CMR-based planning of catheter and surgical interventions for aortopulmonary collaterals before Fontan completion: pilot study of 5 cases

Keisuke Sato

doi:10.1186/1532-429x-17-s1-p218

Abstract

Background Aortopulmonary collateral arteries (APCAs) are frequently observed in single ventricle patients. However those patients require staged surgery toward Fontan completion, APCAs are believed to cause evil situations against Fontan circulation such as impediment of anterograde pulmonary blood flow, volume overload for single ventricle and decrease in systemic blood flow. Therefore, interventions for APCAs are often considered especially before Fontan completion. Planning of interventions used to be based on fluoroscopic angiogram (FA). But FA can provide the information about the location and size of APCAs. Therefore, FA-based planning depends on the operator’s impression about the amount of APCAs. Cardiac MRI (CMR) was reported to useful for quantify APCAs. The aim of this study is to apply CMR to planning of interventions for APCAs before Fontan completion.

Highlights

Aortopulmonary collateral arteries (APCAs) are frequently observed in single ventricle patients
The proportion of APCAs to Qp was reduced after coil embolization with Cardiac MRI (CMR)-based planning
The proportion of APCAs to Qp was increased in one case (7%) it was performed on the basis of CMR planning

Summary

Introduction

Aortopulmonary collateral arteries (APCAs) are frequently observed in single ventricle patients. Those patients require staged surgery toward Fontan completion, APCAs are believed to cause evil situations against Fontan circulation such as impediment of anterograde pulmonary blood flow, volume overload for single ventricle and decrease in systemic blood flow. Interventions for APCAs are often considered especially before Fontan completion. Planning of interventions used to be based on fluoroscopic angiogram (FA). FA can provide the information about the location and size of APCAs. FA-based planning depends on the operator’s impression about the amount of APCAs. Cardiac MRI (CMR) was reported to useful for quantify APCAs. The aim of this study is to apply CMR to planning of interventions for APCAs before Fontan completion

Objectives

Methods

Results

Conclusion