1 / 23

Assessment of pulmonary vascular resistance

Assessment of pulmonary vascular resistance. Darshan Reddy le Roux Institute of Thoracic Surgery Durban, South Africa. Pulmonary vascular resistance. pulmonary vascular resistance. ratio to systemic vascular resistance. pulmonary vascular reactivity. operability.

luisa
Download Presentation

Assessment of pulmonary vascular resistance

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Assessment of pulmonary vascular resistance Darshan Reddy le Roux Institute of Thoracic Surgery Durban, South Africa

  2. Pulmonary vascular resistance

  3. pulmonary vascular resistance ratio to systemic vascular resistance pulmonary vascular reactivity operability non invasive investigations clinical evaluation

  4. Wilkinson JL. Haemodynamic calculations in the catheter laboratory. Heart 2001; 85 : 113-12

  5. Sources of errors Correction for BSA (m2) Unstable haemodynamics hypoventilation acidosis

  6. Rajgopalan N et al. Noninvasive Estimation of Pulmonary Vascular Resistance in Pulmonary Hypertension. ECHOCARDIOGRAPHY: A Jrnl of CV Ultrasound & Allied Tech. Vol. 26, No. 5, 2009.

  7. Rajgopalan N et al. Noninvasive Estimation of Pulmonary Vascular Resistance in Pulmonary Hypertension. ECHOCARDIOGRAPHY: A Jrnl of CV Ultrasound & Allied Tech. Vol. 26, No. 5, 2009.

  8. Choice of vasodilator 100% oxygen Nitric oxide

  9. Resistance ratios PVR / SVR ratio Pulmonary vascular disease < 0.25 normal 0.25 – 0.50 moderate > 0.75 severe Factors in neural, hormonal and blood viscosity influences

  10. 3 year old girl Cyanosis Heterotaxy syndrome - Univentricle / AVSD / MGV / PS / TAPVC

  11. PVR = 1.15 TPG = 8mmHg PA mean pressure 9

  12. TAPVC repair and bidirectional Glenn shunt

  13. Determinants of outcome haemodynamic data non-restrictive anastomosis pulmonary vascular reactivity non-compliant atrium / ventricular dysfunction

  14. 3 month old baby failure to thrive tachypnoea Echo: Anomalous RPA arising from aorta LA/LV volume loading LA/Ao ratio 2.45 Severe TR PAS 78+5mmHg

  15. Anomalous RPA from aorta

  16. The state of the pulmonary vasculature RPA pressures systemic supra-systemic Elevated LA pressures LPA bearing RV output Established PVOD

  17. Pulmonary vascular resistance Invasive Non-invasive echocardiography MRI

  18. Conclusion

  19. References • Wilkinson JL. Haemodynamic calculations in the catheter laboratory. Heart 2001; 85 : 113-120 • Rajgopalan N et al. Noninvasive Estimation of Pulmonary Vascular Resistance in Pulmonary Hypertension. ECHOCARDIOGRAPHY: A Jrnl of CV Ultrasound @ Allied Tech. Vol. 26, No. 5, 2009.

More Related