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Evaluation of pulmonary circulation in ostium secundum type atrial septal defect by right and left ventricular volume characteristics



Evaluation of pulmonary circulation in ostium secundum type atrial septal defect by right and left ventricular volume characteristics



Journal of the Japanese Association for Thoracic Surgery 31(11): 2008-2012



Right and left ventricular volume variables were calculated in 13 patients with an uncomplicated atrial septal defect (ASD) (group 1) and in 9 patients with no demonstrable heart disease (group 2). The right (RVSO) and left ventricular systolic output (LVSO) ratio was 1.08 .+-. 0.15 (mean .+-. SD) in patients of group 2. In group 1 patients, RVSO/LVSO ratios were 1.26-3.41 (2.45 .+-. 0.66) and showed no significant linear correlation with pulmonary to systemic flow ratios estimated by Fick's method (Qp/s). In 5 of the 6 patients in whom Qp/Qs ratios were < 1.80, RVSO/LVSO ratios ranged from 1.89 to 3.41. This discrepancy was quite significant. Surgery was performed in 2 patients in whom Qp/Qs ratios were 1.51 and 1.53, respectively. Sizes of the defect were large and defect areas per body surface area were 3.02 and 2.75 cm2/m2, respectively. RVSO/LVSO ratios of these 2 patients were 3.41 and 2.98, respectively and they were thought to be in the high pulmonary flow group. RVSO/LVSO ratios showed a better correlation with the clinical and radiographic findings in these 2 patients. Another 1 patient in whom the Qp/Qs ratio was 1.62 had a small defect and the defect area per body surface area was 0.70 cm2/m2. The RVSO/LVSO ratio of this patient was 1.26 and this patient was thought to be in the normal pulmonary flow group. Evidently, the RVSO/LVSO ratio is a useful method to evaluate the pulmonary circulation in ASD.

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