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The role of cardiovascular magnetic resonance in candidates for Fontan operation: proposal of a new algorithm.

Authors :
Ait-Ali L
De Marchi D
Lombardi M
Scebba L
Picano E
Murzi B
Festa P
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.

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