Læknablaðið - 15.11.1991, Blaðsíða 17
LÆKNABLAÐIÐ
341
op á milli gátta sé þess gætt að halda
skekkjuvöldum í lágmarki. Er því unnt að
rannsaka flesta þessara sjúklinga og ákveða
hvort þörf sé á aðgerð án hjartaþræðingar.
PAKKIR
Rannsókn þessi er tileinkuð Kvenfélaginu
Hringnum, sem um árabil hefur stutt
Bamaspítala Hringsins með framlögum og
gjöfum. Omskoðunartæki það sem notað var
í þessari rannsókn var þeirra gjöf og án þess
hefði okkur ekki verið fært að vinna þessa
rannsókn.
SUMMARY
Twelve patients with left-to-right shunt at the
atrial level (11 with atrial septal defect (ASD)
and one with partial anomalous pulmonary venous
connection (PAPVC)) underwent diagnostic cardiac
catheterization (cath) after quantification of the
shunt had been estimated using Doppler technique.
The pulmonary blood flow and the systemic blood
flow was measured during the cath using the Fick
method. The results of the Doppler technique and
the cath method were compared.
The pulmonary blood flow (Qp) by Doppler ranged
from 4.4 - 9.3 (median 6.7) l/min/m2 and 4.1 -
8.9 (median 6.7) l/min/m2 by the Fick method.
Correlation (Spearman rank): r = 0.85 and p <
0.01. The systemic blood flow (Qs) using Doppler
ranged from 2.6 - 4.8 (median 3.8) l/min/m2
and 3.0 - 5.1 (median 3.7) l/min/m2 by the Fick
method. Correlation: r = 0.87, p < 0.01. When
Qp/Qs ratio using these two methods was compared
the r = 0.83, p < 0.01.
We conclude that the Doppler method is an
effective and reliable method of measuring the size
of left-to-right shunt at the atrial level is this group
of patients.
HEIMILDIR
1. Steingart RM, Meller J, Barovick J, Patterson
R, Herman MV, Teicholtz LE. Pulsed Doppler
echocardiographic measurment of beat-to-beat
changes in stroke volume in dogs. Circulation 1980;
62: 542.
2. Huntsman LL, Gams E, Johnson CC, Fairbanks E.
Transcutaneous determination of aortic blood flow
velocities in man. Am Heart J 1975; 89: 605.
3. Griffith J, Henry WL. An ultrasound system for
combined cardiac imaging and Doppler blood flow
measurement in man. Circulation 1978; 57: 925.
4. Huntsman LL, Steward DK, Bames SR, Franklin
SB, Colocousis JS, Heisel SA. Noninvasive Doppler
determination of cardiac output in man: clinical
validation. Circulation 1983; 67: 593.
5. Alverson DC, Eldridge M, Dillon T, Yabek
SM, Berman WJ. Noninvasive pulsed Doppler
detemiination of cardiac output in neonates and
children. J Pediatr 1982; 101: 46.
6. Sanders SP, Yeager S, Williams RG. Measurement
of systemic and pulmonary blood flow and
Qp:Qs ratio using Doppler and two-dimensional
echocardiography. Am J Cardiol 1983; 51: 952.
7. Nanda N. Doppler Evaluation of Cardiac Output.
In: Doppler Echocardiography. Tokyo: Igaku-Shoin,
1985: 149.
8. Goerke J, Mines AH. Physics of the Heart and
Circulation. In: Cardiovascular Physiology. New
York: Raven Press, 1988: 56.
9. Rudolph AM, ed. Catheterization and
Angiocardiography. In: Congenital Diseases of the
Heart. Chicago: Year Medical Publishers, 1974.
10. Colton T. Nonparametric Methods. In: Statistics in
Medicine. Boston, Little Brown & Company, 1974:
216.
11. Krabill KA, Ring S, Foker JE. et al.
Echocardiographic versus Cardiac Catheterization
Diagnosis of Infants with Congenital Heart Defects
Requiring Cardiac Surgery. Am J Cardiol 1987; 60:
351.
12. Ludomirski A, Hutha JC. Color Doppler of
Congenital Heart Disease in the Child and Adult.
New York: Futura Publishing Company Inc, 1987:
16.
13. Goldberg SJ, Allen HD, Marx GR, Flinn CJ.
Flow computation. In: Doppler Echocardiography.
Philadelphia: Lea & Febiger, 1985: 68.
14. Grossmann W, ed. Profiles in Congenital
Heart Disease. In: Cardiac Catheterization and
Angiocardiography. Philadelphia: Lea & Febiger,
1980: 377.