Multimodality Imaging Innovations In Adult Congenital Heart Disease by Unknown

Author:Unknown
Language: eng
Format: epub
ISBN: 9783030619275
Publisher: Springer International Publishing

where sat = oxygen saturation, MV = mixed venous, PV = pulmonary venous, and PA = pulmonary arterial. In cases where Qp:Qs ratio is >3, the difference between the pulmonary vein and pulmonary artery oxygen saturation is small; in this scenario, it is suggested to report Qp:Qs as “greater than 3:1” rather than providing a particular ratio.

11.5.2 Shunt Evaluation

It is important to understand the concept of effective pulmonary blood flow (QEP) and effective systemic blood flow (QES). Effective pulmonary blood flow represents the total amount of deoxygenated (or “blue”) blood returning from the systemic venous circulation, represented by the mixed venous oxygen saturation that passes through the lungs to be re-oxygenated (pulmonary venous oxygen saturation). In the absence of a shunt defect, QEP equals QP [29–31].

Similarly, QES represents the total flow of blood oxygenated in the lungs (“red” blood) returned via the pulmonary veins to the left atrium that eventually reaches the systemic capillary circulation. Once again, in a person without a significant shunt, QES roughly equals QS (and QEP = QES).

In a patient with a left-to-right shunt, the total amount of blood flow arriving via the pulmonary arteries (Qp) will comprise both “blue” and “red” blood. The additional “shunted” blood flow into the lungs (“red” portion of Qp) can be calculated as:

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