Myocardial perfusion and coronary flow reserve assessed by positron emission tomography in patients after Fontan-like operations

• Published in: Pediatric cardiology 2003-07, Vol.24 (4), p.386-392
• Main Authors: Hauser, M, Bengel, F M, Kühn, A, Sauer, U, Nekolla, S G, Eicken, A, Schwaiger, M, Hess, J
• Format: Article
• Language: English
• Subjects: Adolescent; Blood Flow Velocity; Cardiac Catheterization; Case-Control Studies; Child; Cohort Studies; Coronary Angiography; Coronary Circulation - physiology; Echocardiography, Transesophageal; Electrocardiography; Female; Follow-Up Studies; Fontan Procedure - adverse effects; Fontan Procedure - methods; Heart Function Tests; Hemodynamics - physiology; Humans; Male; Myocardial Ischemia - diagnostic imaging; Myocardial Ischemia - etiology; Probability; Reference Values; Risk Assessment; Sensitivity and Specificity; Severity of Illness Index; Statistics, Nonparametric; Tomography, Emission-Computed; Tricuspid Atresia - surgery; Ventricular Dysfunction, Left - diagnostic imaging; Ventricular Dysfunction, Left - physiopathology
• ISSN: 0172-0643; 1432-1971
• DOI: 10.1007/s00246-002-0355-5

Ventricular dysfunction in patients after Fontan-like operations (FLOs) is a serious complication that might contribute to poor long-term results. Ischemic heart disease will have debilitating consequences on a Fontan heart. Ten patients (15.8 +/- 5.01 years) after FLO had transesophageal echocardiography and cardiac catheterization 9.3 +/- 4.2 years after surgery. Myocardial perfusion was assessed by NH3-positron emission tomography (rest/adenosine) and compared with that of 10 healthy adults (26.1 +/- 6.3 years). Ventricular function was normal in 4 and reduced in 6 patients; end systolic and end diastolic meridional wall stress was significantly elevated in the FLO group. Coronary angiography revealed no stenosis of the coronaries. Compared to normals, myocardial blood flow (MBF) at rest was higher in the FLO group (0.99 +/- 0.25 vs 0.77 +/- 0.17 ml/g/min, p