Cardiac Magnetic Resonance and the Need for Routine Cardiac Catheterization in Single Ventricle Patients Prior to Fontan: A Comparison of 3 Groups

Abstract

Single ventricle patients not requiring an intervention can undergo successful Fontan completion with CMR and echo alone with similar short-term outcomes to C, which was used as a control, preventing an invasive test and exposure to radiation. CMR can add information in a significant number of patients. Cath and CMR are utilized together for interventions and assessment of aortopulmonary collaterals.

Less Invasive, More Informative: A New Mathematical Model of Oxygen Kinetics of Bidirectional Glenn Circulation

“…Effort is continuing to grow to obtain valuable information and better understanding, with less invasive approaches including magnetic resonance imaging (MRI), mathematical modeling, and computational fluid dynamics. [8][9][10] In an article by Fang et al in the February 2018 Journal edition, "Validation of a Mathematical Model of a Bidirectional Glenn Circulation with Aortopulmonary Collaterals and the Implications for Qp/Qs Calculation," the authors develop a mathematical model of oxygen delivery kinetics of the BDG circulation in the presence of APC flow. 11 This article provides a framework for understanding the mechanisms of oxygenation in the unique BDG circulation and improves on previously described models by Santamore et al 12 One of the elegant features of the model presented by Fang et al is that in defining coefficients for the extent of APC flow (k), the model equations collapse when k ¼ 0 and match the previous work by Santamore.…”

Catheter hemodynamic assessment of the univentricular circulation

“…At present, only a few centers have the ability to combine invasive catheter hemodynamics and magnetic resonance imaging (MRI) evaluation simultaneously. [242526] However, ultimately, this should be the best clinical practice, especially in patients who are considered for transplantation, for a failing Fontan circulation.…”

Computed Tomography Imaging in Patients with Congenital Heart Disease Part I: Rationale and Utility. An Expert Consensus Document of the Society of Cardiovascular Computed Tomography (SCCT)

“…273 Some centers now propose a completely non-invasive diagnostic pathway for patients with single ventricle heart disease through third stage palliation. 274,275 The single ventricle patient population is high risk for adverse event with anesthesia. [276][277][278] For single ventricle patients that may require anesthesia for CMR, cardiovascular CT may be a reasonable alternate imaging modality if performed with no or minimal sedation.…”