Contrary to the opinion of French pediatrician HenriLouis that isolated ventricular septal defects (VSDs) are universally well tolerated, the subsequent discoveries of Eisenmenger, Abbott, Wood, and others have taught us that the prognosis of left-to-right shunt lesions is not always benign. After more than a century of research, as pediatric cardiologists and congenital heart surgeons, we clai...

background: we sought to assess right ventricular (rv) systolic and diastolic functions via tissue doppler imaging (tdi) in order to discriminate right-to-left (bidirectional) from left-to-right intracardiac shunts. methods: a tissue doppler velocity study via doppler echocardiography was performed in 20 patients with left-to-right shunt (without evidence of significant pulmonary hypertension) ...

SEVERAL METHODS are now used in conjunction with cardiac catheterization for localizing and quantitating right-to-left shunts. These include the recording of indicator-dye concentration curves after selective intracardiac dye injection,14 the external recording of radioactivity following injection of radioactive materials,5 6 and the use of cardioangiograms or cineangiograms to picture the cour...

The presence of right to left shunts at atrial level in 40 patients with an uncomplicated atrial septal defect was determined by measuring the pulmonary vein to systemic artery oxygen stepdown . In six patients (group 1) a sizeable right to left shunt was found: left atrial oxygen stepdown was greater than or equal to 0.7 vol%, mean right to left shunt 0.67 1/min/m2 (range 0.36-1.0), and arteri...