Abstract 11066: Acute Efficacy of Systemic to Pulmonary Arterial Collateral Embolization
Background The significance and optimal treatment of systemic to pulmonary arterial collateral (SPC) vessels in single ventricle patients are poorly understood. The acute efficacy of SPC embolization has not been demonstrated in a quantifiable fashion. We sought to assess the acute efficacy of SPC embolization on blood flow as measured by phase contrast magnetic resonance imaging (PC-MRI), and hypothesized that embolization acutely decreases SPC flow and increases systemic blood flow (QS).
Methods Six superior cavopulmonary connection patients underwent SPC flow quantification by PC-MRI including measurement of superior and inferior caval, total pulmonary artery, total pulmonary vein, ascending and descending aortic flows (QSVC, QIVC, QPA, QPV, QAo, QDAo respectively), both immediately before and after cardiac catheterization with coil and particle embolization of angiographically evident SPC vessels. All studies were performed under a single anesthetic.
Results After embolization we found a significant decrease in SPC flow of 0.9 (range 0.6-1.3) l/min/m2 (p<0.001); a mean reduction of 46 (range 32 - 60) percent. There was a significant decrease in the mean QP:QS from 1.2 before to 0.7 after embolization (p=0.006), and an increase in QS from an average of 3.3 to 4.3 l/min/m2 (p=0.018), and QSVC from an average of 1.7 to 2.1 l/min/m2 (p=0.05).
Conclusion For the first time we report the acute efficacy of SPC embolization, demonstrating a significant decrease in SPC burden and QP:QS and increase in QSVC and QS. Further studies are needed to assess the procedure’s durability and the effect on Fontan and longer-term outcomes.
- © 2012 by American Heart Association, Inc.