Journal of the Korean Pediatric Society 2003;46(5):484-489.
Published online May 15, 2003.
Echocardiographic Parameters of Pulmonary Atresia with Intact Ventricular Septum(PA/IVS)
Young Seok Lee1, Yeo Hyang Kim2, Myung Chul Hyum2, Sang Bum Lee2
1Department of Pediatrics, School of Medicine, Dong-A University, Taegu, Korea
2Department of Pediatrics, College of Medicine, Kyungpook National University, Pusan, Korea
심실 중격 결손을 동반하지 않은 폐동맥 폐쇄 환아에서의 심초음파 계측치
이영석1, 김여향2, 현명철2, 이상범2
1동아대학교 의과대학 소아과학교실
2경북대학교 의과대학 소아과학교실
Correspondence: 
Sang Bum Lee, Email: leesb@knu.ac.kr
Abstract
Purpose
: To understand morphologic and hemodynamic variations in patients with pulmonary atresia with intact ventricular septum(PA/IVS), and to decide the best treatment modalities, we measured right ventricular volume, inflow, and outflow valvular annulus size in these patients and compared them with those of normal newborns.
Methods
: Eight patients with PA/IVS diagnosed by echocardiography from January to December 2001 were enrolled in this study. Among the total eight patients, five were male and three were female. The mean age of patients was 6.9 days(1-34 days), and the mean body weight was 3,343 gm (2,970-4,000 gm). Ten fullterm newborn infants with sepsis or hyperbilirubinemia without heart disease were enrolled as a control group. Echocardiographic and Doppler studies using Acuson Aspen (7Mh probe) were recorded on super-VHS videotape and later on, with review mode. We measured volumes of right and left ventricles, aortic, pulmonic, mitral and tricuspid valvular annulus sizes using an installed program, and then these parameters were compared with those of the control group.
Results
: Mean Z-value of tricuspid valvular annulus in PA/IVS was -3.69?.80(-8.4--0.45), and tricuspid/mitral valvular annulus size ratio 0.68?.15(0.43--0.84). The more the tricuspid/mitral valvular annulus size ratio, the more Z-value of tricuspid valvular annulus(P=0.003, r=0.885). Those patients who underwent pulmonary valvuloplasty(balloon or surgical) had a tendency toward larger volume of the right ventricle, more Z-value of pulmonic and tricuspid valvular annulus, and more tricuspid/mitral valvular annulus size ratio than those patients who underwent a shunt operation.
Conclusion
: Compared to a measurement of the volume of the right ventricle, measurements of tricuspid/mitral valvular annulus size ratio and Z-value of tricuspid valvular annulus may be easier and better parameters to decide the treatment method and to predict prognosis in PA/IVS patients.
Key Words: Pulmonary atresia with intact ventricular septum(PA/IVS), Z-value of tricuspid valvular annulus, Tricuspid/mitral valvular annulus size ratio


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