Aortopulmonary Collateral Flow is Related to Pulmonary Artery Size and Affects Ventricular Dimensions in Patients After the Fontan Procedure

Abstract

Background: Aortopulmonary collaterals (APCs) are frequently found in patients with a single-ventricle (SV) circulation. However, knowledge about the clinical significance of the systemic-to-pulmonary shunt flow in patients after the modified Fontan procedure and its potential causes is limited. Accordingly, the aim of our study was to detect and quantify APC flow using cardiovascular magnetic resonance (CMR) and assess its impact on SV volume and function as well as to evaluate the role of the size of the pulmonary arteries in regard to the development of APCs.

Factors associated with systemic to pulmonary arterial collateral flow in single ventricle patients with superior cavopulmonary connections

“…This is in contrast to prior reports which have demonstrated an inverse relationship between CollF and pulmonary artery (PA) size 2 12 13 16. The cause of this discrepancy is not clear.…”

Reduced Right Ventricular Output Reserve in Patients With Systemic Sclerosis and Mildly Elevated Pulmonary Artery Pressure

“…Right ventricular output reserve and contractile reserve in patients with PAH have previously been assessed using different methods and surrogate parameters, including invasive single‐beat pressure‐volume loop analysis , stress Doppler echocardiography assessing the capability of patients to increase right ventricular systolic pressure during low‐level exercise , and echocardiographic strain during stress Doppler echocardiography . Although invasive single‐beat pressure‐volume loop analysis is most likely the most sophisticated method to evaluate load‐independent right ventricular contractile reserve, its application can be dangerous for patients (due to stiff catheters), is too costly and complex for routine clinical practice, and requires special equipment such as conductance catheters with special software for online pressure‐volume signals and transit‐time ultrasonic flow probes . Therefore, RHC by Swan‐Ganz catheters has previously been used to assess the increase in CI during exercise in PAH patients and was performed in this study.…”

Aortopulmonary collateral flow quantification by MR at rest and during continuous submaximal exercise in patients with total cavopulmonary connection

“…3,5,6 There are, however, no data comparing APC flow rates at rest and during physiological exercise by MR. We designed and built an exercise apparatus that allows submaximal exercise performance in the magnet, offering the option for calculation of APC flow during exercise 7 Therefore, the aim of this study was to quantify APC flow at rest and during continuous submaximal exercise in patients with TCPC. 3,5,6 There are, however, no data comparing APC flow rates at rest and during physiological exercise by MR. We designed and built an exercise apparatus that allows submaximal exercise performance in the magnet, offering the option for calculation of APC flow during exercise 7 Therefore, the aim of this study was to quantify APC flow at rest and during continuous submaximal exercise in patients with TCPC.…”

“…In recent years, magnetic resonance imaging (MRI) techniques have been used to reliably quantify APC flow during the resting condition. 3,5,6 There are, however, no data comparing APC flow rates at rest and during physiological exercise by MR. We designed and built an exercise apparatus that allows submaximal exercise performance in the magnet, offering the option for calculation of APC flow during exercise 7 Therefore, the aim of this study was to quantify APC flow at rest and during continuous submaximal exercise in patients with TCPC. For maximal homogeneity of the patient group, patients should have neither echocardiographic nor clinical signs of APC flow.…”