Can the Pulmonary Artery Wedge Pressure be Used Reliably as a Surrogate for the Left Atrial Mean Pressure in Pre-Fontan Evaluation?

Bassel Mohammad Nijres*, Raid Abdulla, Sawsan Awad, Joshua Murphy

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

The correlation between mean pulmonary artery wedge pressure (PAWP) and left atrial mean pressure (LAMP) has been poorly studied in patients with single ventricle (SV) physiology (Bernstein et al. in Pediatr Cardiol 33: 15–20 2012). The aim of this study is to determine if the PAWP can be used safely as a surrogate to the LAMP to calculate the pulmonary vascular resistance (PVR) during the pre-Fontan evaluation. Also, we aimed to understand if the presence of significant systemic-to-pulmonary collaterals (SPCs) is a confounding factor for accurate estimation of the LAMP. From February 2007 to February 2017, forty-one patients were eligible for inclusion in the study. These patients were varied in terms of underlying cardiac malformation. Sex distribution was equal with 20 males and 21 females. Median weight was 11.8 kg, median body surface area was 0.51 m2, median age at catheterization was 2 years, and the median age at Glenn surgery was 5 months. We found the left and right PAWP and LAMP correlated strongly and the differences in the measurements were negligible. Similar findings were observed when calculating PVRs using PAWP and LAMP. These findings were more pronounced in the absence of significant SPCs. PAWP and LAMP correlation was still valid in the presence of significant SPCs; however, the correlation among the calculated PVRs was more attenuated.

Original languageEnglish (US)
Pages (from-to)1434-1440
Number of pages7
JournalPediatric cardiology
Volume38
Issue number7
DOIs
StatePublished - Oct 1 2017

Keywords

  • Left atrial mean pressure
  • Pre-Fontan evaluation
  • Pulmonary artery wedge pressure
  • Pulmonary vascular resistance
  • Single ventricle
  • Systemic-to-pulmonary collaterals

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Cardiology and Cardiovascular Medicine

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