atrial septal defect qp/qs


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PDF CHD Clinical Practice Algorithm: PFO/Atrial Septal Defect < 5

CHD Clinical Practice Algorithm: Atrial Septal Defect Post-Intervention10 Inclusion Criteria: • After surgical or cath based ASD closure Cath Lab Closure Or Surgical Surgical Cath Standard Surgical Follow up: Post-op ECG echo and CXR done prior to discharge Clinic follow-up within 2 weeks to 3 months with echo +/- ECG and CXR

  • What should Qp and QS be in ASD?

    In the case of an isolated ASD (i.e. no other shunts or regurgitant valve disease), Qp should equal the RV stroke volume, and Qs should equal the LV stroke volume. Qp/Qs will be >1 in most cases because left atrial pressure typically exceeds right atrial pressure.

  • What is the Qp/Qs of a right atrial shunt?

    Qp/Qs will be >1 in most cases because left atrial pressure typically exceeds right atrial pressure. However, in patients with pulmonary hypertension and right ventricular hypertrophy (i.e. Eisenmenger physiology), it is possible for the shunt to reverse and be predominantly right-to-left, resulting in a Qp/Qs < 1.0.

  • How do you know if you have a secundum atrial septal defect?

    Diagnosed via echo with a secundum atrial septal defect Simple ASD w/o comorbiditiesExclusion Criteria: Pregnancy Dilated right sided structures History of stroke or prothrombotic state Clinic Visit ECG Echocardiogram1 After surgical or cath based ASD closure Post-op ECG, echo and CXR done prior to discharge

Why Cardiac MRI Is Beneficial

Cardiac MRI is well suited for the examination of an ASD because it can accurately quantify the shunt, and its effect on cardiac structure and function. It can directly visualize blood flowing across the ASD. It is totally non-invasive and does not require contrast. cardiacmri.com

MRI Technique

Short and long axis SSFP images are obtained to quantify the end-diastolic and end-systolic volumes of both ventricles, and to determine global systolic function (LV and RV EF). Phase contrast images are acquired to quantify blood flow in the main pulmonary artery (Qp) and the ascending aorta (Qs) to determine the shunt ratio (Qp/Qs). For the most

IV. Analysis

The best way to quantify the shunt ratio (Qp/Qs) is to divide the blood flow in the main pulmonary artery (Qp) by the blood flow in the ascending aorta (Qs). In the case of an isolated ASD (i.e. no other shunts or regurgitant valve disease), Qp should equal the RV stroke volume, and Qs should equal the LV stroke volume. Qp/Qs will be >1 in most cas

v. Which Imaging Findings Affect Treatment?

The severity of ASD can be quantified in terms of Qp/Qs and defect size. Percutaneous closure and surgery are generally reserved for patients with Qp/Qs > 1.5, unless they are undergoing cardiac surgery for other reasons. cardiacmri.com

VI. Drawbacks of Existing Tests

Transthoracic echocardiography is most commonly used to assess for an ASD. Many patients also undergo transesophageal echocardiography for a better anatomic assessment. MRI is less invasive and is superior for quantifying the size of the shunt (Qp/Qs), as well as its affect on RV size and function. MRI is also good at identifying other possible ass

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