Congenital Cardiac Anesthesia Society
A Section of the the Society for Pediatric Anesthesia

Congenital Cardiac Anesthesia Society

  • Member Login
  • Forgot Password?
  • Join
  • Home
  • About
    • Mission Statement
    • Bylaws
    • Board of Directors
    • History
    • Past Presidents
    • Charter Members
    • CCAS Lifetime Achievement Award
    • Mailing List Rental
    • Contact Us
  • Partners
    • SPA
    • SPPM
    • PALC
    • PCICS
    • AmSECT
    • SMACT
    • CHA
    • CCAN
  • Committees
    • CCAS Committees
      • Pediatric Cardiac Anesthesiology Program Director’s Group (PCAPD) Committee
      • Communications Committee
      • CCAS-STS Database Committee
      • Education Committee
      • Global Health Committee
      • Membership Committee
      • Quality and Safety Committee
      • Research Committee
    • CCAS Special Interest Groups
      • Adult Congenital Heart Disease Special Interest Group (SIG)
      • ERAS Special Interest Group (SIG)
      • Hemostasis Special Interest Group (SIG)
      • Latin America Special Interest Group (SIG)
      • Pulmonary Hypertension Special Interest Group (SIG)
      • Trainee Special Interest Group (SIG)
  • Membership
    • Benefits of Membership
    • CCAS Member App
    • Membership Categories
    • Join CCAS
      • Online Application
      • Printable Application
    • Renew Your Dues
    • Sponsor a Member
    • Get Involved
  • Meetings
    • Upcoming Meetings
    • Past Meetings
    • Other Meetings
    • Exhibit Information
  • Education
    • CCAS Virtual Visiting Professor Program
    • CCAS Webinar Series
      • CCAS Webinar Series – Recordings
    • CCAS COVID 19 Webinar
    • ACHD-SIG Anesthesia Rounds
    • Lecture Series
    • Echo Tutorial
    • Archived Questions
    • Poll of the Month Archives
    • Review Articles
      • CCAS-CHiP Network Journal Watch Collaboration
      • SCVA Articles
    • Journals of Interest
    • Books of Interest
    • Educational Links
  • Resources
    • CCAS Position Statements
    • CCAS Committee Resources
    • CCAS Special Interest Group (SIG) Resources
    • CCAS Cognitive Aids
    • Newsletters
    • Research Resources
    • Mission Trips
    • Societies
    • Job Opportunities
  • Research
    • Research Committee
    • CCAS 2025 Meeting Scholarship for Students and Residents
    • Research Network & Collaborative Opportunities
    • Research Resources
    • Dolly D. Hansen, MD Research Award
    • New for 2026! CCAS QI/Education Award
    • Podcast Series for Aspiring CCAS Researchers
    • Highlight on a CCAS Researcher
    • Call for Surveys
    • STS-CCAS Database
    • Donate to the Dolly Hansen Fund
  • Trainees
    • Introduction to Pediatric Cardiac Anesthesiology
    • Trainee Lecture Series
    • Advanced Training
    • Pediatric Cardiac Anesthesiology Fellowship Common Goals and Objectives
    • Frequently Asked Questions
    • Pediatric Cardiac Anesthesia Education Resources
    • Coaching/Mentoring Initiative
  • Patients
    • FAQs for Cardiac Anesthesia
    • FAQs for Cardiac Anesthesia – Spanish
    • SmartTots FAQs for Parents
    • Useful Resources for Parents

QOW 456

Author: Sana Ullah, MB ChB, FRCA. Children’s Health, Dallas


A 9-month-old infant with a perimembranous ventricular septal defect demonstrates a peak Doppler velocity of 3 m/s across the defect by transthoracic echocardiography. There is no evidence of right or left ventricular outflow tract obstruction. Vital signs are as follows: HR 120, BP 110/60, and SpO2 98%. What is the estimated pulmonary artery systolic pressure?

Correct! Wrong!

EXPLANATION


In the presence of regurgitant jets or shunt lesions, Doppler echocardiography is commonly used to estimate intracardiac pressures and gradients using the simplified Bernoulli equation:


P = 4V2
P = maximum instantaneous pressure gradient
V = peak velocity (m/s)


In the case of absent right ventricular outflow tract (RVOT) obstruction or pulmonary valve stenosis, the right ventricular systolic pressure (RVSP) approximates the pulmonary artery systolic pressure (PASP). Therefore, Doppler techniques can be used to measure the RVSP and hence approximate PASP.


In the presence of a ventricular septal defect (VSD), the peak velocity (V) across the lesion can be used to quantify the pressure gradient between the left and right ventricles during systole. If the left ventricular systolic pressure (LVSP) is known, the RVSP is calculated using the following equation:


RVSP = LVSP – 4(VVSD)2


In the absence of LVOT obstruction, the LVSP is equal to the systolic blood pressure (SBP) measured by the cuff. Hence,


RVSP = SBP – 4(VVSD)2


Using the patient data from the stem into this equation:


RVSP = 110 – 4(3)2
RVSP = 110 – 36
RVSP = 74 mmHg


As there is no RVOT obstruction or pulmonary valve stenosis, the PASP is the same as the RVSP, i.e. 74mmHg.


REFERENCES


Anderson B. Echocardiography: The Normal Examination and Echocardiographic Measurements. (pp. 134-137). Australia. MGA Graphics, 2000.


Poll of the Month

June 2025
At your institution, do patients presenting for elective cardiac surgery who are found to be anemic on routine testing undergo formal preoperative anemia testing and treatment?
View Results
Total Answers 65
Total Votes 65

Upcoming Meeting Information


CCAS 2026 Annual Meeting

March 12, 2026
Sheraton Denver Downtown
Denver, CO

 

 

 

 

Join CCAS
Renew
Donate
Get Involved
Upcoming
Job Postings
  • Member Login
  • Forgot Password?
2209 Dickens Road, Richmond, VA 23230 • 804-282-9780 • [email protected]
Copyright © 2025 The Congenital Cardiac Anesthesia Society | View Privacy Policy