Pulmonary Venous Flow Characteristics in Ostium Secundum Type Atrial Septal Defect

Pulmonary Venous Flow Characteristics in Ostium Secundum Type Atrial Septal Defect The pulmonary venous flow characteristics in ostium secundum atrial septal defect (ASD) have not been previously studied in detail. ASD dramatically alters cardiac hemodynamics during both ventricular systole and diastole. This study investigated the pulmonary venous flow pattern in patients with ostium secundum ASD. Fourteen patients who had a shunt ratio of pulmonary to systemic flow (Qp/Qs) <1.5 (group I), seventeen patients who had shunt ratio Qp/Qs <1.5 (grupII) and fifteen healthy subjects (grup III) were included in the study. The left upper pulmonary venous flow of all subjects was analysed by transesophageal echocardiography. We showed a single continuous antegrade wave extending from the beginning of systole to the onset of atrial contraction in 88% of patients who had a shunt ratio of Qp/Qs >1.5. The pulmonary venous flow was biphasic (systolic and diastolic waves) in only two patients (12%) in group II. The atrial reversal flow wave was significantly lower in group II than in group I (p<0.001) and in group III (p<0.001). In patients who had a shunt ratio <1.5, pulmonary venous flow was biphasic. There was no difference regarding pulmonary venous systolic and diastolic waves between group I and group III. Atrial reversal wave velocity was lower in group I than in group III (p<0.001). Pulmonary venous flow comprises a single continuous antegrade wave and a diminished atrial reversal wave in patients who have a shunt ratio < 1.5, whereas biphasic pulmonary venous flow and diminished atrial reversal wave are present in patients who have a shunt ratio <1.5. Investigating the pulmonary venous flow in patients with atrial septal defect may provide information on the size of the shunt in the atrial septum.