Since the Fontan procedure results in low pulsatile pulmonary blood flow similar to that seen in patients with a Glenn shunt, it may also be associated with abnormal distribution of flow to the lower lung lobes and with the development of pulmonary arteriovenous fistulae (PAVF). In 12 patients 0.8 to 4.5 years after Fontan procedure and in 20 patients 0.2 to 18 years after receipt of Glenn shunts we assessed ventilation (with 133Xe) and perfusion (after a peripheral injection of 99mTc-macroaggregated albumin) to compare upper to lower lobe distribution of blood flow with that in a control group. The presence of PAVF was assessed by radionuclide activity in kidneys and the brain and by a two-dimensional echocardiographic contrast study. A decreased upper/lower lobe perfusion ratio was noted in 13 of 20 patients with Glenn shunts (65%) and correlated with the time after surgery (p less than .05). Despite the shorter follow-up period, two of 12 (16%) patients who had undergone the Fontan procedure also had a decreased upper/lower lobe perfusion ratio, and one of these developed right heart failure. Brain and kidney radionuclide counts above control values were observed in all patients with Glenn shunts and in 11 of 12 patients who...Continue Reading
Validity of measuring regional pulmonary arterial blood flow with macroaggregates of human serum albumin
Circulatory bypass of the right side of the heart. IV. Shunt between superior vena cava and distal right pulmonary artery; report of clinical application
EFFECTS OF PULMONARY VASCULAR CONGESTION ON POSTURAL CHANGES IN THE PERFUSION AND FILLING OF THE PULMONARY VASCULAR BED
Repeat balloon occlusion of a pulmonary arteriovenous fistula following cavopulmonary anastomosis in tetralogy of Fallot
Morphological studies of pulmonary arteriovenous shunting in a lamb model of superior cavopulmonary anastomosis.
Surgical removal of pulmonary arteriovenous malformations subsequent to total cavopulmonary connection conversion long after a Björk procedure.
The phosphatidylcholine-transfer protein catalyzed import of phosphatidylcholine into isolated rat liver mitochondria
Assessment of the intrapulmonary ventilation-perfusion distribution after the Fontan procedure for complex cardiac anomalies: relation to pulmonary hemodynamics
Postoperative pulmonary flow dynamics after Fontan surgery: assessment with nuclear magnetic resonance velocity mapping
Prevalence and risk factors for aortopulmonary collateral vessels after Fontan and bidirectional Glenn procedures
Clinical significance of pulmonary arteriovenous malformations after staging bidirectional cavopulmonary anastomosis
Comparison of contrast echocardiography versus cardiac catheterization for detection of pulmonary arteriovenous malformations
New approach to the surgical management of pulmonary arteriovenous malformations after cavopulmonary anastomosis
Additional pulmonary blood flow with the bidirectional Glenn anastomosis: does it make a difference?
Bubble contrast echocardiography in detecting pulmonary arteriovenous shunting in children with univentricular heart after cavopulmonary anastomosis
Bidirectional cavo-pulmonary anastomosis with an additional flow source to the lungs: clinical experience in 21 cases
Quantitative lung perfusion scintigraphy in postoperative evaluation of congenital right ventricular outflow tract obstructive lesions
The mid-term follow-up of pulmonary perfusion in patients after extracardiac total cavopulmonary connection
Right ventricular failure after left ventricular assist device implantation: the need for an implantable right ventricular assist device
Intrapulmonary arteriovenous shunting may be a universal phenomenon in patients with the superior cavopulmonary anastomosis: a radionuclide study
Pulmonary blood supply in bidirectional cavopulmonary anastomosis with pulsatile pulmonary blood flow: quantitative analysis using radionuclide angiocardiography
Progressive cyanosis following Kawashima operation: slow resolution after redirection of hepatic veins
Case of double-outlet right ventricle after repair with pulmonary arteriovenous malformations using cardiac CT
Radionuclide and angiographic assessment of pulmonary perfusion after Fontan procedure: comparative interim outcomes
The Fontan procedure: evolution in technique; attendant imperfections and transplantation for "failure"
Bosentan induces clinical and hemodynamic improvement in candidates for right-sided heart bypass surgery
Occlusion of a large pulmonary arteriovenous malformation in a paediatric patient using multiple vascular plugs
Systemic arteriovenous fistulae for end-stage cyanosis after cavopulmonary connection: a useful bridge to transplantation
Progressive intrapulmonary shunting in a child after bidirectional Glenn operation only resolved after total cavopulmonary completion
Regression of pulmonary arteriovenous malformations after transcatheter reconnection of the pulmonary arteries in patients with unidirectional Fontan
Exercise testing identifies patients at increased risk for morbidity and mortality following Fontan surgery
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