Doppler echocardiographic evaluation of pulmonary blood flow after the Fontan operation: the role of the lungs.

Abstract

OBJECTIVE: To document whether the act of respiration influences pulmonary blood flow in patients after the Fontan operation. DESIGN: Prospective study in which patients acted as their own controls. SETTING: Supraregional paediatric cardiology centre. PATIENTS: Sixteen patients who had undergone atriopulmonary anastomosis (Fontan operation) for the treatment of congenital heart disease. INTERVENTION: Doppler assessment of pulmonary artery flow patterns with a simultaneous respirometer, electrocardiogram and phonocardiogram. RESULTS: Total (mean (1SD) ) forward pulmonary flow was 63.6 (35)% higher during inspiratory cardiac cycles than during expiratory ones. CONCLUSIONS: The act of breathing provides an additional energy supply to pulmonary blood flow in patients after the Fontan operation.