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In normal pediatric echocardiograms, the distance from the junction of superior vena cava and right atrium to inferior vena cava and right atrium (SVC-IVC) is linearly related to height. We examine this relationship in children listed for heart transplant with dilated cardiomyopathy (DCM) compared to a previously defined normal distribution of SVC-IVC in order to maximize potential donor acceptance.
Measurements of SVC-IVC and left ventricular end-diastolic diameter (LVEDd) in 55 patients (pts) with DCM (age 2 months – 19 years, median 7.8 years) were correlated with height, weight, body surface area (BSA), and BSA0.5. Regression analyses were performed to find the best-fit equation and correlation coefficient. Generalized linear modeling compared DCM to normal SVC-IVC values from 254 pts.
There was a strong linear relationship in DCM pts between SVC-IVC and height (R2=0.84) and a logarithmic relationship to weight (R2=0.80). LVEDd did not correlate to SVC-IVC or any other parameter. In 89% of DCM pts, SVC-IVC was over 2 standard deviations above predicted normal values (mean z-score = 4.3±2.1). Predicted SVC-IVC in DCM pts was different than published norms (p<0.001).
SVC-IVC in pediatric DCM pts, while linearly related to height, is consistently above normal values (figure). When matching pediatric heart recipients to donors, SVC-IVC may help accurately size donor hearts, especially for bicaval anastomosis, and substantially increase the donor pool.
Poster Sessions, Expo North
Saturday, March 09, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Congenital Cardiology Solutions: Congenital Imaging
Abstract Category: 13. Congenital Cardiology Solutions: Pediatric
Presentation Number: 1160-117
- 2013 American College of Cardiology Foundation