Four-Dimensional Flow in Fontan Patients: Advanced Haemodynamic Assessment

TL;DR

This paper reviews how 4D Flow MRI helps assess blood flow in Fontan patients, improving understanding of their complex heart condition.

Contribution

The paper provides a focused review on the application of 4D Flow MRI in Fontan physiology and its role in advanced hemodynamic assessment.

Findings

4D Flow MRI allows detailed 3D blood flow measurement in Fontan patients.

The technique enables assessment of advanced hemodynamic parameters relevant to Fontan physiology.

4D Flow MRI is used for image-based simulations to better understand Fontan pathophysiology.

Abstract

Staged palliation with the creation of a Fontan circulation is the standard surgical approach in patients with a single ventricle. The Fontan circulation is a complex circuit that is associated with various complications that may present early or later in life and can limit life quality and expectancy. In this context, a good understanding of the Fontan physiology is important to improve outcomes for single-ventricle patients. Cardiovascular magnetic resonance (CMR) is recommended for the long-term follow-up of Fontan patients, as it provides functional and haemodynamic information. Four-dimensional (4D) Flow MRI is a time-resolved, three-dimensional, velocity-encoded cardiovascular magnetic resonance technique that is increasingly used in Fontan patients because it not only enables measuring blood flow within a three-dimensional (3D) volume, but also allows for assessing more advanced haemodynamic parameters that may help in understanding the Fontan physiology and pathophysiology. Furthermore, 4D Flow is used for image-based simulations using computational fluid dynamics. In this review, we provide an overview of the use of cardiovascular magnetic resonance flow assessment, with a focus on four-dimensional flow (‘4D Flow’).

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