Hemodynamic Assessment in Patients with One-and-a-Half Ventricle Repair Revealed by Four-Dimensional Flow Magnetic Resonance Imaging

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 pa...

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Bibliographic Details
Published in:Pediatric cardiology 2013-02, Vol.34 (2), p.447-451
Main Authors: Uribe, Sergio, Bächler, Pablo, Valverde, Israel, Crelier, Gérard R., Beerbaum, Philipp, Tejos, Cristian, Irarrazaval, Pablo
Format: Article
Language:English
Subjects:
Adolescent
Arteriovenous Shunt, Surgical - methods
Cardiac Surgery
Cardiology
Case Report
Female
Heart Ventricles - abnormalities
Heart Ventricles - surgery
Hemodynamics
Humans
Image Processing, Computer-Assisted
Magnetic resonance imaging
Magnetic Resonance Imaging, Cine - methods
Medical research
Medicine
Medicine & Public Health
Medicine, Experimental
Pulmonary Artery - surgery
Pulmonary Atresia - diagnosis
Pulmonary Atresia - physiopathology
Pulmonary Atresia - surgery
Vascular Surgery
Vena Cava, Superior - surgery
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Summary: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.
ISSN:0172-0643
1432-1971
DOI:10.1007/s00246-012-0288-6