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The role of cardiovascular magnetic resonance in candidates for Fontan operation: proposal of a new algorithm.
- Source :
-
Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance [J Cardiovasc Magn Reson] 2011 Nov 11; Vol. 13, pp. 69. Date of Electronic Publication: 2011 Nov 11. - Publication Year :
- 2011
-
Abstract
- Background: To propose a new diagnostic algorithm for candidates for Fontan and identify those who can skip cardiac catheterization (CC).<br />Methods: Forty-four candidates for Fontan (median age 4.8 years, range: 2-29 years) were prospectively evaluated by trans-thoracic echocardiography (TTE), Cardiovascular magnetic resonance (CMR) and CC. Before CC, according to clinical, echo and CMR findings, patients were divided in two groups: Group I comprised 18 patients deemed suitable for Fontan without requiring CC; group II comprised 26 patients indicated for CC either in order to detect more details, or for interventional procedures.<br />Results: In Group I ("CC not required") no unexpected new information affecting surgical planning was provided by CC. Conversely, in Group II new information was provided by CC in three patients (0 vs 11.5%, p = 0.35) and in six an interventional procedure was performed. During CC, minor complications occurred in one patient from Group I and in three from Group II (6 vs 14%, p = 0.7). Radiation Dose-Area product was similar in the two groups (Median 20 Gycm(2), range: 5-40 vs 26.5 Gycm(2), range: 9-270 p = 0.37). All 18 Group I patients and 19 Group II patients underwent a total cavo-pulmonary anastomosis; in the remaining seven group II patients, four were excluded from Fontan; two are awaiting Fontan; one refused the intervention.<br />Conclusion: In this paper we propose a new diagnostic algorithm in a pre-Fontan setting. An accurate non-invasive evaluation comprising TTE and CMR could select patients who can skip CC.
- Subjects :
- Adolescent
Adult
Cardiac Catheterization
Child
Child, Preschool
Echocardiography
Humans
Italy
Predictive Value of Tests
Prospective Studies
Unnecessary Procedures
Young Adult
Algorithms
Fontan Procedure
Heart Defects, Congenital diagnosis
Heart Defects, Congenital surgery
Magnetic Resonance Imaging
Patient Selection
Subjects
Details
- Language :
- English
- ISSN :
- 1532-429X
- Volume :
- 13
- Database :
- MEDLINE
- Journal :
- Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance
- Publication Type :
- Academic Journal
- Accession number :
- 22077996
- Full Text :
- https://doi.org/10.1186/1532-429X-13-69