Skip to content

Advertisement

  • Meeting abstract
  • Open Access

1057 Pulmonary artery size and function after Fontan operation at young age: assessment with phase contrast magnetic resonance imaging

  • 1,
  • 2,
  • 3,
  • 1,
  • 4,
  • 5,
  • 5,
  • 2 and
  • 1
Journal of Cardiovascular Magnetic Resonance200810 (Suppl 1) :A182

https://doi.org/10.1186/1532-429X-10-S1-A182

  • Published:

Keywords

  • Pulmonary Artery
  • Cardiovascular Magnetic Resonance
  • Dobutamine
  • Contrast Magnetic Resonance Imaging
  • Fontan Operation

Introduction

little is known about the effects of long-term non-pulsatile flow on pulmonary artery (PA) growth after Fontan operation. Furthermore, the effects on flow variables and shear stress have not been studied in a patient group operated on at young age.

Purpose

In this study, we assessed PA size, flow variables, and shear stress long-term after Fontan operation at young age and compared them with healthy controls, using cardiovascular magnetic resonance (CMR) imaging.

Methods

14 patients (9 males, aged 13.1 ± 4.0 years, follow-up after Fontan completion 9.7 (5.4–16.8) years) and 17 healthy controls (9 males, aged 13.3 ± 2.3 years) were included. Flow measurements in the branch PA were made during a CMR study, using phase contrast velocity-encoded imaging. In patients, flow measurements were repeated during low-dose dobutamine stress of 7.5 μg/kg/min. Shear stress was determined according to a previously published method [1].

Results

CMR scanning and dobutamine administration was well tolerated by all subjects without side effects. Results of the flow studies and shear stress determination are summarized in Table 1 (NS = not significant).

Table 1

 

controls

patients, rest

patients, stress

p-value (controls vs patients)

p-value (rest vs stress)

Heart rate (/min)

72 ± 12

69 ± 12

93 ± 17

NS

<0.001

Stroke index (ml/m2)

31 ± 7

19 ± 7

19 ± 7

<0.001

NS

Total flow (ml/min/m2)

2189 ± 463

1244 ± 74

1705 ± 308

<0.001

<0.001

Average flow (ml/s)

56 ± 15

28 ± 6

39 ± 13

<0.001

<0.001

Peak flow (ml/s)

187 ± 48

55 ± 31

71 ± 44

<0.001

<0.001

Diameter (mm)

16.2 ± 1.7

15.1 ± 2.7

15.2 ± 2.8

NS

NS

Distensibility

0.41 ± 0.09

0.22 ± 0.06

0.20 ± 0.07

<0.001

NS

Shear stress (N/m2)

0.84 ± 0.14

0.38 ± 0.15

0.50 ± 0.18

<0.001

<0.001

Conclusion

PA diameter is normal in patients long-term after Fontan operation at young age. However, flow variables, distensibility and shear stress are significantly lower compared to healthy controls, implicating pulmonary endothelial and/or vascular dysfunction.

Authors’ Affiliations

(1)
Erasmus MC – Sophia, Rotterdam, The Netherlands
(2)
Free University Medical Center, Amsterdam, The Netherlands
(3)
University Medical Center Utrecht, Utrecht, The Netherlands
(4)
UMC St Radboud, Nijmegen, The Netherlands
(5)
Erasmus MC, Rotterdam, The Netherlands

References

  1. J Am Coll Cardiol. 2005, 45: 846-854. 10.1016/j.jacc.2004.12.026.Google Scholar

Copyright

Advertisement