Hemodynamic assessment in patients with one-and-a-half ventricle repair revealed by four-dimensional flow magnetic resonance imaging.

Abstract:

:We report hemodynamic findings in two patients with pulmonary atresia and intact ventricular septum (PAIVS) after "one-and-a-half ventricle repair" and placement of a bidirectional Glenn shunt using four-dimensional (4D) flow magnetic resonance imaging. Quantification of flow and analysis of flow patterns revealed the hemodynamic "battle" between the right ventricle (RV) and the Glenn shunt. Moreover, with a novel approach we calculated during Glenn anastomosis the flow distribution from the superior vena cava (SVC) to the pulmonary arteries. Our results showed a highly asymmetric flow distribution, with most of the flow from the SVC toward the RV and not to the lungs. The evidence provided by 4D flow demonstrates poor efficiency of this system and suggests that both patients might benefit from adding an artificial pulmonary valve to avoid right heart failure.

journal_name

Pediatr Cardiol

journal_title

Pediatric cardiology

authors

Uribe S,Bächler P,Valverde I,Crelier GR,Beerbaum P,Tejos C,Irarrazaval P

doi

10.1007/s00246-012-0288-6

subject

Has Abstract

pub_date

2013-02-01 00:00:00

pages

447-51

issue

2

eissn

0172-0643

issn

1432-1971

journal_volume

34

pub_type

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