Hemodynamic characterization in mid-term follow-up after modified Fontan procedure incorporating right ventricular restoration
ZHANG Chun-zhen
YIN Zong-tao
FANG Min-hua
YANG Ben-qiang
SUN Yu
ZHANG Xu
ZHANG Yong
WANG Hui-shan
Abstract：Objective To evaluate the hemodynamic characteristics of modified Fontan procedure incorporating right ventricular functional restoration(MFRVF)during mid-term follow-up.Methods A total of 6 patients who underwent MFRVF at General Hospital of Northern Theater Command from January 2013 to June 2016 were enrolled,including 3 males and 3 females,aged 6.5(2.0,12.0)years old,ranging from 2 to 17 years old.All patients completed follow-up for(10.3±0.9)years.Analyze the patient's last follow-up echocardiography(to observe the anastomosis diameter,flow velocity at each anastomosis,and ventricular systolic function),CT 3D reconstruction(morphological evaluation of surgically implanted Y-shaped extracardiac conduit),radionuclide pulmonary perfusion(to observe the dominant lung perfusion and left/right pulmonary blood flow ratio),and cardiac MRI 4D-Flow(to observe dynamic changes of Y-shaped conduit during cardiac cycle,energy loss in luminal flow,and lateral wall pressure).Results Echocardiography demonstrated satisfactory anastomotic dimensions and flow velocities.CT 3D reconstruction confirmed optimal conduit morphology without compression or torsion.Pulmonary perfusion scintigraphy revealed right lung-dominant perfusion and the left/right pulmonary blood flow ratio basically reached 1∶1 with near-physiological state.Cardiac MRI 4D-Flow showed conduit-generated"functional right ventricle"effects during cardiac cycle,with balanced inferior vena cava-to-pulmonary artery flow distribution.Conclusion MFRVF achieves stable Fontan circulation dynamics in mid-term follow-up,characterized by preserved ventricular function and optimized pulmonary hemodynamics.
Keywords：Right ventricular functional restorationFontan procedureCardiac 4D-Flow MRI
Publication Date：2025-05-25
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：3( 161-163 )