Journal article
Magnetic Resonance Imaging Assessment of Blood Flow Distribution in Fenestrated and Completed Fontan Circulation with Special Emphasis on Abdominal Blood Flow
Korean journal of radiology, Vol.20(7), pp.1186-1194
07/2019
DOI: 10.3348/kjr.2018.0921
PMCID: PMC6609425
PMID: 31270982
Abstract
To investigate the regional flow distribution in patients with Fontan circulation by using magnetic resonance imaging (MRI).
We identified 39 children (18 females and 21 males; mean age, 9.3 years; age range, 3.3-17.0 years) with Fontan circulation in whom flow volumes across the thoracic and abdominal arteries and veins were measured by using MRI. The patients were divided into three groups: fenestrated Fontan circulation group with MRI performed under general anesthesia (GA) (Group 1, 15 patients; average age, 5.9 years), completed Fontan circulation group with MRI performed under GA (Group 2, 6 patients; average age, 8.7 years), and completed Fontan circulation group with MRI performed without GA (Group 3, 18 patients; average age, 12.5 years). The patient data were compared with the reference ranges in healthy controls.
In comparison with the controls, Group 1 showed normal cardiac output (3.92 ± 0.40 vs. 3.72 ± 0.69 L/min/m²,
= 0.30), while Group 3 showed decreased cardiac output (3.24 ± 0.71 vs. 3.96 ± 0.64 L/min/m²,
= 0.003). Groups 1 and 3 showed reduced abdominal flow (1.21 ± 0.28 vs. 2.37 ± 0.45 L/min/m²,
< 0.001 and 1.89 ± 0.39 vs. 2.64 ± 0.38 L/min/m²,
< 0.001, respectively), which was mainly due to the diversion of the cardiac output to the aortopulmonary collaterals in Group 1 and the reduced cardiac output in Group 3. Superior mesenteric and portal venous flows were more severely reduced in Group 3 than in Group 1 (ratios between the flow volumes of the patients and healthy controls was 0.26 and 0.37 in Group 3 and 0.63 and 0.53 in Group 1, respectively). Hepatic arterial flow was decreased in Group 1 (0.11 ± 0.22 vs. 0.34 ± 0.38 L/min/m²,
= 0.04) and markedly increased in Group 3 (0.38 ± 0.22 vs. -0.08 ± 0.29 L/min/m²,
< 0.0001). Group 2 showed a mixture of the patterns seen in Groups 1 and 3.
Fontan circulation is associated with reduced abdominal flow, which can be attributed to reduced cardiac output and portal venous return in completed Fontan circulation, and diversion of the cardiac output to the aortopulmonary collaterals in fenestrated Fontan circulation.
Details
- Title: Subtitle
- Magnetic Resonance Imaging Assessment of Blood Flow Distribution in Fenestrated and Completed Fontan Circulation with Special Emphasis on Abdominal Blood Flow
- Creators
- Pablo Caro-Dominguez - University of TorontoRajiv Chaturvedi - University of TorontoGovind Chavhan - University of TorontoSimon C Ling - University of TorontoDeane Yim - University of TorontoPrashob Porayette - University of TorontoChristopher Z Lam - University of TorontoTae Kyoung Kim - University Health NetworkMike Seed - University of TorontoLars Grosse-Wortmann - University of TorontoShi Joon Yoo - University of Toronto
- Resource Type
- Journal article
- Publication Details
- Korean journal of radiology, Vol.20(7), pp.1186-1194
- DOI
- 10.3348/kjr.2018.0921
- PMID
- 31270982
- PMCID
- PMC6609425
- NLM abbreviation
- Korean J Radiol
- ISSN
- 1229-6929
- eISSN
- 2005-8330
- Language
- English
- Date published
- 07/2019
- Academic Unit
- Cardiology; Stead Family Department of Pediatrics; Internal Medicine
- Record Identifier
- 9984354040902771
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