The ratio of flow in the superior and inferior caval veins after construction of a bidirectional cavopulmonary anastomosis in children

Benedicte Eyskens, Luc Mertens, Ronald S Kuzo, Tom De Jaegere, John Lawrenson, Steven Dymarkowski, Jan Bogaert, Willem Daenen, Marc Gewillig

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

In patients who have undergone a superior cavopulmonary anastomosis, the superior caval venous flow provides the only, or the most important, pulmonary blood supply, while the inferior caval venous blood is not oxygenated, being mixed with the pulmonary venous blood before entering the systemic circulation. In healthy children, the contribution of superior caval venous flow to total cardiac output has been shown to decrease during growth. Patients who have undergone a superior cavopulmonary anastomosis, however, often have a higher oxygen saturation than predicted by the age-matched ratio of superior to inferior caval venous flows. This study was designed, therefore, to assess the ratio of flows in the superior and inferior caval veins subsequent to a superior cavopulmonary anastomosis. We carried out 18 magnetic resonance imaging studies with velocity-mapping and heart catheterisations so as to assess the contribution of superior caval venous flow to total cardiac output. Patients were divided into 3 groups according to their age. There were five aged from 8 to 24 months, eight aged from 24 to 48 months, and five older than 48 months. No significant difference could be found in the ratios of superior-to-inferior caval venous flow, nor of superior caval venous-to-systemic flow, between the 3 groups. The ratio of venous flows was 0.89 ± 0.34 in those aged from 8 to 24 months, 1.09 ± 0.42 in those from 24 to 48 months, and 1.25 ± 0.27 in the older patients (F analysis of variance 1.06, p 0.37). The ratio of superior caval venous-to-systemic flow was 0.46 ± 0.08 in the youngest patients, 0.50 ± 0.09 in those aged from 24 to 48 months, and 0.55 ± 0.05 in the older patients (F analysis of variance 0.76, p 0.49). These findings suggest that the hemodynamics of a cavopulmonary anastomosis may affect the normal decrease of superior caval venous flow with age. This could be related to a redistribution of flow, with a proportionally higher flow to the head and upper body after construction of a superior cavopulmonary anastomosis. Since increasing cyanosis and progressive exercise intolerance are the main indications for creation of a total cavopulmonary connection, these findings should be taken into account when determining the timing for completion of the Fontan circulation.

Original languageEnglish (US)
Pages (from-to)123-130
Number of pages8
JournalCardiology in the Young
Volume13
Issue number2
DOIs
StatePublished - Apr 2003
Externally publishedYes

Fingerprint

Right Heart Bypass
Venae Cavae
Veins
Cardiac Output
Analysis of Variance
Lung
Cyanosis
Cardiac Catheterization
Hemodynamics

Keywords

  • Children
  • Magnetic resonance imaging
  • Pulmonary flow
  • Velocity mapping

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Pediatrics, Perinatology, and Child Health

Cite this

The ratio of flow in the superior and inferior caval veins after construction of a bidirectional cavopulmonary anastomosis in children. / Eyskens, Benedicte; Mertens, Luc; Kuzo, Ronald S; De Jaegere, Tom; Lawrenson, John; Dymarkowski, Steven; Bogaert, Jan; Daenen, Willem; Gewillig, Marc.

In: Cardiology in the Young, Vol. 13, No. 2, 04.2003, p. 123-130.

Research output: Contribution to journalArticle

Eyskens, B, Mertens, L, Kuzo, RS, De Jaegere, T, Lawrenson, J, Dymarkowski, S, Bogaert, J, Daenen, W & Gewillig, M 2003, 'The ratio of flow in the superior and inferior caval veins after construction of a bidirectional cavopulmonary anastomosis in children', Cardiology in the Young, vol. 13, no. 2, pp. 123-130. https://doi.org/10.1017/S1047951103000258
Eyskens, Benedicte ; Mertens, Luc ; Kuzo, Ronald S ; De Jaegere, Tom ; Lawrenson, John ; Dymarkowski, Steven ; Bogaert, Jan ; Daenen, Willem ; Gewillig, Marc. / The ratio of flow in the superior and inferior caval veins after construction of a bidirectional cavopulmonary anastomosis in children. In: Cardiology in the Young. 2003 ; Vol. 13, No. 2. pp. 123-130.
@article{9028ef9ebdf747878b4f26e00e17fa58,
title = "The ratio of flow in the superior and inferior caval veins after construction of a bidirectional cavopulmonary anastomosis in children",
abstract = "In patients who have undergone a superior cavopulmonary anastomosis, the superior caval venous flow provides the only, or the most important, pulmonary blood supply, while the inferior caval venous blood is not oxygenated, being mixed with the pulmonary venous blood before entering the systemic circulation. In healthy children, the contribution of superior caval venous flow to total cardiac output has been shown to decrease during growth. Patients who have undergone a superior cavopulmonary anastomosis, however, often have a higher oxygen saturation than predicted by the age-matched ratio of superior to inferior caval venous flows. This study was designed, therefore, to assess the ratio of flows in the superior and inferior caval veins subsequent to a superior cavopulmonary anastomosis. We carried out 18 magnetic resonance imaging studies with velocity-mapping and heart catheterisations so as to assess the contribution of superior caval venous flow to total cardiac output. Patients were divided into 3 groups according to their age. There were five aged from 8 to 24 months, eight aged from 24 to 48 months, and five older than 48 months. No significant difference could be found in the ratios of superior-to-inferior caval venous flow, nor of superior caval venous-to-systemic flow, between the 3 groups. The ratio of venous flows was 0.89 ± 0.34 in those aged from 8 to 24 months, 1.09 ± 0.42 in those from 24 to 48 months, and 1.25 ± 0.27 in the older patients (F analysis of variance 1.06, p 0.37). The ratio of superior caval venous-to-systemic flow was 0.46 ± 0.08 in the youngest patients, 0.50 ± 0.09 in those aged from 24 to 48 months, and 0.55 ± 0.05 in the older patients (F analysis of variance 0.76, p 0.49). These findings suggest that the hemodynamics of a cavopulmonary anastomosis may affect the normal decrease of superior caval venous flow with age. This could be related to a redistribution of flow, with a proportionally higher flow to the head and upper body after construction of a superior cavopulmonary anastomosis. Since increasing cyanosis and progressive exercise intolerance are the main indications for creation of a total cavopulmonary connection, these findings should be taken into account when determining the timing for completion of the Fontan circulation.",
keywords = "Children, Magnetic resonance imaging, Pulmonary flow, Velocity mapping",
author = "Benedicte Eyskens and Luc Mertens and Kuzo, {Ronald S} and {De Jaegere}, Tom and John Lawrenson and Steven Dymarkowski and Jan Bogaert and Willem Daenen and Marc Gewillig",
year = "2003",
month = "4",
doi = "10.1017/S1047951103000258",
language = "English (US)",
volume = "13",
pages = "123--130",
journal = "Cardiology in the Young",
issn = "1047-9511",
publisher = "Cambridge University Press",
number = "2",

}

TY - JOUR

T1 - The ratio of flow in the superior and inferior caval veins after construction of a bidirectional cavopulmonary anastomosis in children

AU - Eyskens, Benedicte

AU - Mertens, Luc

AU - Kuzo, Ronald S

AU - De Jaegere, Tom

AU - Lawrenson, John

AU - Dymarkowski, Steven

AU - Bogaert, Jan

AU - Daenen, Willem

AU - Gewillig, Marc

PY - 2003/4

Y1 - 2003/4

N2 - In patients who have undergone a superior cavopulmonary anastomosis, the superior caval venous flow provides the only, or the most important, pulmonary blood supply, while the inferior caval venous blood is not oxygenated, being mixed with the pulmonary venous blood before entering the systemic circulation. In healthy children, the contribution of superior caval venous flow to total cardiac output has been shown to decrease during growth. Patients who have undergone a superior cavopulmonary anastomosis, however, often have a higher oxygen saturation than predicted by the age-matched ratio of superior to inferior caval venous flows. This study was designed, therefore, to assess the ratio of flows in the superior and inferior caval veins subsequent to a superior cavopulmonary anastomosis. We carried out 18 magnetic resonance imaging studies with velocity-mapping and heart catheterisations so as to assess the contribution of superior caval venous flow to total cardiac output. Patients were divided into 3 groups according to their age. There were five aged from 8 to 24 months, eight aged from 24 to 48 months, and five older than 48 months. No significant difference could be found in the ratios of superior-to-inferior caval venous flow, nor of superior caval venous-to-systemic flow, between the 3 groups. The ratio of venous flows was 0.89 ± 0.34 in those aged from 8 to 24 months, 1.09 ± 0.42 in those from 24 to 48 months, and 1.25 ± 0.27 in the older patients (F analysis of variance 1.06, p 0.37). The ratio of superior caval venous-to-systemic flow was 0.46 ± 0.08 in the youngest patients, 0.50 ± 0.09 in those aged from 24 to 48 months, and 0.55 ± 0.05 in the older patients (F analysis of variance 0.76, p 0.49). These findings suggest that the hemodynamics of a cavopulmonary anastomosis may affect the normal decrease of superior caval venous flow with age. This could be related to a redistribution of flow, with a proportionally higher flow to the head and upper body after construction of a superior cavopulmonary anastomosis. Since increasing cyanosis and progressive exercise intolerance are the main indications for creation of a total cavopulmonary connection, these findings should be taken into account when determining the timing for completion of the Fontan circulation.

AB - In patients who have undergone a superior cavopulmonary anastomosis, the superior caval venous flow provides the only, or the most important, pulmonary blood supply, while the inferior caval venous blood is not oxygenated, being mixed with the pulmonary venous blood before entering the systemic circulation. In healthy children, the contribution of superior caval venous flow to total cardiac output has been shown to decrease during growth. Patients who have undergone a superior cavopulmonary anastomosis, however, often have a higher oxygen saturation than predicted by the age-matched ratio of superior to inferior caval venous flows. This study was designed, therefore, to assess the ratio of flows in the superior and inferior caval veins subsequent to a superior cavopulmonary anastomosis. We carried out 18 magnetic resonance imaging studies with velocity-mapping and heart catheterisations so as to assess the contribution of superior caval venous flow to total cardiac output. Patients were divided into 3 groups according to their age. There were five aged from 8 to 24 months, eight aged from 24 to 48 months, and five older than 48 months. No significant difference could be found in the ratios of superior-to-inferior caval venous flow, nor of superior caval venous-to-systemic flow, between the 3 groups. The ratio of venous flows was 0.89 ± 0.34 in those aged from 8 to 24 months, 1.09 ± 0.42 in those from 24 to 48 months, and 1.25 ± 0.27 in the older patients (F analysis of variance 1.06, p 0.37). The ratio of superior caval venous-to-systemic flow was 0.46 ± 0.08 in the youngest patients, 0.50 ± 0.09 in those aged from 24 to 48 months, and 0.55 ± 0.05 in the older patients (F analysis of variance 0.76, p 0.49). These findings suggest that the hemodynamics of a cavopulmonary anastomosis may affect the normal decrease of superior caval venous flow with age. This could be related to a redistribution of flow, with a proportionally higher flow to the head and upper body after construction of a superior cavopulmonary anastomosis. Since increasing cyanosis and progressive exercise intolerance are the main indications for creation of a total cavopulmonary connection, these findings should be taken into account when determining the timing for completion of the Fontan circulation.

KW - Children

KW - Magnetic resonance imaging

KW - Pulmonary flow

KW - Velocity mapping

UR - http://www.scopus.com/inward/record.url?scp=11844255987&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=11844255987&partnerID=8YFLogxK

U2 - 10.1017/S1047951103000258

DO - 10.1017/S1047951103000258

M3 - Article

C2 - 12887067

AN - SCOPUS:11844255987

VL - 13

SP - 123

EP - 130

JO - Cardiology in the Young

JF - Cardiology in the Young

SN - 1047-9511

IS - 2

ER -