BACKGROUND: Hemodynamic changes within a stenosed pulmonary vein might not reflect the severity of the obstruction if redistribution of pulmonary artery flow occurs. OBJECTIVE: The purpose was to investigate flow changes in branch pulmonary arteries in the presence of pulmonary vein stenosis. MATERIALS AND METHODS: Twelve children (age range 3-180 months) who had undergone MRI for pulmonary vein stenosis were identified. The severity of vein stenosis was assessed from percentage diameter reduction. Pulmonary artery flow distribution was correlated with the severity of pulmonary vein stenosis. Nine of the patients had unilateral stenosis; three had bilateral involvement. RESULTS: Unilateral vein stenosis was associated with diastolic reversal in the ipsilateral branch pulmonary artery (mean flow reversal 12.3%, range 2.4-42%) and continuous diastolic forward flow in the contralateral pulmonary artery in seven of nine patients. Severe stenosis was associated with decreased systolic flow to the ipsilateral lung. The ratio of net forward flow through pulmonary arteries correlated well with the cross-sectional area ratio of pulmonary arteries (r=0.75, P=0.006). CONCLUSIONS: Severe pulmonary vein obstruction results in redistribution of pulmonary arterial flow. When investigating pulmonary vein stenosis by MR, an evaluation of the pulmonary arterial system should be included to assess the functional importance of an obstruction.
BACKGROUND: Hemodynamic changes within a stenosed pulmonary vein might not reflect the severity of the obstruction if redistribution of pulmonary artery flow occurs. OBJECTIVE: The purpose was to investigate flow changes in branch pulmonary arteries in the presence of pulmonary vein stenosis. MATERIALS AND METHODS: Twelve children (age range 3-180 months) who had undergone MRI for pulmonary vein stenosis were identified. The severity of vein stenosis was assessed from percentage diameter reduction. Pulmonary artery flow distribution was correlated with the severity of pulmonary vein stenosis. Nine of the patients had unilateral stenosis; three had bilateral involvement. RESULTS: Unilateral vein stenosis was associated with diastolic reversal in the ipsilateral branch pulmonary artery (mean flow reversal 12.3%, range 2.4-42%) and continuous diastolic forward flow in the contralateral pulmonary artery in seven of nine patients. Severe stenosis was associated with decreased systolic flow to the ipsilateral lung. The ratio of net forward flow through pulmonary arteries correlated well with the cross-sectional area ratio of pulmonary arteries (r=0.75, P=0.006). CONCLUSIONS: Severe pulmonary vein obstruction results in redistribution of pulmonary arterial flow. When investigating pulmonary vein stenosis by MR, an evaluation of the pulmonary arterial system should be included to assess the functional importance of an obstruction.
Authors: Eduardo B Saad; Antonio Rossillo; Cynthia P Saad; David O Martin; Mandeep Bhargava; Demet Erciyes; Dianna Bash; Michelle Williams-Andrews; Salwa Beheiry; Nassir F Marrouche; James Adams; Ennio Pisanò; Raffaele Fanelli; Domenico Potenza; Antonio Raviele; Aldo Bonso; Sakis Themistoclakis; Joannes Brachmann; Walid I Saliba; Robert A Schweikert; Andrea Natale Journal: Circulation Date: 2003-11-17 Impact factor: 29.690
Authors: R H Mohiaddin; R Paz; S Theodoropoulos; D N Firmin; D B Longmore; M H Yacoub Journal: J Thorac Cardiovasc Surg Date: 1991-06 Impact factor: 5.209
Authors: Thorsten Dill; Thomas Neumann; Okan Ekinci; Christiane Breidenbach; Anna John; Ali Erdogan; Georg Bachmann; Christian W Hamm; Heinz-F Pitschner Journal: Circulation Date: 2003-02-18 Impact factor: 29.690
Authors: Luisa Morales-Nebreda; Christopher S Chung; Rishi Agrawal; Anjana V Yeldandi; Benjamin D Singer; Ankit Bharat; Donald R McCrimmon; James M Walter Journal: Ann Am Thorac Soc Date: 2019-10
Authors: Steven C Greenway; Shi-Joon Yoo; Giedrius Baliulis; Christopher Caldarone; John Coles; Lars Grosse-Wortmann Journal: J Cardiovasc Magn Reson Date: 2011-11-21 Impact factor: 5.364