Hostname: page-component-cd9895bd7-q99xh Total loading time: 0 Render date: 2024-12-27T15:13:29.694Z Has data issue: false hasContentIssue false
  • English
  • Français

Abnormalities in myocardial perfusion after surgical correction of pulmonary atresia with intact ventricular septum

Published online by Cambridge University Press:  15 January 2008

Britt-Marie Ekman-Joelsson ,
Håkan Berggren ,
Ann-Britt Boll ,
Rune Sixt  and
Jan Sunnegårdh
Britt-Marie Ekman-Joelsson*
Affiliation:
Paediatric and Adolescent Medical Care, Skaraborgs Hospital, Skövde, Sweden
Håkan Berggren
Affiliation:
The Queen Silvia Children’s Hospital, Göteborg University, Göteborg, Sweden
Ann-Britt Boll
Affiliation:
The Queen Silvia Children’s Hospital, Göteborg University, Göteborg, Sweden
Rune Sixt
Affiliation:
The Queen Silvia Children’s Hospital, Göteborg University, Göteborg, Sweden
Jan Sunnegårdh
Affiliation:
The Queen Silvia Children’s Hospital, Göteborg University, Göteborg, Sweden
*
Paediatric and Adolescent Medical Care, Skaraborgs Hospital, 541 85 Skövde, Sweden. Tel: +46-500-431000; Fax: +46-500-432299; E-mail: britt-mari.ekman-joelsson@vgregion.se
Get access Rights & Permissions [Opens in a new window]

Abstract

We describe the results of myocardial perfusion scintigraphy performed 4 to 15 years after surgery in 12 patients with pulmonary atresia and intact ventricular septum. We used single photon emission computed tomography after injection of technetium Tc-99m tetrofosmin at submaximal exercise test. The patients, 7 girls and 5 boys, with a mean age of 11 years, and a range from 6 to 19 years, had either undergone biventricular repair, in 5 cases, or univentricular palliation in the remaining 7. This second group included 4 patients with ventriculo-coronary arterial communications. Of the children, 3 with biventricular repair and 6 with univentricular palliation had perfusion defects. Children with biventricular repair had perfusion defects in the ventricular septum, while those having univentricular palliation also had defects located to the left ventricular free wall. All children with ventriculo-coronary arterial communications had perfusion defects both in the ventricular septum and in the left ventricular free wall.

Keywords

Myocardial perfusion scintigraphycongenital heart defectFontan circulation
Type
Original Article
Information
Cardiology in the Young , Volume 18 , Issue 1 , February 2008 , pp. 89 - 95
Copyright
Copyright © Cambridge University Press 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Ferencz, C, Rubin, JD, McCarter, RJ, et al. . Congenital heart disease: Prevalence at live birth. The Baltimore-Washington Infant Study. Am J Epidemiol 1985; 121: 31–36.CrossRefGoogle Scholar
2. Freedom, R, Wilson, G, Trusler, GA, William, WG, Rowe, RD. Pulmonary atresia and ventricular septum. Scand J Thor Cardiovasc Surg 1983; 17: 1–28.Google ScholarPubMed
3. Ashburn, DA, Blackstone, EH, Wells, WJ, et al. . Congenital Heart Surgeons Study members. Determinants of mortality and type of repair in neonates with pulmonary atresia and intact ventricular septum. J Thorac Cardiovasc Surg 2004; 127: 1000–1007.Google Scholar
4. Dyamenahalli, U, McCrindle, BW, McDonald, C, et al. . Pulmonary atresia with intact ventricular septum: management of, and outcomes for, a cohort of 210 consecutive patients. Cardiol Young 2004; 14: 299–308.Google Scholar
5. Ekman-Joelsson, B-M, Sunnegårdh, J, Hanséus, K, et al. . The outcome of children born with pulmonary atresia and intact ventricular septum in Sweden from 1980 to 1999. Scan Cardiovasc J 2001; 35: 192–198.Google ScholarPubMed
6. Fenton, KN, Pigula, FA, Gandhi, SK, Russo, L, Duncan, KF. Interim mortality in pulmonary atresia with intact ventricular septum. Ann Thorac Surg 2004; 78: 1994–1998.Google Scholar
7. Akiba, TA, Becker, AE. Disease of the left ventricle in pulmonary atresia with intact ventricular septum. J Thorac Cardiovasc Surg 1994; 108: 1–8.Google Scholar
8. Fyfe, DA, Edwards, WD, Driscoll, DJ. Myocardial ischemia in patients with pulmonary atresia and intact ventricular septum. JACC 1986; 8: 402–406.CrossRefGoogle ScholarPubMed
9. Oosthoek, PW, Moorman, AFM, Sauer, U, Gittenberger-de Groot, AC. Capillary distribution in the ventricles of hearts with pulmonary atresia and intact ventricular septum. Circ 1995; 91: 1790–1798.CrossRefGoogle ScholarPubMed
10. Robicsek, F, Bostoen, H, Sanger, P. Atresia of the pulmonary valve with normal pulmonary artery and intact ventricular septum in a 21-year-old woman. Angiology 1966; 17: 896–901.Google Scholar
11. Schiller, NB, Shah, PM, Crawford, M. Recommendations for quantitation of the left ventricle by two-dimensional echocardiography. J Am Soc Echocardiogr 1989; 2: 358–367.Google Scholar
12. Gentle, TL, Colan, SD, Giglia, TM, Mandell, VS, Mayer, JE, Sanders, SP. Right ventricular decompression and left ventricular function in pulmonary atresia with intact ventricular septum. The influence of less extensive coronary anomalies. Circulation 1993; 88 (part 2): 183–188.Google Scholar
13. Bulkely, BH, Weisfeldt, ML, Hutchins, GM. Asymmetric septal hypertophy and myocardial fiber disarray. Circulation 1977; 56: 292–298.CrossRefGoogle Scholar
14. Akagi, T, Benson, LN, Williams, WG, Trusler, GA, Freedom, RM. Ventriculo-coronary arterial connections in pulmonary atresia with intact ventricular septum, and their influences on ventricular performance and clinical course. Am J Cardiol 1993; 72: 586–590.CrossRefGoogle ScholarPubMed
15. Hausdorf, G, Grävinghoff, L, Keck, EW. Effects of persisting myocardial sinusoids on left ventricular performance in pulmonary atresia with intact ventricular septum. Eur Heart J 1987; 8: 291–296.Google Scholar
16. O’Connor, WN, Stahr, BJ, Cottrill, CM, Todd, EP, Noonan, JA. Ventriculocoronary connections in hypoplastic right heart syndrome: autopsy serial section study of six cases. JACC 1988; 11: 1061–1072.CrossRefGoogle ScholarPubMed
17. Hisagi, M, Suzuki, Y, Nakayama, S. Biventricular repair for pulmonary atresia with intact ventricular septum associated with sinusoidal communications. Jpn J Thorac Cardiovasc Surg 2003; 51: 25–28.CrossRefGoogle ScholarPubMed
18. Steinberger, J, Berry, JM, Bass, JL, et al. . Results of a right ventricular outflow patch for pulmonary atresia with intact ventricular septum. Circulation 1992; 86 (suppl II): 167–175.Google ScholarPubMed
19. Ellemann, A, Van Heerden, PDR, Van Heerden, BB, Kloppwe, JF. 99mTc-MIBI stress-rest myocardial perfusion scintigraphy in patients with complete bundle branch bloc. Cardiovasc J South Afr 2001; 91: 252–256.Google Scholar
20. Burggraf, GW, Craige, E. Echocardiographic studies of left ventricular wall motion and dimensions after valvular heart surgery. Am J Cardiol 1975; 35: 473–480.CrossRefGoogle ScholarPubMed
21. Vignola, PA, Boucher, CA, Curfman, GD, et al. . Abnormal interventricular septal motion following cardiac surgery: Clinical, surgical, echocardiographic and radionuclide correlates. Am Heart J 1979; 97: 27–34.Google Scholar
22. Mi, YP, Cheung, YF. Assessment of right and left ventricular function by tissue Doppler echocardiography in patients after biventricular repair of pulmonary atresia with intact ventricular septum. Int J Cardiol 2006; 109: 329–334.CrossRefGoogle ScholarPubMed
23. Ilbawi, MN, Idriss, FS, Muster, AJ, et al. . Effects of elevated coronary sinus pressure on left ventricular function after the Fontan. J Thorac Cardiovasc Surg 1986; 92: 231–237.CrossRefGoogle ScholarPubMed
24. Gewillig, M, Kalis, N. Pathophysiologic aspects after cavopulmonary anastomosis. Thorac Cardiovasc Surg 2000; 48: 336–341.Google Scholar
25. Lavalaye, JM, Schroeder-Tanka, JM, Tiel-van Buul, M, van der Wall, EE, Lie, KI, van Royen, EA. Implementation of technetium-99-m MIBI SPECT imaging guidelines: optimizing the two day stress-rest protocol. Int J Card Imaging 1997; 13: 331–335.Google Scholar
26. Hachamovitch, R, Hayes, SW, Friedman, JD, Cohen, I, Berman, DS. Stress myocardial perfusion single-photon emission computed tomography is clinically effective and cost effective in risk stratification of patients with a high likelihood of coronary artery disease (CAD) but no known CAD. J Am Coll Cardiol 2004; 43: 200–208.CrossRefGoogle ScholarPubMed
27. Fu, Y-C, Kao, C-H, Hwang, B, Jan, S-L, Chi, C-S. Discordance between dipyramidole stress Tc-99m sestamibi SPECT and coronary angiography in patients with Kawasaki disease. J Nucl Cardiol 2002; 9: 41–46.CrossRefGoogle ScholarPubMed
28. Miyagawa, M, Mochizuki, T, Murase, K, et al. . Prognostic value of dipyramidolethallium myocardial scintigraphy in patients with Kawasaki disease. Circulation 1998; 98: 990–999.Google Scholar
29. Fukuda, T, Ishbashi, M, Yokoyama, T, et al. . Myocardial ischemia in Kawasaki disease: Evaluation with dipyramidole stress technetium 99m tetrofosfamin scintigraphy. J Nucl Cardiol 2002; 9: 632–637.CrossRefGoogle ScholarPubMed
30. Yates, RW, Marsden, PK, Badawi, RD, et al. . Evaluation of myocardial perfusion using positron emission tomography in infants following a neonatal arterial switch operation. Pediatr Cardiol 2000; 21: 111–118.Google Scholar
31. Björkhem, G, Evander, E, White, T, Lundström, N-R. Myocardial scintigraphy with 201Thallium in pediatric cardiology: a review of 52 cases. Pediatr Cardiol 1990; 11: 1–7.CrossRefGoogle ScholarPubMed
32. Lee, ML. Regression of cardiac enzyme and ventriculocoronary communication in an infant with pulmonary atresia and intact ventricular septum after radiofrequency valvulotomy and valvuloplasty. Pediatr Cardiol 2005; 26: 792–796.Google Scholar
33. Altehoefer, C, vom Dahl, J, Biedermann, M, et al. . Significance of defect severity in Technetium-99-m-MIBI SPECT at rest to assess myocardial viability: comparison with Fluorine-18-FDG PET. J Nucl Med 1994; 35: 569–574.Google Scholar
34. Dogruca, Z, Kabasakal, L, Yapar, F, Nisil, C, Vural, VA, Önsel, C. A comparison of Tl-201 stress-reinjection-prone SPECT and TC-99-sestamibi gated SPECT in the differentiation of inferior wall defects from artefacts. Nucl Med Commun 2000; 21: 719–727.Google Scholar