Current practice guidelines for adults with congenital heart disease recommend serial
imaging to ensure the integrity of the surgical Fontan pathway, but its visualisation
by means of transthoracic echocardiography is limited. Accordingly, cross-sectional
imaging is commonly performed to exclude Fontan obstruction. However, angiography
(invasive or noninvasive) provides anatomic instead of functional information. Cardiac
catheterisation, the gold standard method for hemodynamic evaluation, also poses challenges
for assessing Fontan pathway stenosis because, as in other forms of venous obstruction,
minimal pressure gradients might be recorded despite the presence of hemodynamically
and anatomically significant stenosis.
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Reference
- Hemodynamic and clinical implications of impaired pulmonary vascular reserve in the Fontan circulation.J Am Coll Cardiol. 2020; 76: 2755-2763
Article Info
Publication History
Published online: May 05, 2022
Accepted:
April 21,
2022
Received:
February 27,
2022
Footnotes
See page 1125 for disclosure information.
Identification
Copyright
© 2022 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
