Continuous monitoring of pulmonary artery pressure after cardiac surgery in infants and children.

Increases in pulmonary vascular resistance in the post-operative period are becoming more widely recognised as a cause of sudden clinical deterioration and death after the correction of congenital heart disease. Therefore pulmonary artery pressure was continuously monitored in the post-operative period in 45 selected infants and children who had undergone surgery for congenital heart disease by inserting an 18 gauge intravenous catheter into the main pulmonary artery through the right ventricular infundibulum at the time of operation. Episodes of low cardiac output which were accompanied by significant increases in PAP/AOP ratio occurred in 20 patients and were managed by alteration in ventilation and/or administration of pulmonary vasodilators. There was a small but significant morbidity associated with the procedure. It should therefore be reserved for those cases considered to be at risk of developing episodes of increased pulmonary vascular resistance.