Optimal decision-making to determine the type and timing of surgical intervention
for various congenital heart disease (CHD) requires adequate understanding and interpretation
of anatomic and physiologic data obtained from various imaging modalities. Cardiac
magnetic resonance (CMR) has revolutionized the way we evaluate the anatomy and physiology
of CHD. In addition to 2- and 3-dimensional anatomic data and volumetry, phase-contrast
CMR allows quantitative measurements of cardiac output, pulmonary blood flow, pulmonary-to-systemic
flow ratio, the amount of intracardiac shunt, valve regurgitation, and aortopulmonary
collateral flows. This review article describes the utilization of CMR-derived flow
data in surgical decision-making in three distinct subgroups: (1) patients with borderline
left ventricle (LV) with emphasis on the ascending aortic flow and other physiologic
parameters, (2) single ventricle patients who undergo bidirectional cavopulmonary
shunt with emphasis on the impact of superior vena cava blood flow on postoperative
physiology, and (3) patients with pulmonary atresia and major aortopulmonary collateral
arteries with emphasis on the impact of total pulmonary blood flow and systemic-to-pulmonary
flow ratio on clinical outcomes.
Keywords
Abbreviations:
ASD (Atrial Septal Defect), AV (Atrioventricular), BCPS (Bidirectional Cavopulmonary Shunt), CHD (Congenital Heart Disease), CMR (Contrast Magnetic Resonance), EFE (Endocardial Fibroelastosis), LV (Left Ventricle), LVEDVi (LV end-diastolic volume index), LVESVi (LV end-systolic volume index), MAPCA (Major aortopulmonary collateral arteries), PA (Pulmonary Atresia), PVR (Pulmonary Vascular Resistance), Qp:Qs (Pulmonary-to-systemic flow ratio), Qpa (Total pulmonary artery blood flow), Qpv (Total pulmonary vein blood flow), RVSP (Right Ventricular Systolic Pressure), SVC (Superior Vena Cava), TNPAI (Total neopulmonary artery index), VSD (Ventricular Septal Defect)To read this article in full you will need to make a payment
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Article info
Footnotes
Classification: Review article
Category: Congenital Heart Disease
Conflicts of Interest: There is no external funding and no conflicts of interest.
Identification
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