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Magnetic resonance imaging-guided surgical design: can we optimise the Fontan operation?

Published online by Cambridge University Press:  09 January 2014

Christopher M. Haggerty
Affiliation:
The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology & Emory University, Atlanta, United States of America
Ajit P. Yoganathan
Affiliation:
The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology & Emory University, Atlanta, United States of America
Mark A. Fogel*
Affiliation:
Department of Pediatrics, Division of Cardiology, The Children's Hospital of Philadelphia, The University of Pennsylvania School of Medicine, Philadelphia, United States of America Department of Radiology, The Children's Hospital of Philadelphia, The University of Pennsylvania School of Medicine, Philadelphia, United States of America
*
Correspondence to: Dr Mark A. Fogel, MD, FACC, FAHA, FAAP, The Children's Hospital of Philadelphia, Division of Cardiology, 34th St. and Civic Center Blvd., Philadelphia, PA 19104, United States of America. Tel: +215 590 7566; Fax: +215 590 5825; E-mail: fogel@email.chop.edu

Abstract

The Fontan procedure, although an imperfect solution for children born with a single functional ventricle, is the only reconstruction at present short of transplantation. The haemodynamics associated with the total cavopulmonary connection, the modern approach to Fontan, are severely altered from the normal biventricular circulation and may contribute to the long-term complications that are frequently noted. Through recent technological advances, spear-headed by advances in medical imaging, it is now possible to virtually model these surgical procedures and evaluate the patient-specific haemodynamics as part of the pre-operative planning process. This is a novel paradigm with the potential to revolutionise the approach to Fontan surgery, help to optimise the haemodynamic results, and improve patient outcomes. This review provides a brief overview of these methods, presents preliminary results of their clinical usage, and offers insights into its potential future directions.

Type
Original Article
Copyright
Copyright © Cambridge University Press 2013 

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