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  • Title: Impact of Free-Breathing Phase-Contrast MRI on Decision-Making in Fontan Surgical Planning.
    Author: Wei ZA, Trusty PM, Zhang Y, Tang E, Whitehead KK, Fogel MA, Yoganathan AP.
    Journal: J Cardiovasc Transl Res; 2020 Aug; 13(4):640-647. PubMed ID: 31732919.
    Abstract:
    Fontan surgical planning ranks proposed surgical options according to their hemodynamics assessed by computational fluid dynamic (CFD) modeling. CFD commonly utilizes blood flow acquired under breath-holding (BH) conditions. Ignoring the free-breathing (FB) effect on blood flow waveforms may impact the ranking of surgical options. This study investigates such a potential impact by including ten Fontan patients who had blood flow acquisitions under both BH and FB conditions. A virtual surgery platform was used to generate two surgical options for each patient: (1) a traditional Fontan conduit and (2) a Y-graft. These options were ranked based on clinically relevant hemodynamic metrics: power loss (PL) and hepatic flow distribution (HFD). No difference was found in the ranking of options between using FB and BH flow acquisitions. The findings indicated that decision-making is not affected by the types of flow acquisition for Fontan surgical planning.
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