Determinants and clinical significance of flow via the fenestration in the Fontan pathway

A multimodality study

Lars Grosse-Wortmann, Andreea Dragulescu, Christian Drolet, Rajiv Chaturvedi, Yasuhiro Kotani, Luc Mertens, Katherine Taylor, Gustavo La Rotta, Glen Van Arsdell, Andrew Redington, Shi Joon Yoo

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background: The use of a fenestration in the Fontan pathway remains controversial, partly because its hemodynamic effects and clinical consequences are insufficiently understood. The objective of this study was to quantify the magnitude of fenestration flow and to characterize its hemodynamic consequences after an intermediate interval after surgery. Methods: Twenty three patients with a fenestrated extracardiac conduit prospectively underwent investigation by cardiac magnetic resonance (CMR), echocardiography, and invasive manometry under the same general anesthetic 12±4 months after Fontan surgery. Fenestration flow was determined using phase contrast CMR by subtracting flow in the Fontan pathway above the fenestration from Fontan flow below the fenestration. Results: Fenestration flow constituted a mean of 31±12% (range 8-50%) of ventricular preload. It was associated with a lower Qp/Qs (r=-0.64, p=0.001) and oxygen saturation (r=-0.74, p

Original languageEnglish
Pages (from-to)811-817
Number of pages7
JournalInternational Journal of Cardiology
Volume168
Issue number2
DOIs
Publication statusPublished - Sep 30 2013
Externally publishedYes

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Magnetic Resonance Spectroscopy
Hemodynamics
General Anesthetics
Manometry
Echocardiography
Oxygen

Keywords

  • Fenestration
  • Fontan
  • Magnetic resonance imaging

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Determinants and clinical significance of flow via the fenestration in the Fontan pathway : A multimodality study. / Grosse-Wortmann, Lars; Dragulescu, Andreea; Drolet, Christian; Chaturvedi, Rajiv; Kotani, Yasuhiro; Mertens, Luc; Taylor, Katherine; La Rotta, Gustavo; Van Arsdell, Glen; Redington, Andrew; Yoo, Shi Joon.

In: International Journal of Cardiology, Vol. 168, No. 2, 30.09.2013, p. 811-817.

Research output: Contribution to journalArticle

Grosse-Wortmann, L, Dragulescu, A, Drolet, C, Chaturvedi, R, Kotani, Y, Mertens, L, Taylor, K, La Rotta, G, Van Arsdell, G, Redington, A & Yoo, SJ 2013, 'Determinants and clinical significance of flow via the fenestration in the Fontan pathway: A multimodality study', International Journal of Cardiology, vol. 168, no. 2, pp. 811-817. https://doi.org/10.1016/j.ijcard.2012.10.008
Grosse-Wortmann, Lars ; Dragulescu, Andreea ; Drolet, Christian ; Chaturvedi, Rajiv ; Kotani, Yasuhiro ; Mertens, Luc ; Taylor, Katherine ; La Rotta, Gustavo ; Van Arsdell, Glen ; Redington, Andrew ; Yoo, Shi Joon. / Determinants and clinical significance of flow via the fenestration in the Fontan pathway : A multimodality study. In: International Journal of Cardiology. 2013 ; Vol. 168, No. 2. pp. 811-817.
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