Counter-clockwise vortical blood flow in the main pulmonary artery in a patient with patent ductus arteriosus with pulmonary arterial hypertension: a cardiac magnetic resonance imaging case report.

Autor: Reiter G; Siemens Healthcare, Graz, Austria., Reiter U; Division of General Radiology, Department of Radiology, Medical University of Graz, Auenbruggerplatz 9/P, A-8036, Graz, Austria. ursula.reiter@medunigraz.at., Kovacs G; Division of Pulmology, Department of Internal Medicine, Medical University of Graz, & LBI for Lung Vascular Research Graz, Graz, Austria., Adelsmayr G; Division of General Radiology, Department of Radiology, Medical University of Graz, Auenbruggerplatz 9/P, A-8036, Graz, Austria., Greiser A; Siemens Healthcare, Erlangen, Germany., Stalder AF; Siemens Healthcare, Erlangen, Germany., Olschewski H; Division of Pulmology, Department of Internal Medicine, Medical University of Graz, & LBI for Lung Vascular Research Graz, Graz, Austria., Fuchsjäger M; Division of General Radiology, Department of Radiology, Medical University of Graz, Auenbruggerplatz 9/P, A-8036, Graz, Austria.
Jazyk: angličtina
Zdroj: BMC medical imaging [BMC Med Imaging] 2016 Aug 08; Vol. 16 (1), pp. 45. Date of Electronic Publication: 2016 Aug 08.
DOI: 10.1186/s12880-016-0150-z
Abstrakt: Background: In patients with pulmonary hypertension (PH), duration of vortical blood flow along the main pulmonary artery enables estimation of the mean pulmonary arterial pressure (mPAP) non-invasively. It remains to date not known, if this method is applicable in patients with pulmonary arterial hypertension (PAH) and abnormal aortic-to-pulmonary shunting.
Case Presentation: The present case analyzes the effect of a patent ductus arteriosus (PDA) on pulmonary artery flow patterns in PAH (mPAP from right heart catheterization, 75 mmHg). PH-associated vortical blood flow, which is typically observed rotating in a clockwise direction when viewed in right ventricular outflow tract orientation, was found nested in PDA left-to-right shunting. Even though rotating counter-clockwise, duration of vortical flow translated into correct non-invasive mPAP estimate.
Conclusions: This case indicates that PH-associated vortex rotation is not restricted to clockwise direction, and that vortex-based estimation of elevated mPAP might also be feasible in patients with PAH and PDA.
Databáze: MEDLINE
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