Role of imaging in the evaluation of single ventricle with the Fontan palliation

Shelby Kutty, Rahul H. Rathod, David A. Danford, David S. Celermajer

Research output: Contribution to journalReview article

Abstract

The Fontan operation for single ventricle palliation consists of the creation of a complete cavopulmonary connection, usually by incorporating inferior vena caval flow into a pulmonary arterial circulation already receiving flow from the superior vena cava. In single ventricle palliated in this way, the anatomy is complex, and the pathophysiological complications are frequent; so, cardiac imaging is a key aspect of clinical surveillance. Common problems that echocardiography and MRI may disclose and characterise in the Fontan palliation of single ventricle include obstruction of systemic venous and pulmonary arterial flow, atrioventricular and semilunar valve dysfunction, unintended collateral flow patterns, ventricular dysfunction, aortic arch obstruction, interatrial obstruction, fenestration flow and patch leaks. Despite the broad scope of these modalities for detection of such problems, often no single imaging method is comprehensive in any given patient. Therefore, physicians must recognise the limitations of each modality, and circumvent these by application of suitable alternatives. New imaging tools are becoming available, which may ultimately prove to be of value in the Fontan circulation. Proper application of diverse new technologies such as four dimensional flow, computational fluid dynamics and three-dimensional printing will require critical evaluation in the single ventricle population.

Original languageEnglish (US)
Pages (from-to)174-183
Number of pages10
JournalHeart
Volume102
Issue number3
DOIs
StatePublished - Feb 1 2016
Externally publishedYes

Fingerprint

Fontan Procedure
Ventricular Dysfunction
Venae Cavae
Superior Vena Cava
Pulmonary Circulation
Hydrodynamics
Thoracic Aorta
Echocardiography
Anatomy
Technology
Physicians
Lung
Population
Three Dimensional Printing

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Role of imaging in the evaluation of single ventricle with the Fontan palliation. / Kutty, Shelby; Rathod, Rahul H.; Danford, David A.; Celermajer, David S.

In: Heart, Vol. 102, No. 3, 01.02.2016, p. 174-183.

Research output: Contribution to journalReview article

Kutty, Shelby ; Rathod, Rahul H. ; Danford, David A. ; Celermajer, David S. / Role of imaging in the evaluation of single ventricle with the Fontan palliation. In: Heart. 2016 ; Vol. 102, No. 3. pp. 174-183.
@article{97b2da14763b4548a9404a8d96ddfc9d,
title = "Role of imaging in the evaluation of single ventricle with the Fontan palliation",
abstract = "The Fontan operation for single ventricle palliation consists of the creation of a complete cavopulmonary connection, usually by incorporating inferior vena caval flow into a pulmonary arterial circulation already receiving flow from the superior vena cava. In single ventricle palliated in this way, the anatomy is complex, and the pathophysiological complications are frequent; so, cardiac imaging is a key aspect of clinical surveillance. Common problems that echocardiography and MRI may disclose and characterise in the Fontan palliation of single ventricle include obstruction of systemic venous and pulmonary arterial flow, atrioventricular and semilunar valve dysfunction, unintended collateral flow patterns, ventricular dysfunction, aortic arch obstruction, interatrial obstruction, fenestration flow and patch leaks. Despite the broad scope of these modalities for detection of such problems, often no single imaging method is comprehensive in any given patient. Therefore, physicians must recognise the limitations of each modality, and circumvent these by application of suitable alternatives. New imaging tools are becoming available, which may ultimately prove to be of value in the Fontan circulation. Proper application of diverse new technologies such as four dimensional flow, computational fluid dynamics and three-dimensional printing will require critical evaluation in the single ventricle population.",
author = "Shelby Kutty and Rathod, {Rahul H.} and Danford, {David A.} and Celermajer, {David S.}",
year = "2016",
month = "2",
day = "1",
doi = "10.1136/heartjnl-2015-308298",
language = "English (US)",
volume = "102",
pages = "174--183",
journal = "Heart",
issn = "1355-6037",
publisher = "BMJ Publishing Group",
number = "3",

}

TY - JOUR

T1 - Role of imaging in the evaluation of single ventricle with the Fontan palliation

AU - Kutty, Shelby

AU - Rathod, Rahul H.

AU - Danford, David A.

AU - Celermajer, David S.

PY - 2016/2/1

Y1 - 2016/2/1

N2 - The Fontan operation for single ventricle palliation consists of the creation of a complete cavopulmonary connection, usually by incorporating inferior vena caval flow into a pulmonary arterial circulation already receiving flow from the superior vena cava. In single ventricle palliated in this way, the anatomy is complex, and the pathophysiological complications are frequent; so, cardiac imaging is a key aspect of clinical surveillance. Common problems that echocardiography and MRI may disclose and characterise in the Fontan palliation of single ventricle include obstruction of systemic venous and pulmonary arterial flow, atrioventricular and semilunar valve dysfunction, unintended collateral flow patterns, ventricular dysfunction, aortic arch obstruction, interatrial obstruction, fenestration flow and patch leaks. Despite the broad scope of these modalities for detection of such problems, often no single imaging method is comprehensive in any given patient. Therefore, physicians must recognise the limitations of each modality, and circumvent these by application of suitable alternatives. New imaging tools are becoming available, which may ultimately prove to be of value in the Fontan circulation. Proper application of diverse new technologies such as four dimensional flow, computational fluid dynamics and three-dimensional printing will require critical evaluation in the single ventricle population.

AB - The Fontan operation for single ventricle palliation consists of the creation of a complete cavopulmonary connection, usually by incorporating inferior vena caval flow into a pulmonary arterial circulation already receiving flow from the superior vena cava. In single ventricle palliated in this way, the anatomy is complex, and the pathophysiological complications are frequent; so, cardiac imaging is a key aspect of clinical surveillance. Common problems that echocardiography and MRI may disclose and characterise in the Fontan palliation of single ventricle include obstruction of systemic venous and pulmonary arterial flow, atrioventricular and semilunar valve dysfunction, unintended collateral flow patterns, ventricular dysfunction, aortic arch obstruction, interatrial obstruction, fenestration flow and patch leaks. Despite the broad scope of these modalities for detection of such problems, often no single imaging method is comprehensive in any given patient. Therefore, physicians must recognise the limitations of each modality, and circumvent these by application of suitable alternatives. New imaging tools are becoming available, which may ultimately prove to be of value in the Fontan circulation. Proper application of diverse new technologies such as four dimensional flow, computational fluid dynamics and three-dimensional printing will require critical evaluation in the single ventricle population.

UR - http://www.scopus.com/inward/record.url?scp=84958953634&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84958953634&partnerID=8YFLogxK

U2 - 10.1136/heartjnl-2015-308298

DO - 10.1136/heartjnl-2015-308298

M3 - Review article

C2 - 26567230

AN - SCOPUS:84958953634

VL - 102

SP - 174

EP - 183

JO - Heart

JF - Heart

SN - 1355-6037

IS - 3

ER -