Preoperative prediction from cineangiograms of postrepair right ventricular pressure in tetralogy of Fallot

Normative angiographic data relating to the dimensions of the aorta and pulmonary trunk in children and adolescents

“…Successful total repair, the choice of a valved versus a nonvalved conduit to be placed between the right ventricle and the pulmonary arteries, and the degree of postoperative right ventricular hypertension and pulmonary insufficiency in tetralogy of Fallot, are all influenced by the pulmonary arterial size and cross-sectional area. 2,16 The surgical approach to patients with functionally univentricular physiology, namely the need for a bidirectional Glenn shunt, and the suitability for the Fontan operation, is also highly dependent on the pulmonary arterial size and capacitance. 3,17 Hypoplastic pulmonary arteries may cause right ventricular hypertension and failure in tetralogy of Fallot, and low cardiac output syndrome in patients put forward for the Fontan operation, both conditions with high postoperative morbidity and mortality.…”

“…The ratios between the diameters of the right and left pulmonary arteries relative to the diameter of the ascending or descending aorta have previously been used to predict good or acceptable postoperative results. 2,17 In the setting of congenital cardiac disease, however, the quantity and distribution of flow of blood may differ from normal, making the dimensions of the ascending and descending aorta smaller or larger than in the healthy child. A descending thoracic aorta that is smaller than normal, as is common in tetralogy of Fallot, would lead to an increased ratio between the pulmonary arteries and the descending aorta, thus falsely overestimating the size of the pulmonary arteries.…”

Computed tomographic versus catheterization angiography in tetralogy of Fallot

“…11 The PRV/LV ratio was calculated as 0.484/(RPA diameter þ LPA diameter)/descending thoracic aorta diameter at diaphragm þ 0.2007. 12 Ageadjusted Z-scores for the pulmonary annulus and RPA and LPA were calculated using the Detroit data. 13 Angiograms were performed under local anesthesia.…”

“…The Nakata index, PRV/LV ratio, and age-adjusted Z-scores for the pulmonary annulus and PA were calculated in a similar way as for MDCTA. [11][12][13] Intracardiac and extracardiac anatomy as delineated by the two modalities were compared. Pulmonary annulus and PA sizes (MPA, RPA and LPA), the presence of peripheral pulmonic stenosis, Nakata index, Z-score, and PRV/LV ratio as measured by the two modalities were compared.…”

Efficacy and safety of balloon dilation as palliative treatment for tetralogy of Fallot

“…Measurements of the pulmonary valve "annulus," right and left pulmonary arteries and the descending aorta at the level of the diaphragm were made from the cineangiograms using the methods described by Blackstone et al 5 These measurements were made to the nearest 0.5 mm and were corrected for magnification. The measurements of the pulmonary arteries were made at peak systole and were normalized to the maximum systolic diameter of the descending aorta at the level of the diaphragm.…”