SR-MED-005

Pulmonary Artery Shape and Eccentricity

Peyton Lawless
 INTRODUCTION

Hypothesis

Research Question My null hypothesis is that the shape of the 50 patients pulmonary arteries

Does the symmetry and shape of the pulmonary will not have a significantly different area than the theoretical circular shape. If the

artery, measured at the annulus and ST junction, shape is not significantly different, than it can be said that the shape of the annulus

impact the effectiveness of the valve’s function? and ST junction was not significant enough to credit the heath of the patients to the

ovalization characteristic.

Previous Work Done:

J.L Mercer, M.S. studying the Acceptable Size of the

Pulmonary Valve Ring in Congenital Heart Defect
 METHODS

Variables Procedure:
1. Used the data provided from Colorado Children's
Hospital to find the area of the value using the two
diameters
2. Using the larger of the diameters, I found the area of the
ST-Junction Annulus valve assuming that the valve was circular

Area of Patient Theoretical Area of Theoretical

Valve Area Patient Valve Area

Age Gender Age Gender

Extraneous Factors 3. Used a statistical hypothesis test to determine if the

average means were different
4. Found the percent difference between the means
5. Blocked the data by age and gender to test for extraneous
factors
RESULTS

Table #1: Average Percent Difference in the Population of 50 Patients Aged 1 to 2 Years Old

Population Total Annulus ST Junction Female Male

Population
(Annulus and
ST Junction)

Average 22.5% 26% 19% 22.5% 22%

Percent
Difference in
Area
 Table #2: Hypothesis T-Test for The Difference in Area of The Annulus and the
ST Junction in the Population of 50 Patients Aged 1 to 2 Years Old

Population Annulus ST Junction

Hypothesis Test 4.829 8.88

Table #3: Average Percent Difference in Area Of Different Age Intervals in the
Population of 50 Patients Aged 1 to 2 Years Old

Average Percent Difference in Average Percent Difference in

Age Interval (years) Area (Annulus) Area (ST Junction)
1-1.25 27% 18%
1.25-1.5 22% 20%
1.5-1.75 29% 21%
1.75-2 26% 16%
Graph #1: Difference of Average Areas for the Actual Area of the Valve and the Area of the Valve Assuming a Percent
Circular Shape in the Population of 50 Patients Aged 1 to 2 Years Old
Graph #2: Age vs the Difference in Area of the Actual Valve and the Graph #3: Age vs the Difference in Area of the Actual Valve and the
Valve assuming the Shape is Circle for the Annulus in the Valve assuming the Shape is Circle for the ST Junction in the
Population of 50 Patients Aged 1 to 2 Years Old Population of 50 Patients Aged 1 to 2 Years Old
CONCLUSIONS

I am rejecting the null hypothesis that there is no difference between the areas of the Annulus and the ST
Junction and their theoretical areas assuming they are perfect circles.

Data Evidence: Percent Difference:The percent difference between the areas of the patient valves and the theoretical perfect
circles was 26% for the Annulus measurement and 19% for the ST Junction (Table 1). Although there is a 7% difference
between these two percent differences, both of them are significantly different as seen through the error bars which show no
overlap (Graph 1)

Data Evidence: The T-Test for the Annulus and the ST Junction also showed a significant difference using a hypothesis test.
Using the p-value of 0.05, the T-Test for the Annulus was 4.829 and 8.88 for the ST Junction which is significantly above
the accepted value of 0.05 needed in order to reject the null hypothesis.

Data Evidence: Therefore, with 95% confidence, we can say the efficiency to move blood in the Pulmonary Artery specifically
in the Annulus and ST Junction up to a 26% difference in the area of the Annulus and 19% difference in the ST Junction will
not impact the blood flow in the heart to the extent of harming a patient.
 DISCUSSION

Rational:

Only 22% of the circle valve would be lost due to the shape. For actual blockage in the heart, anything less than 40% is

considered mild blockage and is not constricting the blood flow or causing symptoms.

Applications:

The next step in this research would be to develop a larger data set that has a larger difference in the area due to more

extreme oval-shaped valves. This would allow doctors to find the extent that the shape can vary from a perfect circle without

harming the patient. Another possible study would be to see if the oval shape of these valves is better than a perfect circle.

From the research, the shape to an extent does not impact the effectiveness of the valve to move blood however, finding

whether the shape could be used to help patients would be an interesting study that could have many helpful implications to

doctors.
 Extraneous Factors

Gender Age
Gender does not impact the extent to which the Age does not impact the extent to which the shape of the
shape of the pulmonary artery has on transporting pulmonary artery has on transporting blood.
blood.
Annulus:
Data Evidence: The average percent difference in the area of
the Annulus and ST Junction was 22.5% for females and
22% for males

Data Evidence: There was no difference in the area between

the male and females. The average male weight was 0.9147
kg more than the females (9% difference) and the male body
surface area was 0.0322 meters squared more than the ST-Junction:
females (7% difference). Although the male babies are
slightly larger, the average difference in the area of the ST
Junction and Annulus was 0.5% greater in women showing
that gender is not an extraneous factor.
 REFERENCES

Anwar, Ashraf F, et al. “Assessment of Pulmonary Valve and Right Ventricular Outflow Tract with Real-Time Three-Dimensional Echocardiography.” Springer Science+Business Media,

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https://www.verywellhealth.com/pulmonary-artery-anatomy-1763912.

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2018, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6085843/.

Mercer, J.L. “Acceptable Size of the Pulmonary Valve Ring in Congenital Heart Defect.” The Annals of Thoracic Surgery.

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https://www.mayoclinic.org/diseases-conditions/pulmonary-hypertension/symptoms-causes/syc-20350697.