PubMed · 3070455
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K Menzel. 1988. [Perinatal cardiovascular problems].. https://pubmed.ncbi.nlm.nih.gov/3070455/
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We describe two distinct cases in which discontinuous pulmonary arteries were identified by echocardiography and color Doppler imaging. In both cases, perfusion of one or both pulmonary arteries was dependent on a patent ductus arteriosus. Establishment of the source of perfusion and the anatomy of the discontinuous pulmonary arteries were evident only after an infusion of prostaglandin had been initiated, thus demonstrating that its use was a key component in the identification of this disease entity.
The aim of the present study was to test the hypothesis that a relationship exists between respiratory-induced blood pressure variability (BPV) and transductal shunting in premature infants with respiratory distress. Ten premature infants (27-32 weeks gestation) with respiratory distress ventilated in the synchronised, positive-pressure mode were examined. The interrelations between blood pressure and transthoracic impedance were described using time and frequency domain analysis. Haemodynamic effects of left-to-right transductal shunting were assessed using Doppler echocardiography (ratio of diastolic flow to systolic flow in the subdiaphragmatic aorta). The dependence of blood pressure fluctuations on the respiratory cycle was seen consistently in both time-domain and cross-spectral analysis. The amplitude of these fluctuations varied between infants. In the time domain, the beat-to-beat pressure difference was 0.69-4.1 mmHg for diastolic and 0.99-5.24 mmHg for systolic blood pressure. There was a positive linear relationship between the respiratory-related BPV indicators and the extent of left-to-right transductal shunting ( r=0.86 for diastolic and 0.80 for systolic pressure, P<0.01). Respiratory-related BPV was not correlated to the indicators of left ventricle preload. It is concluded that respiratory related BPV involves both diastolic and systolic blood pressure and is correlated to the magnitude of left-to-right transductal shunting in the population studied.
We describe two patients who both presented shortly after birth with congestive heart failure due to an absent pulmonary valve and patent ductus arteriosus. Diagnostic evaluation revealed in both cases an aneurysmatic dilation of the pulmonary vascular tree and an abundant left-to-right shunt over a large patent ductus arteriosus. Ventricular septal defects were not detected. Early surgical closure of the patent ductus arteriosus improved the hemodynamic situation so that implantation of a homograft valve could be delayed.