% of patients, reversed in 21%.
Conclusions:
- Congenital heart diseases associated with increased pulmonary flow characteristically demonstrate continuous, high-velocity pulmonary venous flow.
- Significant alterations in pulmonary venous flow, particularly the atrial contraction pattern, are observed in these conditions.
Objectives:
To describe pulmonary venous flow patterns using transthoracic echocardiograms on children suffering from different congenital heart defects with increased pulmonary flow.
Methods:
Prospective study and consecutive selection of children suffering from congenital heart defects with increased pulmonary flow. The transthoracic, apical view, Doppler echocardiogram was used, positioning the sample-volume at the lower pulmonary vein, 4mm from its junction with the left atrium. The data analyzed included: dominant systolic or diastolic pulmonary venous flow and atrial contraction waveform characteristics, designated as "A" for absent and "R" for reversed.
Results:
The study included twenty-nine patients with a mean age of 29.9 +/- 58.9 months, suffering from the following congenital heart conditions: interatrial and interventricular communication defects, patent ductus arteriosus, atrioventricular septal defects, total transposition of the great arteries and truncus arteriosus. All the patients presented a continuous pattern of high velocity pulmonary venous flow. Nine patients presented a dominant systolic waveform (31%), eighteen presented a dominant diastolic wave form (62%) and 2 patients had systolic and diastolic wave forms of equal amplitude (7%). Six patients (21%) presented a R atrial contraction waveform and 23 (79%) presented an A atrial contraction waveform.
Conclusion:
Congenital heart diseases with increased pulmonary flow present a continuous pattern of high velocity pulmonary venous flow with alterations mainly in the atrial contraction reversal pattern.
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