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Pulmonary Ventilation and Perfusion Abnormalities and Ventilation Perfusion Imbalance in Children with Pulmonary Atresia or Extreme Tetralogy of Fallot

Department of Paediatrics and Child Health, Institute of Child Health, University of Cape Town and Red Cross War Memorial Children's Hospital, Rondebosch, South Africa

Correspondence: For reprints contact: Professor M.D. Mann, Institute of Child Health, 7700 Rondebosch, South Africa.

ABSTRACT

Xenon-133 lung ventilation and perfusion scans were done preoperatively after cardiac catheterization and cineangiocardiography in 19 children; 6 had pulmonary atresia with an intact ventricular septum and hypoplastic right ventricle, 4 pulmonary atresia with associated complex univentricular heart, and 9 extreme Tetralogy of Fallot. The four patients with discrepancies in the sizes of the left and right pulmonary arteries on angiography had marked asymmetry of pulmonary perfusion and ventilation-perfusion imbalance on scintigraphy. Similar degrees of asymmetry and imbalance were present in 6 of the 15 children with equal-size pulmonary vessels. Asymmetry of pulmonary perfusion and ventilation-perfusion imbalance were associated with a poor prognosis.

FOOTNOTES

^* Current address: Department of Cardiology, IWK Children's Hospital, Halifax, Nova Scotia, Canada.

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