Abstract 13255: Changes in Flow Distribution and Ventricular Performance Parameters in Single Ventricle Patients After Fontan During Late Childhood, Teen and Early Adulthood Years: A Serial Cardiac Magnetic Resonance Study
Background: Flow distribution & ventricular performance parameters in single ventricle pts after Fontan are important to understand for long term outcome. Serial cardiac magnetic resonance (CMR) in this group in late childhood, teen & early adulthood years where adolescent changes occur have not been described.
Methods: Retrospective review of CMR scans from 2005 till present. Pts with > 2 scans, flow & ventricular performance parameters were studied; the longest time between scans were chosen. Significance was P<0.05.
Results: 26 pts with > 2 scans were found. Time between scans was 2.7+1.5 yrs. The table demonstrates no significant differences in indexed ventricular end-diastolic volume, aortic cardiac index or branch pulmonary artery flow between scans. Total caval return (TCR) (true systemic output) decreased by nearly 0.3 liters/minute/meter2 on average due to decreased superior vena caval return (R=0.7, P<0.05). A positive correlation existed between the difference in TCR between the 2 scans and time between scans (R=0.45, P=0.04, graph); younger pts (13.5+6.22 yrs) showed decreased TCR on the 2nd scan while older pts (16.8+7.2 yrs) showed a slight increase. Aortic to pulmonary collateral flow trended greater at the 2nd scan but did not reach significance.
Conclusions: During late childhood, teen and early adulthood yrs, Fontan pts true systemic output decreases slightly with decreased superior vena caval return. During early adolescent growth spurt, true systemic output decreases & may not be maintained with growth. Aortic to pulmonary collateral flow remains nearly the same but trends higher. Other flow & ventricular performance parameters remain stable.
- Fontan physiology
- Magnetic resonance
- Ventricular function
- Congenital heart disease
- Cardiovascular imaging
- © 2011 by American Heart Association, Inc.