DOPPLER FLOW PROFILES IN THE RIGHT AND LEFT PULMONARY-ARTERY IN CHILDREN WITH CONGENITAL HEART-DISEASE AND A BIDIRECTIONAL CAVOPULMONARY SHUNT

The systolic and diastolic Doppler tracings in the right and left pulm onary artery were analyzed in 10 patients with complex cyanotic congen tial heart disease, aged 6 months to 12 years (median 3 years), after employment of a bidirectional cavopulmonary shunt. The postoperative i nterval ranged from 2 weeks to 1.7 years (median 1.3 years). In childr en with pulmonary atresia or severe pulmonary stenosis with minimal an tegrade pulsatile pulmonary blood flow Doppler echocardiography confir med a systolic and diastolic bidirectional shunt from the vena cava su perior to both pulmonary arteries. In children with pulmonary stenosis , Doppler echocardiography confirmed a systolic shunt only to the righ t pulmonary artery and a diastolic bidirectional shunt into both pulmo nary arteries. As the left pulmonary artery was perfused by the pulsat ile transvalvular flow it was difficult to detect a concomitant systol ic Glenn-related flow in those patients. Quantitative analysis of the diastolic Doppler tracings revealed a significant difference in the ve locity time integral in the right and left pulmonary artery indicating a dominant right lung perfusion in diastole.