Congenital heart disease
-
Congenital heart disease · Nov 2006
Comparative StudyPhysiologic limitation of omega exists in patients after the Norwood palliation and is underestimated by the arterial venous oxygen saturation difference.
Survival after the Norwood palliation (NW) is dependent on maximizing systemic oxygen delivery. Omega (Omega) is used to express the excess of oxygen delivery to oxygen consumption. We hypothesized that an intrinsic deficiency in the ability to maximize the relationship between oxygen delivery (DO(2)) and oxygen consumption (VO(2)) is present in infants after NW and is underestimated by arterial venous oxygen saturation difference (a-vO(2)). ⋯ Omega is lower for patients in the immediate postoperative period after NW and prior to their bidirectional Glenn operation than in patients after biventricular repair. This places NW patients closer to the critical point of DO(2) and therefore at greater risk for hemodynamic compromise than BV patients. The a-vO(2) difference underestimates this risk.
-
Congenital heart disease · Nov 2006
The impact of aortic arch geometry on flow dynamics using a simplified approach with magnetic resonance velocity mapping.
We sought to determine, in vivo, the impact of aortic arch geometry on flow dynamics, which affects overall cardiovascular energetics and has implications for organ perfusion and Doppler flow calculations. ⋯ Right aortic arch geometry impacts flow dynamics in the ascending aorta whereas it is not altered in the descending aorta, where flow is predominantly in the posterior half. The sidedness of the aortic arch determined the location of maximum velocity. Alternatively, this also may suggest that hemodynamics could have played a role in the development of right aortic arch in certain individuals.