Abstract
Accurate assessment of pulmonary artery pressures (PAP) is important in determining the indication for Fontan procedure in patients with single ventricle physiology. However, it is sometimes difficult to measure PAP directly. Pulmonary vein wedge pressure (PVWP) may be used as an alternative to PAP in such cases. Several studies have demonstrated that PVWP correlates with PAP 1 Rao S. Sissman N.J. The relationship of pulmonary venous wedge to pulmonary arterial pressures. Circulation. 1971; 44: 565-574 Crossref PubMed Scopus (13) Google Scholar , 2 Hawker R.E. Celermajor J.M. Comparison of pulmonary artery and pulmonary venous pressures in congenital heart disease. Br Heart J. 1973; 35: 386-391 Crossref PubMed Google Scholar , 3 Waldman J.D. LaCorte M. Dick M. John S.A. Miettinen O.S. LaFarge C.G. The pulmonary venous wedge pressure in pulmonary artery hypertension. Cathet Cardiovasc Diagn. 1977; 3: 231-239 Crossref PubMed Scopus (8) Google Scholar , 4 Chern M.S. Yeh S.J. Lin F.C. Wu D. Hung J.S. Estimation of pulmonary artery pressure from pulmonary vein wedge pressure. Cathet Cardiovasc Diagn. 1994; 31: 277-282 Crossref PubMed Scopus (6) Google Scholar since a technique of catheterization for obtaining PVWP was introduced by Hellems et al. 5 Hellems H.K. Haynes F.W. Dexter L. Kinney T.D. Pulmonary capillary pressure in animals estimated by venous and arterial catheterization. Am J Physiol. 1948; 155: 98-105 PubMed Google Scholar However, these studies were based on patients with simple heart disease, and little is known about patients with complex heart disease. Accurate measurements of PAP and pulmonary vascular resistance (Rp) are critical in the selection of patients with complex heart disease for the Fontan procedure. If PVWP is used as an alternative to PAP, a small difference between PAP and PVWP could produce a big difference in the Rp, resulting in misinterpretation in determining the indication for the Fontan procedure. Thus, it is necessary to know not only the correlation between PVWP and PAP, but also to know how closely PVWP estimates PAP in patients with single ventricle physiology. The purpose of this report was to evaluate how accurately PVWP estimates PAP and to assess the relation focusing on the clinical use of PVWP as an alternative to PAP in patients who are being evaluated as Fontan candidates.
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