Late ventricular geometry and performance changes of functional single ventricle throughout staged fontan reconstruction assessed by magnetic resonance imaging

Mark A Fogel; Paul M Weinberg; Alvin J Chin; Kenneth E Fellows; Eric A Hoffman

doi:10.1016/0735-1097(96)00111-8

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Late ventricular geometry and performance changes of functional single ventricle throughout staged fontan reconstruction assessed by magnetic resonance imaging

Journal article

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Late ventricular geometry and performance changes of functional single ventricle throughout staged fontan reconstruction assessed by magnetic resonance imaging

Mark A Fogel, Paul M Weinberg, Alvin J Chin, Kenneth E Fellows and Eric A Hoffman

Journal of the American College of Cardiology, Vol.28(1), pp.212-221

07/1996

DOI: 10.1016/0735-1097(96)00111-8

PMID: 8752817

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Abstract

Objectives. We sought to test the hypothesis that late ventricular geometry and performance changes occur in functional single ventricles as they progress through staged Fontan reconstruction. Background. Indexes of ventricular geometry and performance are important in evaluating the functional state of the heart. Magnetic resonance imaging determines these indexes in complex ventricular shapes with minimal geometric assumptions. Previous studies have shown that 1 week after hemiFontan, the mass/volume ratio markedly increases. Methods. Multiphase, multislice, spin echo (n = 5) and cine (n = 30) magnetic resonance imaging was performed in 35 patients with a functional single ventricle (1 week to 12 years old) at various stages of Fontan reconstruction (15 in the pre hemiFontan stage, 11 after 16 to 9 months] the hemiFontan procedure and 9 after [1 to 2 years] the Fontan procedure). Volume and mass were calculated at end-systole and end-diastole. Ventricular output was then obtained. Ventricular centroid motion was also calculated. Results. No differences was noted (power >72%) from the pre hemiFontan state of 6 to 9 months after the hemiFontan procedure in (mean ± SD) end-diastolic volume (104 ± 24 vs. 123 ± 40 cc/m2), mass (171 ± 46 vs. 202 ± 61 g/m2), ventricular output (7.9 ± 2.2 vs. 6.6 ± 2.4 liters/min per m2) or centroid motion (6.9 ± 2.8 vs. 6.7 ± 2.6 mm/m2). Patients in the Fontan group demonstrated a marked decrease in all indexes, indicating significant volume unloading and decrease in mass and ventricular performance. Mass/volume ratio was not significantly different among all three groups. Conclusions. No geometric and performance changes from the volume-loaded stage are noted 6 to 9 months after the hemiFontan procedure; however, major changes occur 1 to 2 years after the Fontan procedure. The dramatic changes in the mass/volume ratio seen early after the hemiFontan procedure were not detected at 6 to 9 months. Furthermore, diminution of mass, volume and ventricular performance are present at least 2 years after the Fontan procedure.

Details

Title: Subtitle: Late ventricular geometry and performance changes of functional single ventricle throughout staged fontan reconstruction assessed by magnetic resonance imaging
Creators: Mark A Fogel
Paul M Weinberg
Alvin J Chin
Kenneth E Fellows
Eric A Hoffman
Resource Type: Journal article
Publication Details: Journal of the American College of Cardiology, Vol.28(1), pp.212-221
DOI: 10.1016/0735-1097(96)00111-8
PMID: 8752817
NLM abbreviation: J Am Coll Cardiol
ISSN: 0735-1097
eISSN: 1558-3597
Publisher: Elsevier Inc
Language: English
Date published: 07/1996
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Radiology; Internal Medicine
Record Identifier: 9984051894902771

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