The Functional Intraoperative Pulmonary Blood Flow Study Is a More Sensitive Predictor Than Preoperative Anatomy for Right Ventricular Pressure and Physiologic Tolerance of Ventricular Septal Defect Closure After Complete Unifocalization in Patients With Pulmonary Atresia, Ventricular Septal Defect, and Major Aortopulmonary Collaterals

The objective was to determine if intraoperative pulmonary artery (PA) flow studies after complete unifocalization correlate with postrepair hemodynamics for pulmonary atresia (PA), ventricular septal defects (VSD), and major aortopulmonary collaterals. Twenty patients (median age, 8 months; weight, 7.9 kg) underwent unifocalization between 2003 and 2008. A functional PA flow study was achieved by cannulating the unifocalized central PA before intracardiac repair and increasing flow incrementally to 2.5 L/min per m(2). Mean PA pressure (mPAP) was measured. The intent was to close the VSD for a mPAP of