Qualitative Evaluation of Diminished Pulmonary Blood Flow of Congenital Cyanotic Heart Disease by the Pulmonary Venous Wedge Pressure Measurement and Its Surgical Consideration

In 27 cyanotic heart patients with complication of stenosis or atresia involving ventricular septal defect or single ventricle, we evaluatecl the diminished pulmonary blood flow by the pulmonary venous wedge p3'essure (PVWP) measurement. There we}"e significant correlations between mean PVNVP and ayterial oxygen sattiration <r :O.71, P<.Ol) and right pu}monary arteriallascending aortic diameter ratie (r=O.65, P<.Ol). Of the 27 patients, l4 (except one with mean PVWP above }8 mmE(g) survived, but seven of I2 with mean PVWP below 12 mmHg died from sudden hypoxic attack or postoperative low cardiac output syndrome/}ate congestive hea}"t fai}ure. Mean IVWP value is useful as an indirect parameter affected by diminished pulmonary b}oocl fiow. In patients with mean PVLVP below 12 mmHg, the urgent aRd/or initial shunt operation is recommended, in view of tl}e threatened hypoxic state and/or unadeqiiate size of pulmonary arteries vis a vis surgical reconstruction of the right ventricular outfiow