Milhoan K A, Levy D J, Shields N, Rothman A
Division of Pediatric Cardiology, Children's Hospital San Diego and the University of California, San Diego, CA 92123, USA.
Pediatr Cardiol. 2004 Jan-Feb;25(1):17-9. doi: 10.1007/s00246-003-0438-y. Epub 2003 Sep 4.
After the bidirectional cavopulmonary or Fontan operation, the physiologic consequence is passive flow of the systemic venous return to the pulmonary arteries. Knowledge of pulmonary artery pressure (PA) is valuable in the management of these patients, and obtaining this information without the need for a central line or cardiac catheterization would be advantageous. The aim of this study was to evaluate the correlation between upper extremity peripheral venous (PV) pressures and PA or superior vena cava (SVC) pressures in patients who have undergone cavopulmonary or Fontan connections. During cardiac catheterization, 19 patients with complex cyanotic heart disease who had undergone a cavopulmonary shunt or Fontan procedure were studied. Simultaneous pressure measurements were obtained from the peripheral intravenous line placed prior to the procedure and the SVC or PA. The mean pressures were compared. The mean PV pressure was 17.5 +/- 5.6 mmHg. The mean SVC or PA pressure was 16.1 +/- 5.4 mmHg. The mean difference was 1.5 +/- 1.5 mmHg ( p < 0.001). The correlation coefficient PV to SVC or PA pressure was 0.97 ( p < 0.001). PV pressure measurements taken from an upper extremity accurately reflect PA pressures in patients who have undergone a cavopulmonary shunt or Fontan procedure.
在双向腔肺分流术或Fontan手术后，生理结果是体循环静脉回流被动流入肺动脉。了解肺动脉压（PA）对这些患者的管理很有价值，无需中心静脉置管或心导管检查就能获取该信息将很有益处。本研究的目的是评估接受腔肺分流术或Fontan连接术的患者上肢外周静脉（PV）压与PA或上腔静脉（SVC）压之间的相关性。在心脏导管检查期间，对19例接受过腔肺分流术或Fontan手术的复杂青紫型心脏病患者进行了研究。同时从术前放置的外周静脉导管和SVC或PA获取压力测量值。比较平均压力。平均PV压为17.5±5.6 mmHg。平均SVC或PA压为16.1±5.4 mmHg。平均差值为1.5±1.5 mmHg（p<0.001）。PV与SVC或PA压的相关系数为0.97（p<0.001）。在上肢进行的PV压测量能准确反映接受过腔肺分流术或Fontan手术患者的PA压。
