Cardiac Imaging in Patients After Fontan Palliation: Which Test and When?

Frontiers in Pediatrics

article

Paolo Ciliberti¹  Paolo Ciancarella²  Pasqualina Bruno¹  Davide Curione²  Veronica Bordonaro²  Veronica Lisignoli¹  Mario Panebianco¹  Marcello Chinali¹  Aurelio Secinaro²  Lorenzo Galletti¹  Paolo Guccione¹ 

[1] Department of Cardiac Surgery, Cardiology, Heart and Lung Transplantation Bambino Gesu' Children's Hospital;Advanced Cardiothoracic Imaging Unit, Bambino Gesù Children's Hospital

关键词: congenital heart disease;    Fontan operation;    echocardiography;    cardiac CT;    cardiac MRI;   

DOI  :  10.3389/fped.2022.876742

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

The Fontan operation represents the final stage of a series of palliative surgical procedures for children born with complex congenital heart disease, where a “usual” biventricular physiology cannot be restored. The palliation results in the direct connection of the systemic venous returns to the pulmonary arterial circulation without an interposed ventricle. In this unique physiology, systemic venous hypertension and intrathoracic pressures changes due to respiratory mechanics play the main role for propelling blood through the pulmonary vasculature. Although the Fontan operation has dramatically improved survival in patients with a single ventricle congenital heart disease, significant morbidity is still a concern. Patients with Fontan physiology are in fact suffering from a multitude of complications mainly due to the increased systemic venous pressure. Consequently, these patients need close clinical and imaging monitoring, where cardiac exams play a key role. In this article, we review the main cardiac imaging modalities available, summarizing their main strengths and limitations in this peculiar setting. The main purpose is to provide a practical approach for all clinicians involved in the care of these patients, even for those less experienced in cardiac imaging.

【 授权许可】

CC BY